Back is Best, but When Can It End?

​"Back is best" is drilled into the heads of new parents.
The phrase gets stitched into sleep sacks, posted on materials from the pediatrician, and repeated over and over by hospital staff before going home from the hospital. 

This is confusing because up until only a few years ago,  the wisdom handed down was to make babies tummy sleepers to help with spit up and choking.  

The shift to "Back is Best" is because of SIDS- Sudden Infant Death Syndrome. 

Until 1992, the recommendation had been for babies to sleep on their stomachs until the Association of American Pediatrics updated their guidelines. Before then, up to 70% of babies were sleeping on their bellies in the first year, which then plummeted to 11.3 percent by 2002. 

That shift also led to a decrease in infant deaths from SIDS by half, to .057 per 1,000 live births in 2002, from 1.2 in 1992. 

So the recommendation has merit and stats to back it up. 


AND...


For some babies, it is pure bliss once they get old enough to roll over, because for them it was holding them back from sleeping soundly. 

For parents who are trying to help their children sleep well and safely, there is a process of mitigating risks and evaluating everyday reality. Are they ready yet?  So ask:

• Is your baby starting to roll over? 
• Can they raise their head?
• Can they bring their hands to their mouth and move their face from side to side? 

Those are all actions that can help parents feel better about their choice to not interrupt their baby sleeping soundly on their stomachs.

We are proponents of the Safe Sleep movement and follow AAP guidelines. We also know that the choice to put your baby to sleep on their stomach is one riddled with uncertainty.    When is it okay to leave them be? 



When can you leave your baby on his or her back to sleep?

• Your baby is at an elevated risk of SIDS especially in the first 4-months, until the 1st birthday.  
• There is an increased risk of SIDS for babies who are only used to sleeping on their backs and are then placed on their tummies to sleep. 
• Most babies will learn to roll over between 4-6 months, with some starting as early as 3-months.  
• 0-4 months - ALWAYS place your baby to sleep on his or her back 
• 5-12 months - Once they learn to roll over on their own, you can leave them to sleep in that position
• Twelve months + Your child will have the strength and ability to sleep how he or she wants!

Just as bed-sharing is a "dirty secret" of sleep-deprived parents, we often come into client's homes and hear stories of how they are just trying to survive and have been using unsafe sleep tools to eek out some rest.  Bed-sharing can happen safely, and helping your child to sleep can happen in their own space too.  

Some of the common unsafe things we see are:

• Using pillows and support cushions as sleeping spaces
• Having comfort items in the bed with baby
• Unsafe swaddling methods
• Decorative objects, toys, or sleep devices are resting inside, or on the bed.
• Angled sleep surfaces 

We never want a family to make choices for their baby because they feel they have no other options.  If you are starting to feel like the only place your baby will sleep is on you, or their stomach, we want to help.  We come to your home with compassion and skills, information, and tools.  

If it's nap help, or night-time help, let us know when you'd like more rest and we'll be right over!