Back to Sleep Safely - Supporting Your Reluctant Baby

The Importance of Safe Sleep for Babies

For several decades, health experts have recommended that parents place their babies on their backs when putting them to bed to reduce the risk of sudden infant death syndrome (SIDS). This simple guideline has had a significant impact in reducing SIDS deaths around the world since the early 1990s.

However, despite these recommendations, some babies may not feel comfortable sleeping on their backs. This leaves many parents wondering what to do if their little one won't settle in that position. Parents are understandably concerned that their baby's preference for sleeping on their tummy or side puts them at higher risk of SIDS, yet sleep deprivation can leave the entire family feeling stressed.

There are ways you can encourage your baby to feel safe on their back. Here are some things you can try:

Transition from the Womb

Newborns have an innate sense of safety and comfort from their days inside the womb. Being placed on their back, away from the warm, protective space they once knew, can trigger the Moro reflex - a natural response carried over from prehistoric times. In the past, infants who were separated from their mothers in this vulnerable position were at greater risk of falling prey to predators. Consequently, modern-day babies can feel abandoned and vulnerable when placed on their back, resulting in an involuntary startle response - their arms flinging out, heartbeats racing, and adrenaline surging.

We can help our infants transition to their new environment by offering plenty of snuggles and skin-to-skin contact. Daytime naps may be easiest when the baby is held in a baby carrier or cradled in our arms, avoiding the discomfort of being laid down alone. With time, we can gradually introduce the concept of sleeping on their back by first allowing them to do so while being held, or by lying next to us on the bed after breastfeeding. With our support and presence, the newborn can learn to sleep peacefully on their back, feeling safe and secure even without the protective embrace of the womb.

It is important to note that while babywearing is a safe and comforting way for your baby to sleep, it is not recommended to wear your child while you are sleeping. This practice becomes a safety hazard if you lie down on a bed, sofa, or armchair while wearing your baby. To ensure your little one's safety, it is crucial to remove the carrier and follow safe bed-sharing guidelines.

Take it slowly

Instead of immediately transferring your baby to their cot after they fall asleep during a feed, take advantage of the early REM sleep and enjoy a cuddle for approximately 20 minutes. This light sleep cycle can be easily disrupted, so wait until your baby transitions into deeper, quieter sleep before laying them down on their back. To further prevent any chances of waking, prepare for swaddling ahead of time by laying out the wrap on their bed. Carefully wrap your sleeping baby and leave them in a comfortable position for a peaceful rest.

Chest to Chest Sleep
Watching other primates, such as gorillas, chimpanzees, and orangutans, reveals a common thread: babies sleeping on their mother's chest. The tiny fingers and toes tightly clenched onto their hair have become an iconic representation of natural parenting. Placing your baby on your chest with their head elevated over their bottom creates a secure sleeping atmosphere. Moreover, the parent's breathing and movements have a beneficial effect on the baby's breathing, through stimulation, even during sleep. Notably, chest-to-chest sleeping poses no identified risks but offers numerous documented benefits. It is believed that the reason why tummy sleeping can be hazardous is that babies sleep too deeply, and the adult provides incidental stimulation and prevents this issue.

Start with Small Changes

If your baby is comfortable and falls asleep on their tummy or side, you can allow them to do so while being closely supervised. Once your little one is fast asleep, gently transition them onto their back. As your baby becomes adjusted to this change, you can gradually move them to their back while they are still drowsy, rather than waiting for them to fall into a deep sleep. If the switch is challenging for your baby, consider making gradual adjustments. Begin by moving them from tummy to side sleep, and then transition them from side to back. Remember, small steps can lead to significant progress.

When it Matters Most
Placing your baby on their back to sleep for the first 12 months is the best practice to prevent Sudden Infant Death Syndrome (SIDS). However, as your baby becomes more mobile in the second half of the year, they may move around in their cot both while awake and asleep, making it difficult to ensure they stay on their back all night.

Although it may be tempting to constantly reposition your baby, it is not necessary nor recommended. It's essential to ensure the sleep environment meets all other recommendations, including safe bedding and no toys in the crib. Accepting the factors outside of your control may help alleviate any unnecessary stress and worry.

It's important to note the highest risk for SIDS is around 2-4 months, and 95% of cases occur before 6 months. It's impossible to guarantee that your baby won't be affected by SIDS, and not all babies who don't follow recommended sleeping practices will pass away. Remember to do your best without becoming overly anxious or obsessive about sleep habits. It's reassuring to know that 99.9% of babies do not die from SIDS.

Make sure to have open conversations with your health care team regarding safe sleep practices for your little one. By following these guidelines and utilising safe sleep environments, you can provide a secure and healthy environment for your baby.

Don't be tempted to wedge your baby in position

Avoid the temptation to use sleep positioners for your baby. In 2010, both the U.S. Food and Drug Administration (FDA) and Consumer Product Safety Commission (CPSC) issued a warning advising parents to discontinue the use of sleep positioners. The warning was triggered by reports of 12 infant deaths caused by suffocation in or between sleep positioners and the side of a crib or bassinet.

There are no safe inserts for use in infant beds

Several incidents also involved babies who were initially placed on their back or side in a sleep positioner but were later found in a potentially hazardous position. The incidents involved two types of positioners: flat mats with side bolsters and inclined (wedge) mats with side bolsters.

To ensure your child's safety, always place them directly on their sleep surface without any additional props or equipment designed to keep them in a particular position.