Back or belly to sleep?
BABIES don’t come with user manuals, but parents should be able to rely on advice from family, friends and doctors about how to navigate the parenting journey. But what happens when there is conflicting advice, for example on the matter how how babies should sleep?
In the United States, for example, the ‘put me on my back to sleep’ method has been pushed by hospitals in order to reduce the incidence of conditions like Sudden Infant Death Syndrome (SIDS); while some Jamaican midwives seem more keen on the belly sleeping position.
WHAT IS ACTUALLY BEST?
Dr Anona Griffith, paediatrician at Gateway Plaza in Old Harbour, says the back is the most suitable position for the baby.
“The recommended sleeping position for a healthy infant is on the back as issued by the American Academy of Pediatrics (AAP) Task Force on Infant Position and SIDS recommendations published in 1992 and confirmed in 1994, 2000 and 2005,” Dr Griffith said.
She explained that the position in which a baby sleeps goes beyond just the position in which they achieve the deepest sleep.
SIDS is a term used to describe when an infant dies suddenly while they are asleep and the infant’s death remains unexplained even after investigation and autopsy. SIDS has been directly associated with incorrect sleeping positions – the main one being sleeping on the stomach,” Dr Griffith explained
Citing statistics produced in an Australian campaign to reduce incidences of SIDS, Dr Griffith said that there was a decline of 83 per cent in the number of deaths associated with SIDS over a 20-year period spanning 1985 to 2005 while the United States has seen a 50 per cent decline.
She pointed out that issues with choking is another reason that sleeping on the stomach is not recommended.
“The body is programmed to protect the airway at all times and so babies will automatically swallow or cough up whatever they throw up while on the back. On the other hand, in the stomach sleeping position, anything regurgitated or refluxed (puke) from the stomach can collect at the opening of the trachea or windpipe making it easier for that fluid to be aspirated or go into the lungs and cause choking,” Dr Griffith explained.
She said many parents and caregivers also use the side sleep position as an alternative; however, this position is unstable and increases the possibility of the child rolling onto his/her stomach which could cause SIDS and choking. She said there is an increased risk of SIDS when an infant who is accustomed to sleeping on his back is placed on the stomach or side.
Dr Griffith said that while the back has been proven to be the safest position in which a baby can sleep, there are some exceptions to the rule including special medical conditions involving airway abnormalities that could require that infants be placed in specific sleeping positions to improve oxygenation.
She also recommended other sleeping guidelines for babies in accordance with the AAP Task Force. These include:
1. The sleep surface should be firm. Use an appropriate mattress with a fitted sheet. Sleeping surfaces should not include pillows, quilts or other soft surfaces.
2. Sleep area should not be cluttered with toys, soft objects and loose bedding. The area around the infant’s face should remain clear.
3. The infant’s sleep area should be separate from but close to that of others. After feeding, the infant should be placed in a separate area to sleep and not between other individuals.
4. Smoking must not be allowed around the baby.
5. The baby should be dressed in light sleep clothing and kept in a comfortable room temperature.
