Why babies should sleep on their back and how to train them to do so

How a baby sleeps matters. You should always put your baby on their back to sleep and not on their stomach or side. 

Training babies to sleep on their backs (called supine position) is one of the most loving and precautionary measures parents can take.

The benefits of sleeping on the back
Putting your baby to sleep on their back is the safest position for an infant to sleep because it reduces the risk of sudden infant death syndrome (SIDS). SIDS is the sudden and unexplained death of a baby in the first year of life. In many developed countries, SIDS is responsible for more infant deaths than any other cause.

Apart from reducing the risk of SIDS, babies who sleep on their backs have other advantages. One study found that infants who sleep on their backs were less likely to develop ear infections, stuffy noses, and fevers.

Why sleeping on the stomach increases the risk of SIDS
The exact mechanism by which stomach sleeping might lead to SIDS is not known, but studies have shown that stomach sleeping increases the risk of SIDS. The following mechanisms have been suggested:

• Sleeping on the stomach increases the probability that the baby re-breathes their own exhaled breath, leading to carbon dioxide buildup and low oxygen level
• It interferes with body heat dissipation, which can lead to overheating
• It can cause upper airway obstruction

Furthermore, according to studies, compared with infants who sleep on their backs, infants who sleep on their stomachs:

• Are less reactive to noise
• Experience sudden decreases in blood pressure and heart rate control
• Experience less movement, higher arousal thresholds, and longer periods of deep sleep

Training your baby to sleep on the back
The best way to make sure your baby sleeps on their back is to do that from the first day and to keep putting them to sleep on their back whenever they are sleeping, whether during the day or at night. It is very important to keep this routine for your baby.

Some parents do have concerns that their babies might choke on their vomit. However, no research has shown this to be true.

General sleep precautions
Even when you are sure your baby is lying on their back when sleeping, it is essential to also avoid putting them on soft surfaces, such as pillows, quilts, comforters, sheepskins, or bean bags, which may block their airways. A firm crib mattress covered by a sheet is the safest bedding.

Where Tummy Time comes in
While sleeping on the back is important, you should also allow your baby to spend some time on their stomach when they are awake and being observed. This is known as Tummy Time, and it promotes the development of their shoulder and neck muscles and facilitates their head control. It also prevents the development of flat spots on the back of their heads.