Are you concerned about your newborn sleeping on their side? They may prefer falling asleep in this position for one reason or another. Then again, some infants love sleeping on their back, or stomach.
With that said, the American Academy of Pediatrics notes that both side sleeping and stomach sleeping is a SIDS risk factor for babies under one year of age.
What is Side Sleeping?
Scroll through any baby magazine, and you’ll see tons of sweet newborn babies sleeping on their side in each photo. These images are adorable, even though the sleeping position is not advised.
Baby side sleeping is when a parent places a baby entirely on their side (right or left) for a nap or nighttime rest. When a newborn baby sleeps on its side, it becomes much easier for them to roll on to their stomach. As infants this age haven’t developed the skill or muscle strength to roll back over on their back, they increase their chances of suffocation. Plus, it raises risks around “rebreathing” air already expelled, which can decrease your child’s oxygen levels and raise their carbon dioxide intake.
Is Side Sleeping Safe for My Baby? What Are the Risks?
It is highly recommended that infants under 12 months always be placed on their backs when a parent is putting them down for a nap or at bedtime. Below are some additional risks linked to baby side sleeping.
Every new parent’s worst nightmare can be summed up into four words: sudden infant death syndrome (SIDS). It occurs when an otherwise healthy baby passes away suddenly in their sleep with the condition being the leading cause of death for young children between the ages of one month and a year. It’s important to note, the risk is at its highest for babies between the age of two and four months, but can occur any time up until 12 months.
A newborn baby sleeping on its side isn’t the only risk factor for SIDS. Others include:
- Babies placed to sleep on their stomach
- Exposure to secondhand smoke, or a mom that smokes while pregnant
- Premature birth
- Bottle-fed babies have an increased risk of SIDS, versus breastfed babies
- Babies that co-sleep in their parent’s beds
- Infants that sleep on a sofa, couch, or car seat
- Babies that sleep with toys or blankets in the crib
- Babies with parents that misuse drugs or alcohol
Have you ever woken up in the morning with a neck sprain from sleeping in a weird position? That’s the best way torticollis can be described, and your newborn is quite susceptible to the condition. Overall, it occurs right at birth and can be caused by your baby’s position in the womb. It can also develop up to three months after.
Torticollis can be hard to diagnose, so if you see the below signs in your baby, it’s time to address this with their pediatrician. The disorder can be treated with some simple at-home neck-strengthening exercises.
Some symptoms of torticollis, include:
- Head tilts in one direction
- Baby prefers breastfeeding on one side
- Moving their eyes, rather than their head to follow you
- They may be unable to turn their head completely
Harlequin Color Change
Harlequin color change is a temporary and harmless condition that causes half of an infant’s body and face to turn red or pink. The color change lasts about two minutes, going away on its own. This occurs due to blood pooling in the smaller blood vessels that your little one is laying on. Most babies eventually outgrow the condition.
When Is Side-Sleeping Safe for Your Baby?
Actually, it’s never safe to allow a newborn baby to sleep on their side, unsupervised. Still, it may be the only way they can settle down to get some shut-eye. If you are able to supervise your baby throughout their nap and be by their side the entire time they sleep, then you can place them on their side. However, you don’t necessarily want to encourage them to sleep like this, as you will not be able to “supervise” every sleep they have.
Another idea is to place your newborn baby sleeping on its side and supervise them as they fall into a deep sleep in that position. After they are down, nudge them onto their backs (without waking them up) before leaving their sleep area.
Below is an outline of side sleeping, and the risks according to your baby’s age.
Under 4 Months
Under no circumstances should a newborn baby sleep on its side at this age as they are unable to move their bodies and necks if they roll on their stomach.
4 to 6 Months
After four months, babies gain better motor skills and get stronger. They can lift their head and roll themselves over, and the risk of anything harmful happening during sleep decreases. At this time, if you find them sleeping on their side, it’s okay to leave them in that position. However, they still should be placed on their back before going to sleep.
7 to 12 Months
During these months, your baby will become more active. They’ll be rolling, crawling, sitting up, standing up, and maybe even walking. When you lay your baby down for a nap or to sleep at night, they may likely start tossing and turning from the get-go. It’s okay to leave them in any sleep position that you find them in.
How to Prevent Side-Sleeping in the First 12 Months
As much as parents try, there are some babies that will prefer sleeping on their side. But there are still ways moms and dads can promote back-sleeping. Below we run through a handful of tips & suggestions:
Consistency - Let Them Reach Deep Sleep
Consistently placing your baby on its back to sleep will help. Nursing, feeding, and rocking your newborn until they fall into a deep sleep and then placing them on their back is a great strategy to start with. How do you know your baby is in ‘deep sleep’? They likely won’t make any noise and movement will be minimal. It’s the perfect time to lay them down on their back in their crib and quietly walk away.
Swaddling your newborn helps encourage back sleep. Just ensure the swaddle isn’t too tight that they can’t move their hips. In addition, know when to stop swaddling, as it can become a risk once your little one gets older and can roll. When this happens, try transitioning them into a sleep slack. Their arms will be free, which allows them to roll should they need to. Plus, sleep sacks keep babies cozy and warm all night long.
A FIRM Mattress
Whether they sleep in a crib, playpen, or bassinet, a firm mattress is needed. What constitutes a ‘firm’ mattress? No imprint is left when the baby is off of it. Softer mattresses allow your newborn to ‘sink’ into them, which makes it easier to roll to the side.
Tips for Improving Sleep Safety
Back sleep, a firm mattress, and swaddling are not only ways to ensure your little one doesn’t sleep on their side, but they are also things parents can do to ensure safe sleeping. Below are some additional tips.
The Sleeping Area
Your baby’s crib should have a fitted sheet that is tight around the mattress, so it won’t loosen during the night. Also, no bumper pads, stuffed toys, or bulky blankets, which increase risk of suffocation.
In addition, your baby should sleep in a crib, bassinet, or playpen. Anything with a flat surface. Many parents are tempted to allow their little ones to sleep in a swing, car seat, or bouncy chair for naps and sometimes bedtime. At the end of the day, these other options can place stress on their neck.
Prop Them Up
Some parents believe that a baby positioner or pillow that “props” your infant up will keep them on their backs during the night, but this is a myth. Both the Food and Drug Administration and the Consumer Product Safety Commission advise against these, as they do pose suffocation risks.
However, if you want to prop your baby up slightly, a thin pillow can be placed under the crib sheet on the mattress.
Baby monitors help give parents a sense of security, especially ones that have video features. You can see and hear what your baby is doing while they are sleeping and react quickly if they need you.
In this day and age, there are some incredible video monitors, with motion detectors that notify parents if there’s unusual activity in the room. One interesting one is the Miku Pro, which not only provides information on the motion, sound, temperature, and humidity in the room but also your baby’s breathing patterns. There are plenty of product options out there to suit each family’s needs.
Lastly, many parents love to co-sleep, and this can be done in a safe sleep environment. As mentioned above, infants should sleep on a flat and firm surface, without loose items around. This means no pillows, blankets, or excess in the adult bed if parents are planning to co-sleep. Headboard railings should be examined and potentially taken off during this time period, as they can pose a risk to your baby’s health if the child slips between them during sleep. There are benefits to bed-sharing; however, there are so many risks, especially when a parent is sleep deprived.
An alternative to having your baby close, without being in the same bed, is moving their crib/bassinet/playpen to your room, temporarily. That way, your little one is near for those nightly feedings, but safely in their own bed.
So there you have it, the risks far outweigh any benefits of babies sleeping on their sides. This should be avoided at all costs when the baby is young.
As the baby gets older and more mobile, they will naturally move around more leading to them sleeping on their sides. We’ve provided a few tips and tricks above, including the use of sleep sacks to help avoid this.
If you ever have any concerns or questions, always consult with your baby's pediatrician.