Should I roll my baby back over if she rolls onto her stomach in her sleep?
- Written by Rosemary Horne, Associate Professor & Deputy Director, The Ritchie Centre, Monash University
The safest place for your baby to sleep is in their own cot in the same room as their parents or adult caregivers. Sound scientific evidence tells us babies should always be placed to sleep on their back, never on their side or stomach.
But what if your baby rolls on to her stomach in her sleep? Should you turn her back over? If she can roll back over by herself then there’s no need, but if she can’t then you should turn her on to her back.
Why is back sleeping so important?
Baby deaths attributed to sudden unexpected death in infancy (referring to all cases of sudden and unexpected death in infancy including sudden infant death syndrome and fatal sleeping accidents) have fallen by 80% since the introduction of safe sleeping campaigns in the 90s. It’s estimated 9,500 infant lives have been saved in Australia alone.
There’s now conclusive evidence from many countries that sleeping babies on their tummies (prone sleeping) significantly increases the risk of sudden unexpected death. Studies have also identified the side sleeping position as unstable, and many infants are found on their tummies after being placed to sleep on their side. Babies who have been born preterm are at increased risk of sudden death.
The position we sleep in dictates how easily and how often we’ll be woken up during sleep. Arousal from sleep is a physiological protective mechanism that is widely believed to be deficient in infants who succumb to sudden and unexpected death.
Read more: What causes SIDS? What we know, don’t know and suspect
When we fall asleep, blood pressure, heart rate and breathing slow, and there can be pauses in breathing (apnoeas). Brief arousals from sleep increase blood pressure, heart rate and breathing rate.
Studies in babies have shown placing a baby on their tummy not only makes them much more difficult to rouse from sleep, but also lowers blood pressure and the amount of oxygen available to the brain. Parents sometimes place their baby on their stomach as they “sleep better this way”. This is because they don’t wake up as frequently in this position.
from www.shutterstock.comSome parents are concerned sleeping their baby on their back will increase the risk of choking. But careful study of the baby airway has shown babies placed to sleep on their backs are less likely to choke on vomit than when on their stomach.
When on the back, the upper respiratory airway is above the oesophagus (digestive tract). So regurgitated milk ascending the oesophagus is readily swallowed again and doesn’t go down the respiratory tract. When the baby is placed on the tummy the oesophagus sits above the baby’s upper airway. If the baby regurgitates or vomits milk, it’s relatively easy for the milk or fluid to be inhaled into the airway and lungs.
Authors: Rosemary Horne, Associate Professor & Deputy Director, The Ritchie Centre, Monash University