Baby Refuses to Sleep on Back

Q: I know that the recommended sleep position for a baby is on his back; however, my baby does not seem to like to sleep on his back. He will only sleep in this position for approximately an hour and then has a fit. He can't roll over yet, but he'll roll from side to side like he is trying to get on his stomach. As soon as I put him on his tummy he is out for hours. He will only sleep for long periods of time during the night if he is on his tummy. I know the risk of SIDS is suppose to be greater with stomach sleeping. Why is this? Is suffocation the cause for concern, or is there another medical reason? Is stomach sleeping as bad as everyone seems to make it sound now? My generation was told to sleep on the tummy and not on the back.

A: I don't have a key bit of information: the age of your baby, but since he isn't yet rolling, I'll assume he is under four months old.

Here is some perspective on the importance of the SIDS/ sleeping position issue. Since 1992, when the "Back To Sleep" campaign was launched to increase the number of infants put to sleep on their backs, the incidence of sudden infant death syndrome has fallen in America by 40 percent!
Yet it remains the third leading cause of death for infants under one year, ranking right behind malformations and issues relating to prematurity. Other countries with similiar campaigns have had similiar sucess.

We still don't know for sure why the tummy position increases the SIDS risk. A leading theory is that it allows overheating or re-breathing air, which is then related to too much carbon dioxide and too little oxygen, and subsequent death. Ninety percent of infants who die of SIDS are under six months of age, most are between three and five months old. Neither do we know why this is the most vulnerable age. Other important risk factors are the use of soft bedding and smoking in the mother.

You are right that medical advice has changed for this generation. You are also right in that many, many children have slept on their stomachs and done fine. And the odds are that your son would, too.

However, any increased risk isn't worth it when it comes to a child, so I'd encourage you to keep him on his back-despite the wails-at least until he is well past six months old.

Dr. Karen Sadler

Pediatrics
Dr. Karen Sadler is a board certified pediatrician who has been working in the Boston area for thirteen years. She completed her medical studies at Harvard Medical School in 1988 and went on to her residency at Children's Hospital Medical Center in Boston. The mother of three, Dr. Sadler is committed to healthcare for the underprivileged, as well as medical education. She is an associate instructor of pediatrics at Boston University School of Medicine and sits on numerous committees including the Massachusetts State Women Infant Child Program.

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