Parental Practice

Won't my baby choke on vomit during sleep if placed on its back?

Many parents place babies on their stomachs to sleep because they think it prevents them from choking on vomit during sleep. In countries where there has been a switch from babies sleeping predominantly on their stomachs to sleeping mainly on their backs there has not been any evidence of increased incidence of aspiration, pneumonia, choking, or other problems. In addition, a review of all the scientific literature found that there is no additional risk of choking on vomit when babies sleep on their backs. Experts actually feel that babies are at a higher risk for choking or aspirating when placed on their tummies than they are when placed on their back. 

Doesn't back sleeping cause flat heads?

There is some suggestion that the incidence of babies developing flat spots may have increased with back sleeping. This is almost always a benign condition, which will disappear within several months after the baby has begun to sit up. Flat spots can be avoided by altering the back sleeping head position, such as turning the head to one side for a week or so and then changing to the other. Parents should be sure to alternate arms when feeding and provide lots of supervised tummy-time while awake. Be sure that your baby does not spend too much time in a car seat and carriers to further minimize the potential for a flat head.

Should infants ever be placed on their tummies?

As much "tummy time" as possible while the infant is awake and being observed is recommended for motor development of the upper body muscles. In addition, tummy time may also help prevent flat spots from developing on the back of the baby's head. Never leave your baby unattended during tummy-time. If the baby tires or is sleepy, place them on their back in a safe sleep area.

What if my baby cries and cries and won't sleep in the back position?

Positional preference appears to be a learned behaviour among infants from birth to 4 to 6 months of age. If placed on their back from day one, most infants become accustomed to the back sleeping position.