Newborn Sleep: Best Sleeping Position for Newborn is Back Position and Newborn Side Sleeping is the Worst

Infant Sleep Position: Sleeping on the Back is the BEST and Sleeping on the Side is the Worst!!!

Since 1992, the American Academy of Pediatrics (AAP) has recommended that all babies should be placed on their backs to sleep to decrease the number of deaths from Sudden Infant Death Syndrome (SIDS). Even though the SIDS rate has declined significantly since this recommendation, we have synthesized various study results to provide a holistic view of the pros and cons of back compared to front and side sleeping positions regarding issues of children's safety, health, sleeping quality, and motor skills. Such holistic views can provide readers with better understanding and can clarify misconceptions, but you should seek a doctors' assessment or intervention if necessary. Based on the results of 13 studies, there are pros and cons to sleeping on the back.


3 Proven Benefits of Back Sleep Position for Infants.

(1) Compared to sleeping on the front, sleeping on the back can significantly reduce the SIDS rate. In the United States, the prevalence of babies sleeping on their front decreased from about 70% in 1992 to about 24% among infants younger than 8 months in 1996, and the SIDS rate declined by 38%.

(2) Regarding the relative risk for SIDS, sleeping on the side has double the risk of sleeping on the back. 

(3) In addition, for premature babies, sleeping on the back reduces the risk of apnea (suspension of external breathing), as they may have more central apneas when lying on their tummy.

(4) Babies who sleep on their back also have fewer health-related problems such as coughing and pyrexia.


Some Disadvantages of Back Sleep Position for Infants.

However, there are some disadvantages to sleeping on the back. For example,

(1) babies that sleep on their front roll over earlier than those that sleep on their side and back, and the general motor skills of babies that sleep on their backs are delayed by an average of 6 months. However, another study found that these delays in motor development disappeared later in life, with all of them achieving motor skill milestones in acceptable age ranges. It is also suggested that play activities which involve the baby lying on the tummy under adult supervision can also help develop infants' motor skills.

(2) Babies sleeping on their front have better sleeping quality, sleep for longer (by 6%), and wake up less often.

(3) One problem with sleeping on the back is that it increases the chance of cranial deformity, cranial asymmetry, and cranial flattening. Even though localized lateral or occipital cranial flattening at birth is a precursor, sleeping on the back can contribute to worsening of the condition after birth. In such a case, it is suggested that parents see the doctor for assessment and intervention during the 1st year of birth (the earlier the better).

Created on November 21 2015 at 08: 00 AM

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Details of Scientific Answers: Click on each bullet to Read References


1: "Factors Associated With The Transition To Nonprone Sleep Positions Of Infants In The United States: The National Infant Sleep Position Study," JAMA, 1998, by M Willinger, HJ Hoffman, KT Wu, JR Hou. (Citations: 243).

Objective.To determine the typical sleep position of infants younger than 8 months in the United States, the changes that occurred after these recommendations, and the factors associated with the placement of infants prone or supine.

2: "Combined Effects Of Sleeping Position And Prenatal Risk Factors In Sudden Infant Death Syndrome: The Nordic Epidemiological Sids Study," Pediatrics, 1997, by N yen, T Markestad, LM Irgens, K Helweg-Larsen. (Citations: 235).

Objective. Prone sleeping is a strong risk factor for sudden infant death syndrome (SIDS). We investigated whether the combined effect of prone sleeping position and prenatal risk factors further increased the SIDS risk. Methods. In the Nordic Epidemiological SIDS Study ...

3: "Side Sleeping Position And Bed Sharing In The Sudden Infant Death Syndrome," Annals Of Medicine, 1998, by RKR Scragg, EA Mitchell. (Citations: 105).

In the last decade there have been major reductions in the sudden infant death syndrome (SIDS) rate following prevention programmes in Australasia, Europe and North America, mainly due to changing infants from the prone sleeping position onto their sides or backs. ...


1: "Effects Of Sleep Position On Infant Motor Development," Pediatrics, 1998, by BE Davis, RY Moon, HC Sachs, MC Ottolini. (Citations: 189).

Background. As a result of the American Academy of Pediatrics' recommendation that healthy infants be placed on their side or back for sleep, the percentage of infants sleeping prone has decreased dramatically. With the increase in supine sleeping, pediatricians have questioned if there are differences in the rate of acquisition of early motor milestones between prone and supine sleeping infants. Methods. To examine this question, we performed a prospective, practice-based study of healthy term infants. Infants were recruited before the age of 2 months. Parents were asked to record infant sleep position and awake time spent prone until 6 months of age. A developmental log was used to track milestones from birth until the infant was walking. Age of acquisition of eight motor milestones was determined, and the mean ages of milestone attainment of prone and supine sleepers were compared. Results. Three hundred fifty-one infants completed the study. Prone sleepers acquired motor milestones at an earlier age than supine sleepers. There was a significant difference in the age of attainment of rolling prone to supine, tripod sitting, creeping, crawling, and pulling to stand. There was no significant difference in age when infants walked. Conclusions. The pattern of early motor development is affected by sleep position. Prone sleepers attain several motor milestones earlier than supine sleepers. However, all infants achieved all milestones within the accepted normal age range. Pediatricians can use this information to reassure parents. This difference in milestone attainment is not a reason to abandon the American Academy of Pediatrics' sleep position recommendations.

2: "Influence Of Supine Sleep Positioning On Early Motor Milestone Acquisition," Developmental Medicine & Child, 2005, by A Majnemer, RG Barr. (Citations: 96).

Abstract This study aimed to determine whether supine sleep-positioned infants have delayed motor skills at age 4 and 6 months, and if delays are associated with decreased exposure to prone position. One 4 and one 6-month-old sample of healthy infants born at ...

3: "A Motor Milestone Change Noted With A Change In Sleep Position," Archives Of Pediatrics, 1997, by JW Jantz, CD Blosser. (Citations: 79).

Research from JAMA Pediatrics A Motor Milestone ChangeNoted With a Change in Sleep Position.

4: "Annotated Bibliography: Effects Of Sleep Position And Play Position On Motor Development In Early Infancy," Physical & occupational therapy in pediatrics, 2005, by PJM Liao, L Zawacki. (Citations: 16).

The prevalence of prone sleeping has decreased dramatically since the American Academy of Pediatrics (AAP) published sleep position guidelines and launched the Back to Sleep Campaign in 1992. One aspect of the guidelines, which suggests placing infants in the ...


1: "Prone Or Supine Body Position And Sleep Characteristics In Infants," Pediatrics, 1993, by A Kahn, J Groswasser, M Sottiaux, E Rebuffat. (Citations: 123).

Page 1. Prone or Supine Body Position and Sleep Characteristics in Infants 1112 PEDIATRICSVol. 91 No. 6 June 1993 A. Kahn, PhD*; J. Groswasser*; M. Sottiaux*; E. Rebuffat*; P. Franco;and M. Dramaix, PhD ABSTRACT. Objective. To evaluate the potential rela- ...


1: "Does The Supine Sleeping Position Have Any Adverse Effects On The Child?: I. Health In The First Six Months," Pediatrics, 1997, by L Hunt, P Fleming, J Golding. (Citations: 55).

Objective. To assess whether the recommendations that infants sleep supine could have adverse health consequences. Design. A prospective study of infants, delivered before, during, and after the Back to Sleep Campaign in the United Kingdom (UK), followed to 6 ...


1: "Effect Of Prone And Supine Position On Sleep, Apneas, And Arousal In Preterm Infants," Pediatrics, 2006, by RY Bhat, S Hannam, R Pressler, GF Rafferty. (Citations: 78).

OBJECTIVE. Prematurely born compared with term born infants are at increased risk of sudden infant death syndrome, particularly if slept prone. The purpose of this work was to test the hypothesis that preterm infants with or without bronchopulmonary dysplasia being ...


1: "An Increase In Infant Cranial Deformity With Supine Sleeping Position.," Journal Of Craniofacial, 1996, by LC Argenta, LR David, JA Wilson. (Citations: 249).

Medical Center Blvd, Winston-Salem, NC 27157-1075. most deformities can be corrected without surgery. In cases where progression of the cranial deformity occurs, despite conservative therapy, surgical intervention should be undertaken at approximately 1 year ...

2: "Prevention And Management Of Positional Skull Deformities In Infants," Pediatrics, 2003, by J Persing, H James, J Swanson, J Kattwinkel. (Citations: 183).

Abstract Cranial asymmetry may be present at birth or may develop during the first few months of life. Over the past several years, pediatricians have seen an increase in the number of children with cranial asymmetry, particularly unilateral flattening of the occiput. ...

3: "Incidence Of Cranial Asymmetry In Healthy Newborns," Pediatrics, 2002, by WK Peitsch, CH Keefer, RA LaBrie, JB Mulliken. (Citations: 182).

Objective. During recent years, coincident with the recommendation to position infants supine, the incidence of posterior deformational plagiocephaly has increased dramatically. The purpose of our study was to determine whether early signs of cranial flattening could ...

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Newborn Sleep: Best Sleeping Position for Newborn is Back Position and Newborn Side Sleeping is the Worst

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