If you remember just one thing from the baby manual your child didn’t come with: newborn babies should sleep on their backs to reduce the risk of Sudden Infant Death Syndrome (SIDS), according to the American Academy of Pediatrics (AAP). But down the road, you'll likely show up at your baby’s crib and find they’ve rolled onto their stomach.
There’s no need to poll your parenting group to find out whether the position is safe. Once a baby can roll onto their stomach and return to their back, it’s perfectly fine for them to sleep tummy-down. That said, experts still recommend putting babies to sleep on their backs until 12 months of age (or older if your baby was preterm). Here’s what else you need to know about baby sleep positions during naps and nighttime so you can rest assured your child will stay safe in their crib.
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When Is It Safe For My Baby to Sleep on Their Stomach?
Babies can sleep on their stomach once they have reached age 1. Before 12 months, always place your baby on their back for every sleep, nap or night. But if they turn onto their stomach on their own, it's okay to leave them that way.
Experts agree that it’s safe for a baby to sleep on their stomach as long as they can get there themself. “When they are old enough to freely roll forward and back, they may choose to sleep on their stomach and that is OK,” says Dr. Elizabeth Murray, DO, a pediatrician at Golisano Children’s Hospital in Rochester, NY, and Fellow of the American Academy of Pediatrics.
It’s why there’s no specific age or month when an infant is deemed ready to sleep on their stomach, says Joan Becker Friedman, RN, certified child sleep consultant at Milwaukee, Wisconsin’s Pea Pod Sleep Consultants. “It’s a matter of reaching developmental milestones.”
Developmental Milestones in Children
When your baby can roll from back to front and front to back independently, it’s fine for them to sleep face down. But you should still put them down on their backs until they are 12-months-old, as per AAP recommendations to reduce the risk of SIDS. If your baby was born prematurely, adjust their age based on their due date before placing them in the crib on their stomach.
And once your baby establishes a preference for stomach sleeping, don’t worry about rolling them to their back. “The key here is the baby has to be able to easily move themself into and out of that position,” Dr. Murray says.
Every baby is different. Be sure to consult with a pediatrician if you have any questions about your infant sleeping on their stomach.
Benefits of Your Baby Sleeping on Their Stomach
It's no wonder why many babies seem to prefer sleeping face down. Intuitively, they're onto something.
It’s More Comfortable
If your baby has started sleeping on their stomach, chances are there’s one big benefit of this new position: They like it! “It’s very typical for babies to roll onto their stomach during sleep,” Becker Freidman says. “For many, it’s more comfortable than back-sleeping.”
If your baby still seems uncomfortable on their back, don’t flip them over or resort to using an infant positioner or nest. “These are not safe and have been associated with infant deaths,” Becker Freidman warns. Limiting your baby carrying or wearing during nap times can help your baby get used to sleeping on their back.
Potentially Longer Sleep Cycles
Becker Friedman says that babies who naturally sleep on their stomachs tend to sleep longer. Research has shown pre-term babies, in particular, get longer periods of quality sleep when placed in the prone position.
When Do Babies Sleep Through the Night?
Risks of Your Baby Sleeping on Their Stomach Too Soon
Placing your baby on their stomach to sleep too soon isn't just breaking widespread recommendations—it can also have dire consequences.
SIDS
Although stomach sleeping has not been proven to directly cause SIDS, it is a risk factor during the first six months of life when infants are especially vulnerable.
The AAP Task Force on Sudden Infant Death Syndrome is crystal clear in their anti-stomach sleeping recommendations, which cite a strong correlation between stomach sleeping and SIDS. What’s more, countries that have launched campaigns encouraging parents to put babies to sleep on their backs have seen SIDS prevalence drop significantly, according to the National Institutes of Health.
Working up to 30 minutes of tummy time per day can help your baby develop neck, shoulder, arm, and back strength—all of the muscles that are needed to roll back to front and front to back independently, according to Becker Freidman. “This way, if a baby's nose and mouth are face down on the mattress, they will be able to turn to the side, move about and breathe easily.”
What Is Tummy Time? And Why It's Important
Suffocation
If a baby without sufficient head control rolls onto their stomach, they could obstruct their airways, which can be a suffocation risk, according to Dr. Murray. The reason why pediatricians don’t recommend stomach sleeping or propping a baby up on their side is that it could set the stage for accidental rolling. As such, it’s important to remove your child’s arms from their swaddle or transition them to a sleep sack that doesn’t inhibit their upper body, after 12 weeks of age or earlier if they begin to show signs of rolling.
“If a baby is swaddled past the point of rolling, they could end up face- and nose-down on the mattress without the ability to wiggle to a free-breathing position,” Becker Freidman says, adding that the same goes for weighted sleepsuits, which pose the same risks to rollers.
Rebreathing
When infants sleep on their stomachs, they may attempt to rebreathe air that gets trapped in the bedding, which can lead to carbon dioxide build-up and low oxygen levels, says Becker Freidman. As a result, most babies will wake up and breathe fresh air, after which they are fine, she says. But some infants will be slower to respond or will not be able to roll over and will lose consciousness, one reason why rebreathing is a suspected SIDS trigger.
Overheating
Research suggests that stomach sleeping may inhibit the ability to release heat and regulate body temperature among low-birthweight babies. This could lead to overheating, another risk factor for SIDS.
To reduce the risk of overheating, dress your baby in a lightweight wearable blanket, keep their head and face uncovered, and watch out for signs your baby is too warm. If they are sweating or feel hot when you touch their chest, remove a layer or adjust the thermostat accordingly.
Upper Airway Obstruction
Many parents think that stomach sleeping infants are less likely to aspirate, or accidentally breathe fluid into the lungs if they spit up while sleeping on their stomach. But it turns out the opposite is true, according to Becker Freidman “Due to the position of the trachea and esophagus, back sleepers are much less likely to aspirate if they spit up,” she says.
A Word From Verywell
Experts agree unanimously that the safest way to put babies under 12 months of age to sleep is face-up. While there is no hard-and-fast age where stomach sleeping is proven safe, a baby who is able to turn onto their stomach in the middle of the night can safely remain in that position. There’s no need to roll them back over.
