Bleary-eyed parents will do just about anything to get their little one to sleep—especially if it works! The truth is, many babies prefer sleeping on their tummies, and if it means getting more zzz’s, what’s the big deal?
According to the American Academy of Pediatrics (AAP), it is a big deal! Since 1994, parents have been told that “back-to-sleep” is the best way to keep infants safe. But what happens if your little one rolls over during the night? And when can babies sleep on their stomach?
Let’s explore the research behind these guidelines and get some answers to your other burning questions when it comes to keeping your baby safe while sleeping.
When Can Babies Sleep on Their Stomachs?
Your baby shouldn’t sleep on their stomach during the first 12 months. During the first year, stomach sleeping has been associated with an increased risk of sudden infant death syndrome (SIDS), suffocation, low oxygen/increased carbon dioxide from poor airflow, and/or overheating.
For this reason, you should always put your baby to sleep on their back since it’s the safest sleeping position until they’re 4 months old and can roll on their side or back.
However, it’s safe to let your baby sleep on their stomach if they roll over, but only if they’re around four to six months old. This is when the baby can safely roll back over on their own, so it’s unlikely they’ll stay sleeping on their stomach for too long.
Is Putting Newborns and Babies to Sleep Face Down Okay?
Sleeping face down was encouraged for many years until doctors noticed an increase in unexplained infant deaths. In 1994, the “Back-to-Sleep” campaign was launched, and the cases of SIDS were cut in half by 2010. Now, back sleeping is one of the top safety recommendations new parents are given.
The risk of SIDS is highest during the first year of life, but particularly during the first six months. From the time you bring your newborn home, it’s advised that you always place him on his back for naps and at bedtime. Research has also discovered other benefits to this position, including fewer fevers, stuffy noses, and ear infections.
What If Your Baby Rolls Onto Their Stomach While Sleeping?
You should always put your baby to sleep on their back, but it’s okay to let the child sleep in any position they choose after you do so. Stomach sleeping is fine only if the baby can roll from back to stomach and from the stomach to back on their own. If babies can change positions on their own, you should let them do so.
However, this is where you should look for clues. You should reposition the baby if they can only roll one way. Most babies can change positions at about four to six months old, so pay a bit more attention to see if they roll on their own or need your help.
How Long Should I Put an Infant on His Back?
The current guidelines recommend that babies be placed “back-to-sleep” for the first year. Once they start rolling over, they may end up on their tummies. As long as they’re able to roll from front to back and back to front efficiently, this shouldn’t be a problem.
Your child is ready to sleep on their tummy once they can hold their head up. Stomach sleeping poses a suffocation risk, so you want the child to be able to move their head if they can’t breathe.
Your baby rolling over both ways indicates they’re ready to sleep on their stomach. This allows the child to move from an uncomfortable position into a more comfortable one, whether on their side, stomach, or back. You can practice this by allowing the baby to spend time on their stomach during the day as it straightens the muscles in the neck and back.
You should always put your baby to sleep on their back until their first birthday. However, if your little one rolls over both ways before turning one, it’s safe to let them sleep however they want because they can probably move from an uncomfortable position at this point.
What Are Further Safety Precautions?
The sleep safety guidelines for infants by the American Academy of Pediatrics were updated in 2016 and include:
- A firm sleeping surface, such as a crib, bassinet, portable crib, or play yard
- No soft materials or objects, including blankets, bedding, bumper pads, pillows, or toys
- Room sharing ideally for the first year but at least for the first six months
- Breastfeeding and the use of a pacifier
- Avoid overheating (a light sleep sack may be used for warmth)
- Discontinue swaddling once infants start rolling
Does the Risk of SIDS Decrease After a Few Months or a Year?
The risk of SIDS is highest in the first six months and gradually decreases after this point. By baby’s first birthday, the risk is substantially lower. That being said, experts recommend continuing to put your little one on her back throughout her entire first year.
Being able to roll over both ways is usually the first sign that your little one is on its way to having the skills to snooze in a variety of positions. Research has found that babies without this skill don’t know to lift and turn their heads when they’re lying face down. Even babies that can lift their heads during tummy time may not be able to safely do so during sleep.
More research is needed to fully understand how SIDS risk decreases over the first year, but for now, we know that following the AAP guidelines (including “back-to-sleep”) is best.
What if a Baby Prefers to Sleep on Their Stomach?
Many babies prefer sleeping on their tummies. For some reason, sleeping with those tiny tushies in the air is comforting for infants (and adorable to us). If your little one is already fighting sleep, stomach sleeping may seem like the easiest solution. Unfortunately, it isn’t the safest.
The best solution is to work on helping your child learn to sleep using safe practices like swaddling, white noise, rocking, sucking, and implementing a pre-bed routine. If your baby has become accustomed to sleeping face down and you’re trying to implement a change, you may see a temporary regression in sleep. Just be patient, and know that your infant will soon adjust.
If babies roll onto their stomach during sleep, you can gently roll them onto their back. Once they’re consistently rolling in both directions, continue to place them on their back, but if they roll onto their tummy during sleep, you can let them stay in that position without having to worry about rolling them over.
After their first birthday, you can feel free to let your little one fall asleep in any way that they choose.
How Can I Further Improve My Child's Safety?
In addition to placing your infant on its back to sleep, it’s important to follow the AAP’s other safety guidelines. These include room sharing, using a pacifier, having a firm surface (like a crib, bassinet, or play yard), and nothing in the bed except for a fitted sheet. If you decide to swaddle or use a sleep sack, make sure that you watch for signs of overheating.
Related: Best Crib Mattresses
When Should I Call the Doctor?
When you’re exhausted, it may be tempting to bring your infant to bed with you or fall asleep holding them on the sofa or in a chair. Unfortunately, all of these scenarios greatly increase the risk of SIDS. If nobody in your household is sleeping, it may be time to ask for help.
Lactation consultants, infant sleep specialists, and doctors are all available to help. They should be able to offer some tools and advice to get everyone the rest they need.
There are a few exceptions when doctors may recommend placing babies on their tummies for sleep. In these situations, doctors should also provide some guidelines on how to go about this in the safest way.
Quick Facts
Is side sleeping okay for a baby?
Unfortunately not. Babies who are sleeping on their sides can easily flip onto their stomachs, facing the same increased risk of SIDS. Until they turn one, all babies should be placed on their backs for sleep.
What about reflux and GERD?
People used to think that babies lying face up would choke if they spit up, but that myth has been disproven. In fact, babies naturally cough up or swallow fluids and tend to do so better when sleeping on their backs.
Will my baby develop a flat spot?
Flat spots on the head can happen when infants lay in the same position for too long. While these are harmless and typically resolve on their own, there are some ways to prevent them. Try limiting time in car seats and swings, encourage plenty of tummy time, and change the direction you lay your little one in the crib from week to week.
Is tummy time safe?
Yes, tummy time is both safe and encouraged. Giving your baby plenty of tummy time while awake is one of the best ways to promote healthy growth and development. Some babies may fuss at first, so start with a few minutes at a time spread throughout the day and gradually increase.
Conclusion
New parents are often bombarded with advice from well-meaning family and friends. But when it comes to your baby’s safety, it’s best to trust the experts. The AAP recommends putting babies “back-to-sleep” until their first birthday.
Once your tiny tot starts rolling, it may end up on the tummy, and that’s okay! By the time babies are blowing out that first candle, they can sleep in any position they choose—even bottoms up! Following this advice can be a challenge when you’re desperate for some rest at 3 AM, but in the end, your little one’s safety is worth it.
Sources and References:
- When Can Your Baby Sleep on Her Stomach? – whattoexpect.com
- Is It Okay for Babies to Sleep on Their Stomach? – thebump.com
More Reading:
Jill Zwarensteyn is the editor for Sleep Advisor and a certified sleep science coach. She is enthusiastic about providing helpful and engaging information on all things sleep and wellness.
Based in Los Angeles, she is an experienced writer and journalist who enjoys spending her free time at the beach, hiking, reading, or exploring new places around town.
She’s also an avid traveler who has a personal goal of being able to successfully sleep on an airplane someday.
