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Putting Back-Sleeping Concerns to Rest

We’re willing to bet that this isn’t the first time you’ve been introduced to the benefits of raising a back-sleeping baby. Most new parents today are well informed when it comes to SIDS and why back sleeping is so strongly recommended. We’d be missing the boat, however, if we didn’t acknowledge the fact that you may find yourself with some practical concerns when faced with putting principle into practice. For the most part, the following concerns cause parents to worry unnecessarily:

  • Spitting up and vomiting. The most common concern we hear is the understandable but unfounded fear that babies will spit up and choke while on their backs. Fortunately, several reassuring studies as well as the test of time have demonstrated that healthy babies put to sleep on their backs are not only able to turn their heads and/or protect their airways if and when they spit up, but are no more likely to have breathing or digestive-related problems than their belly-sleeping counterparts of years past.
  • Flat heads. It is true that the shape of your newborn’s head is not yet set in stone, and that there has been an increase in the number of babies “walking” around with flat heads since back sleeping came into vogue. The fact of the matter is that it’s really not that much of a problem for most back-sleeping babies. In large part, that’s because you have a good deal of control over the situation. All you need to do is alternate the direction your baby faces each time she lies on her back— both while she is asleep and also when awake. By offering your newborn plenty of tummy time and time spent in positions other than flat on her back while she is awake, you can also help decrease the likelihood of a flat or misshapen head.  
  • Delayed milestones. Some of you will undoubtedly hear or read that back sleeping has been associated with delayed motor development. In addressing the question of delayed milestones—or more specifically, a delay in the time when back-sleeping babies first begin to roll over—rest assured that this all seems to even out in the end. Even if your baby doesn’t take to rolling quite as early as her belly-sleeping counterparts of generations past and present, to our knowledge no college application has ever asked applicants how early they mastered the ability to roll over (or, for future reference, sit, crawl, walk, or toilet train). When it comes to strengthening the muscles your baby needs to roll and, at the same time, decreasing your baby’s chances of ending up with a flat head, just be aware that both can be easily accomplished by allowing your baby plenty of time on her belly when she’s awake.
Laura A. Jana, MD, FAAP and Jennifer Shu, MD, FAAP
Last Updated
Heading Home With Your Newborn, 2nd Edition (Copyright © 2010 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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