Hey Rebecca!
My 2 month old will only stay asleep for 10 minutes on his back before he is awoken by gas or a shake of his own arm. Recently I discovered that he will sleep on his tummy (he falls asleep on my chest this way) for up to three hours. All of the baby books forbid tummy sleeping at all for the first year, but a friend told me her pediatrician said it is ok if the baby can lift his head 45 degrees… how can I resolve my conflicting mommy guilt while getting some much needed shut eye??
Alright Tired Toronto Mama, that is truly the question du jour these days. The Back to Sleep campaign that was launched by public health organizations in 1994 urged parents to put their babies to sleep on their backs to safeguard against Sudden Infant Death Syndrome (SIDS). And boy was it ever successful. In less than ten years the rate of stomach sleeping dropped from 70% to 15% and the rate of SIDS had been cut in half. It’s hard to argue with numbers like those.
But argue we do because it can be so very hard to get a baby to sleep flat on it’s back in a crib. Well-meaning and seemingly well-informed parents will do whatever they can to get some shut-eye. (And the babies need sleep, too, let’s not forget. Many a colicky baby is all smiles after the proper amount of sleep.) Jeanne Sager makes the case for these zombie-like parents in this Strollerderby post on Babble. Citing this Globe and Mail article that describes how many parents knowingly break the sleep safety rules (including Today Show’s Natalie Morales), Sager argues that some babies just sleep better on their fronts and that is okay. “Parents shouldn’t have to feel afraid when they tell their pediatrician that they’re changing things up a little – just as every child is different, the rules naturally have to change from kid to kid!”
Well, obviously the baby books are going to toe the line when it comes to SIDS. No expert is going to advise parents to use their own judgment when the data so clearly shows back sleeping to be safer. When viewed as an issue of public health, like vaccinations, there is no doubt that if all babies sleep on their backs, fewer babies will die. But is there ever an instance where this particular baby might reasonably be put on its front to sleep for the greater good of the whole family? I called up Playground Confidential’s sleep expert, Robyn Stremler to find out.
Dr. Stremler is an assistant professor at the University of Toronto Faculty of Nursing and her current research focuses on sleep problems in new families and those with hospitalized children. She is well aware, then, that there are “secret tummy sleepers out there,” but maintains that, “we have to inform parents about the relationship with SIDS. Babies should always be on their backs.” Reading your question, TTM, a number of alarm bells went off for Dr. Stremler. “When I hear that a baby is only sleeping for ten minutes at a time, I want to explore what’s going on here.”
“Nobody sleeps straight through,” Dr. Stremler reminds us. So pay particular attention to how you get your baby to sleep to begin with. “Some babies are always nursed to sleep. This baby falls asleep on her chest and is always used to being on someone. So he’s down for a little bit, but when he arouses just a little, he needs that re-created to fall back asleep.” Infants will often startle themselves awake if they aren’t properly swaddled, Dr. Stremler also warns. There are many other factors besides position that will affect a baby’s sleep and those should be addressed first.
Is there ever a time, a certain age perhaps, when it might be reasonable for a parent to choose to let a baby sleep on it’s tummy? Dr. Stremler maintains that she, personally, needs to agree with the Canadian Pediatric Society in advising against it. But . . . “all these things (like co-sleeping) are up to parents. How comfortable are they? The risk of SIDS is extremely low. If they are already doing a lot of things to further decrease that risk, like breastfeeding and living in a non-smoking environment and putting the baby to sleep on a firm mattress, they can make an informed choice.”
New parents are often at a loss, as this mom blogger relates, and the battle of the experts, particularly regarding sleep, doesn’t help. Attachment parenting is pitted against Ferberization and parents feel like they have to choose sides before they even become parents. The truth is that there are things that help babies sleep better, there are right ways to put a baby to sleep, that have nothing to do with whether you breastfeed on demand or want to keep to a schedule. Swaddle the baby, keep to a consistent wind-down routine, and help your baby fall asleep on it’s own. In fact, Dr. Stremler is currently collecting data for a study that asks if arming new parents with this information will help those families sleep. I can hardly wait to find out because goodness knows it shouldn’t be this hard.
Hey Rebecca is an occasional advice column here at Playground Confidential. I let you help me figure out what to research! Please keep emailing your questions to rebecca@playgroundconfidential.com and let me dig out the solutions.
6 replies on “Hey Rebecca: Back to Sleep Basics”
We have a recent SIDS loss where the baby died while on his tummy asleep on his father's chest. Will most babies die if sleeping like this? No. Researchers are investigating to determine what is the difference between babies who do die (cause of death is cited as SIDS) and this who don't. But we still don't know. But, the data is clear, as are the recommendations of the American Academy of Pediatrics, babies should sleep on their backs in a crib with a firm mattress and a fitted sheet.
Thank you, Linda. Parents do need to be fully aware of the risks and the data.
I have a colleague who lost his 8th child in his 3rd month to SIDS. Both parents are supervisors at two separate daycare centres and have a LOT of experience with children (after having 8 who wouldn't though?!!) It just goes to show that you can do everything right, and still end up with the chance to experience something so tragic…
That's just it. All we can do is try to reduce the odds of anything befalling our children. But there are no guarantees.
You can try swaddling your baby to help train him to sleep on his back. According to research from Dr. Brad Thatch at Washington University, 7 out of 10 babies that refuse to back sleep will successfully back sleep when swaddled. Be aware that swaddling holds in body heat so you may want to dress your baby a little lighter.
Of course babies love to sleep on your chest. That's just fine when you're walking the floors or sitting upright in a chair, but when you lay back on a bed or couch, that baby is tummy sleeping on a very unstable surface.
In all likelihood you do not have a vulnerable baby, but there is no way to tell until it's too late. As a parent, you get to make the decisions.
A couple of suggestions:
Remember that whatever you do, it is your baby and your choice. But I strongly suggest you don’t get into the habit of letting a baby sleep on your chest, because when they are newborn it can seem so sweet and just a way to cope. But if you start doing it again and again, you will soon be tearing out your hair with an 8 month old that won’t sleep unless he/she is snuggled against you all night. If you plan to have a life after 7 pm, make the change now!
Swaddling…yes, can be very helpful, I’m still doing it at 5 mths with my second and most of the time it still helps her. Very helpful at least until 4 months or so, and by then you’ll have some good habits in place and the baby will be used to being put to bed at certain times and what happens. ie, dim the lights, soft music, hushed tones, swaddling…
I picked up the book “The Baby Whisperer solves all your problems..by teaching you to ask the right questions” Like or dislike her, there were a couple of good ideas. She recommends feeding a baby when they wake up, then burping them, then keeping them awake for a short time (depending on age, might be 20 mins or 5 or 90). As soon as they look tired, take them to wherever they will sleep, ie a darkened room, change them, swaddle them and sit quietly with them until they are nodding off and then put them in bed. It made all the difference between my two babies. If they are fed, but also burped and a little tired…they will fall asleep and stay asleep. Much more likely than if they are nursed to sleep and are laying in bed with an air bubble just waiting to cause a problem. (And I say this without judgement, I nursed my firstborn to sleep for MONTHS, lol…and while he slept well at night, he woke after 20 mins during all naps.)
And lastly, we use an Angelcare monitor with the motion sensor as a security measure in case of something happening. An alarm will sound if the baby stops breathing. We still do all the other things, back to sleep, no soft blankets in the crib, etc, but for anyone who still feels nervous, it can be something to feel like extra insurance.
Hope you get some rest soon!