From the Guidelines
It is normal for a newborn to move to a side position when laying down, but for safe sleep practices, parents should always place babies on their backs to sleep. Newborns often have preferences for certain positions due to their time spent in the womb, and they may naturally roll to their side when placed on their back. This tendency, sometimes called positional preference, is generally not concerning and typically resolves as the baby develops stronger neck and trunk muscles. However, for safe sleep practices, parents should always place babies on their backs to sleep and ensure they are in a safe sleep environment with a firm mattress and no loose bedding, pillows, or toys. If the baby rolls to their side after being placed on their back, there's usually no need to reposition them unless they appear uncomfortable. According to the American Academy of Pediatrics, as stated in the 2016 updated recommendations for a safe infant sleeping environment 1, side sleeping is not safe and is not advised. The supine sleep position does not increase the risk of choking and aspiration in infants, even those with gastroesophageal reflux, because infants have airway anatomy and mechanisms that protect against aspiration.
Some key points to consider:
- Always place babies on their backs to sleep to reduce the risk of SIDS, as recommended by the American Academy of Pediatrics 1.
- Ensure the sleep environment is safe, with a firm mattress and no loose bedding, pillows, or toys, as recommended by the American Academy of Pediatrics 1.
- If the baby rolls to their side after being placed on their back, there's usually no need to reposition them unless they appear uncomfortable, as stated in the evidence base for 2016 updated recommendations for a safe infant sleeping environment 1.
- If you notice your baby consistently favors turning their head to one side only or has difficulty turning to both sides equally, mention this to your pediatrician at your next visit, as rarely this could indicate torticollis (tight neck muscles) which may benefit from gentle stretching exercises.
Remember, the most important thing is to prioritize safe sleep practices to reduce the risk of SIDS and ensure the baby's safety and well-being, as emphasized in the 2016 updated recommendations for a safe infant sleeping environment 1.
From the Research
Newborn Sleep Position
- It is not recommended for newborns to sleep on their side, as this position is associated with a higher risk of Sudden Infant Death Syndrome (SIDS) 2, 3.
- The American Academy of Pediatrics recommends that infants be placed to sleep on their backs to reduce the risk of SIDS 4, 5.
- Sleeping on the back is the safest position for infants, as it reduces the risk of SIDS by allowing for easier breathing and reducing the risk of airway obstruction 2, 6.
- Other risk factors for SIDS include prone sleeping, soft bedding, bed sharing, exposure to tobacco smoke, and prematurity, while protective factors include breastfeeding, pacifier use, room sharing, and immunizations 2, 5, 3.
Sleep Environment
- A safe sleep environment is crucial for reducing the risk of SIDS, and this includes using a firm crib mattress, avoiding soft bedding and overheating, and keeping the sleep area free from hazards 2, 5, 3.
- Parents should place infants on their backs to sleep, avoid sharing a bed, and avoid exposing the infant to tobacco smoke 2, 5.
- Supervised prone positioning while the infant is awake, avoiding excessive use of carriers, and upright positioning while awake are also recommended to reduce the risk of SIDS and promote healthy development 2.