Babies should sleep on their backs. Research has found a link between sudden infant death syndrome (SIDS) and babies who sleep on their stomachs (in the prone position). It is reported that the risk of SIDS from prone sleeping is from 1.7 to nearly 13 times higher. Experts now agree that putting a baby to sleep on his or her back is the safest position.
Other reports have found soft surfaces, loose bedding, and overheating with too many blankets also increase the risk for SIDS. Smoking by the mother is also a major risk for SIDS, as are poor prenatal care and prematurity. Since the American Academy of Pediatrics (AAP) made the "back-to-sleep" recommendation in 1992, the SIDS rate has dropped more than 40 percent. Back sleeping also appears to be safer for other reasons. There is no evidence that babies are more likely to vomit or spit up while sleeping on their back. In fact, choking may be more likely when infants are on their stomach. A task force of the US Consumer Product Safety Commission (CPSC), the American Academy of Pediatrics (AAP) and the National Institute of Child Health and Human Development (NICHD) offer the following recommendations for infant bedding:
- Place your baby on his or her back on a firm, tight-fitting mattress in a crib that meets current safety standards.
- Remove pillows, quilts, comforters, sheepskins, stuffed toys, and other soft products from the crib.
- Use a sleeper as an alternative to blankets with no other covering.
- Make sure your baby's head remains uncovered during sleep.
- Do not place your baby on a waterbed, sofa, soft mattress, pillow, or other soft surface to sleep.
- Parents should consider placing the infant's crib near their bed for more convenient breastfeeding and parent contact.
- If a mother chooses to have her infant in her bed to breastfeed, the baby must be returned to the crib or basinet to sleep. A baby should never sleep in an adult bed, on a couch, or on a chair alone, with a parent, or with anyone else.
- While babies should never share a bed, room sharing is encouraged. Keeping the baby’s sleep area in the same room where the parents sleep reduces the risk of SIDS.
To prevent overheating, the report recommends that the infant should be lightly clothed for sleep and the room temperature kept comfortable for a lightly clothed adult. Avoid over bundling and check the baby's skin to make sure it is not hot to the touch.
While babies should sleep on their backs, other positions can be used during the time babies are awake. Babies can be placed on their stomachs while awake to help develop muscles and eyes and to help prevent flattened areas on the back of the head.