# Questioning SIDS "Back to Sleep Campaign"



## Gemini529 (Oct 11, 2009)

OK so I'm not looking to start a HUGE debate here. Well, I guess there's nothing wrong with a healthy debate...so here goes.

My baby is 2 months old and he has a very hard time sleeping on his back. He will fall asleep in my arms and sometimes for a little while in his carseat because it props him upright a bit, but as soon as I try to lay him down in his crib or in a bassinet, or one of his other "containers", he wakes up within 5 minutes. I know people say to swaddle him, but it's July and hot as ever and even on cooler nights, he fights his way out of the swaddlers. He basically won't sleep in the crib unless he is absolutely exhausted, and even then he doesn't seem to sleep well. He kicks around and seems generally restless and unhappy in his sleep.

It seems as soon as I flip him around on his tummy, he immediately cozies up and scrunches up his knees and falls asleep right away. I wonder if babies were "meant" to be sleeping on their tummies and sides and we are going against nature by forcing them to sleep on their backs? To get him to sleep at night, I always lay him on his side next to me in bed, then nurse him to sleep. He falls asleep on his side, then when I move away a little, he rolls onto his tummy and sighs a big happy sigh and sleeps away. Then, after a little while of watching every breath he takes, I always get paranoid because he is on his tummy and flip him around again, which makes him wake up again. Even if I can get him to sleep on his back for a few minutes, he'll always flail his arms and startle himself awake, which does not happen when he's on his tummy.

So my question is, aside from the risk of SIDS (which I admit is a HUGE risk and in no way am I advocating that parents should overlook this...please don't take it that way!) are babies getting good enough sleep on their backs? Obviously not all babies are like mine and maybe some sleep very well on their backs, but I have talked to a lot of other moms who deal with the same sleep issues as me.

I've read some studies that have shown that many babies are reaching developmental and social milestones later because of this and know a lot of moms who really struggle with tummy time because the baby is not accustomed to being on the tummy. I also know a mom who had to have her son's head fixed because of a massive flat spot that developed and doctors even proposed having him wear a helmet all day for a few months!

Does anyone know if there is a link between kids being diagnosed with things like Autism and ADHD and the whole "Back to Sleep" campaign, which started in the early nineties? I would think that if babies are taking longer to reach milestones, that could be something they use as a marker for these types of disorders and cause more kids to be diagnosed. A friend of mine works as an "early intervention specialist" and her job is to go into houses and evaluate babies and toddlers to see if they are at risk for Autism. They use these developmental "milestone markers" as ways to diagnose the babies so I wonder if all of this ties together??

In terms of SIDS, I wonder if it's the tummy sleeping per se, or if it's something else that is making it correlate but not necessarily cause it. For instance, some theories are that mattresses have toxins in them, like flame retardants, which cause babies to breathe in more of when sleeping on tummies (a fix could be to get an organic mattress maybe?) Smokers might have a higher level of toxins in their furniture in general which could account for the higher rate in smoking houses...Rates are higher in the winter because babies are kind of shut in around these toxins and don't get as much fresh air allowing their furniture to "air out."

Have SIDS rates declined because we are more aware of it in general? People have started getting better prenatal care? We have become more health conscious? We smoke less around babies? Smoking has been banned in many public places where previously it was not? We use baby monitors and check on babies more because of our SIDS paranoia? We are more aware of other risk factors? Was the decline in SIDS just from flipping babies around or was it something else?

Personally I believe Autism has many causes, which is why we haven't narrowed it down to just one thing and why we have been able to "rule out" so many things that probably do cause it in some cases but who really knows. Anyway, I'm just thinking out loud here and wondering if anyone wants to weigh in. Again, I'm not promoting changing what doctors are advising but I am questioning the quality of sleep our babies are getting and looking for more information if anyone knows of it. This campaign has been going on for 18 or so years now so I'm thinking it's about time we evaluated how well it's worked out.

Thoughts? Experiences? Advice for getting my baby to sleep better on his back?


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## ein328 (Jan 10, 2009)

Part of the reason why "back to sleep" was instituted is for exactly the reasons you point out- babies tend to sleep better (and more deeply) on their tummies. Some people reason that a baby who is in a deeper sleep is less likely to wake up if a change in breathing pattern occurs, so babies who sleep on their backs (and therefore spend less time in "deep sleep") are safer.

That being said, I would be uncomfortable putting my baby to sleep on her tummy at night. For naps, or any time when I would be monitoring her closely, I would be okay with it.

Also, I think it depends on what kind of surface baby is sleeping on. If baby is on a firm crib mattress, I would probably feel more comfortable. However, we bedshare, and I know our mattress is probably a bit softer then most. Therefore, I feel more comfortable with DD on her back.

Have you tried putting baby on his/her side? That might help.


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## laohaire (Nov 2, 2005)

No science to back me up - but if I were you I'd put him on his belly and be done with it.

Personally I always felt comfortably aware of DD when I was sleeping with her.


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## Hannah32 (Dec 23, 2009)

I'm way too paranoid to let my son sleep on his tummy, but there's no doubt he's prefer to do so. He takes chest naps on me and my hubby that way, but I think that's ok. He's not even a month and he's already worming onto his side at night. Right now, he's usually sleeping quite near me in the bed. I position him on his back, but he always at least turns his head toward me. I keep a hand on his chest, partly because our co sleeper is on its way, and partly to make sure he's breathing.


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## fruitfulmomma (Jun 8, 2002)

I've never purposely put my kids to sleep on their backs. I've heard from several pre-back-to-sleep moms that they didn't do it because of the fear that the baby would choke on their own vomit since they couldn't move their heads early on. I usually feel comfortable with my babies on their sides until they are old enough to move and choose their own positions, which is often their tummies.


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## treeoflife3 (Nov 14, 2008)

My little one wouldn't sleep unless she was on her tummy or side. It got to the point where I had to decide which was worse... a baby and a mama who are ALWAYS way overtired... or the risk of SIDS. Eithery way, it was just very very bad altogether. We already had some other issues going on that made the sleep situation even worse.

I ended up deciding that I needed to let her sleep how she would sleep. I tried to prop her on her side which worked MOST of the time but otherwise she was completely healthy and was close to me with none of the other SIDS risks present. I figured us sleeping at least a few hours a day was considerably safer than neither of us getting ANY sleep on her back.

it was helpful though that from birth she could move her head side to side on her sleep on her tummy. She was born STRONG. I was also afraid of her choking if she was on her back too.. that was my LAST reasoning because SIDs paranoia gets me, but it did help me feel more comfortable knowing she couldn't choke and could move her head too.


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## AFWife (Aug 30, 2008)

Quote:


Originally Posted by *fruitfulmomma* 
I've never purposely put my kids to sleep on their backs. *I've heard from several pre-back-to-sleep moms that they didn't do it because of the fear that the baby would choke on their own vomit since they couldn't move their heads early on*. I usually feel comfortable with my babies on their sides until they are old enough to move and choose their own positions, which is often their tummies.

Before we realized DS had a dairy problem he would wake up choking due to reflux. Scared the CRAP out of me. So, I started putting him on his side. We cosleep and I always woke up when his breathing changed (even on his back...it's weird. I would wake up thinking, "Something's different" and know it was his breathing) He now sleeps on his tummy most of the time. At first DH was worried because "babies suffocate when they sleep on their tummies!!!"


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## Buzzer Beater (Mar 5, 2009)

My DD2 is 8 weeks old and has a heck of a time on her back. She hates hates hates it, waving her arms and making awful noises all night. The only way she sleeps deeply for long periods is on her side in the big bed or in somebody's arms. When she's in the cosleeper we have to put her on her back- she's got casts on for club foot which make it impossible for her to sleep on her tummy. When the casts come off in 2 weeks, I'm putting her right on her stomach so we can all get some sleep. DD1 slept her whole life face down, but she's 19 and that's what we were told to do then.


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## akind1 (Jul 16, 2009)

DS still at 8 months falls asleep on his side. Personally I think it is a nice "middle ground" sort of position, he can curl up how he wants to, isn't on his belly in too deep of a sleep, and not on his back either (I was worried about the same choke on his vomit thing as a PP)


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## Astraia (Jan 1, 2009)

I wish to goodness I'd had DD sleeping on her belly at a younger age. She slept on her back until she was probably +/- 9 months, and she... didn't sleep! At all! I fought and fought and fought and fought with her to sleep, and it's still a big fight. The few times she got onto her belly she slept a lot better, and then once I stopped freaking out about it she slept on her belly full time- even now, she's a tummy sleeper.

I've read that babies are naturally more comfortable on their bellies because it helps them feel cozy and safe and secure, helps prevent flailing limbs (that was a big problem for us, we swaddled for AGES), and allows them to curl up into the position their used to - being on their backs must feel so so odd to them.

DS has slept on his belly from birth. At first only for naps on a firm surface (in his basinette, for example) but he could roll easily from a young age and once he got that figured out I let him sleep on his belly even at night. He sleeps well, and is easy to get to sleep. I'm sure a lot of this is personality, but the difference in quality of sleep between him and my daughter is honestly pretty astounding.

I'm also a bit confused, because I kept hearing from people that babies being SUPER tired is a big SIDS factor. If your baby has trouble sleeping on their backs and they get more and more and more overtired... aren't you then increasing the SIDS factor right there?

I've been thinking this back-to-sleep thing is being over promoted, almost. I think if you follow other guidlines (breastfeed, firm surface, non-smoker, etc) and your baby honestly won't sleep on their backs, then don't force it. I think of it as a guideline, not a rule.


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## alegna (Jan 14, 2003)

Personally, I've been okay with my babies on their tummies when I was next to them (at night or naps) I would not be comfortable with a baby in a room alone on their tummy.

-Angela


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## Gemini529 (Oct 11, 2009)

Thanks everyone for all of the responses. I have also heard that keeping them on their backs prevents them from falling into a "deep sleep" which is part of what perhaps keeps them from getting SIDS. But to me this is like saying that in order to prevent your baby from dying in his sleep, you must make sure that he doesn't ever really sleep.

Whenever I have one of those nights where I'm tossing and turning and don't fall into a deep sleep all night, I wake up feeling just awful. I worry that's what my baby feels like all the time. I feel like it can't be that good for him to never really get a good sleep. I don't know. My mom was told to put us all on our bellies back in the 80's when my siblings and I were babies so she thinks I should just let him sleep on his tummy.

I let him nap on his tummy today and he napped longer than he ever has...3 hours! I checked on him pretty much constantly but it was nice to know he was actually sleeping for once. I'm not sure about tonight. He sleeps in a bassinet right next to me so I can check him all the time but I'm sure I'll be afraid to sleep if I let him.

I haven't heard that about them being overtired leading to SIDS but if that is the case, then my poor LO is probably at risk in that way


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## dogretro (Jun 17, 2008)

DD2 has slept on her belly since we brought her home from the hospital. I hate putting babies to sleep on their backs b/c they do not sleep as well & often startle themselves awake. She sleeps in her crib in her room & she already sleeps thru the night.

DD1 also slept on her belly. It was after a few weeks of being home & she just slept so much better that way.


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## Gemini529 (Oct 11, 2009)

Just wanted to add...I do let him fall asleep on his side. But then I worry that his arm will fall asleep or he'll cut off the circulation cause he's laying on one arm. Maybe I'm just worrying too much about everything but that's how I am!


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## 34me (Oct 2, 2006)

My dd was born at the beginning of the back to Sleep campaign and her brothers followed soon after. I have to admit they all slept on their tummies because they slept better that way but now as 2 teens and a tween they sleep on their backs most of the time! I knew what I was doing but I would have been devistated all the same if something had happened.


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## babydanielsmom (Jan 18, 2008)

Personally I wouldn't be comfortable with a babe that young sleeping on their belly. My ds (7 wks) sleeps on his side. I'm always afraid he"ll start choking in his sleep if he is on his side. HOWEVER, I also have one of these:
http://www.angelcare-monitor.com/United-States/en/home. This monitor picks up the baby's sounds as well as movements (if their is no movement...like from not breathing in 20 sec the monitor alarms). This monitor makes me feel safe b/c I guess I'm a paranoid mama


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## sophiesgrandma (Jun 22, 2006)

I understand about the back to sleep thing and I have two grandchildren who started life on the their backs to sleep until they learned how to roll over themselves.
That said, when I had children (they are now 34, 32 and 26), They all slept on their tummies from birth because that was thought of as safest for infants.
It kind of blows my mind that now it's just the opposite. All my friends of course put their babies to sleep on their tummies also. I was so shocked and scared when I heard that babies must sleep on their backs. I was scared the babies would choke on spit-up or vomit. How things change........


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## Nicole730 (Feb 27, 2009)

You brought up some interesting points about stomach vs back sleeping. Something to think about anyway.

I've definitely been scared into not letting my babies sleep on their stomachs. When they are in bed with me, they sleep on their side, face right by my breast. On their own, it's on their backs. I would not feel comfortable with a baby sleeping stomach down on my bed with me and DH in it because the mattress is too soft.

DS did not sleep for long periods, DD is much better at it. She will fall asleep on her back, it's amazing to me how different she is.


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## Pumpkin_Pie (Oct 10, 2006)

When my son was a newborn, he spent most nights asleep on his belly while he was on my chest. I would lay on my back and then he would fall asleep on my chest and we would both sleep that way. He only had to wiggle a millimeter and I was awake in an instant. When he was a few weeks old, I started having him sleep on his side next to me. I would wedge a small pillow behind his back and he was in between the pillow and my breast and he slept like a champ that way.

I once woke up in a panic and wasn't sure what was going on, but he had gotten the blanket over his head, so I removed it, rearranged everything and we both went back to sleep. When your baby is right beside you, you just become so attuned to their every move that I felt completely ok with side sleeping.

His head did take on a bit of a funny shape with the side sleeping though. It got a little squished on the sides and looked a little narrow for a while, but it went back to normal when he was around 1ish and would sleep in all sorts of crazy positions.


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## lifeguard (May 12, 2008)

My Mom had a realllllly hard time understanding the back to sleep thing, because she had been told (like many pp's here) that it was safer on the tummy because of the vomit thing.

My understanding of it is that the back to sleep is the only thing they have "done" that has shown a measureable drop in the cases of sids. To me that means that is indeed lowering the risk of sids. But with that said there are many factors that change the risk of sids (smokers in the house, maturity of baby, air flow, mattress softness, etc, etc.) so I think each family has to look at their own situation & risk factors & decide whether or not it is worth it.

For me it wasn't worth any additional risk but ds also rolled fairly young & then it was no longer an issue 'cause he'd just roll into whichever position was most comfy for him.


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## ~Demeter~ (Jul 22, 2006)

Actually... around the time the back to sleep campaign started the criteria and testing for SIDS changed. Of course, I have no links to back up my facts right now... but maybe someone else will chime in.

I have 4 children, pregnant with my 5th... all of them have been tummy sleepers from very early on. It's been quite apparent (to me) that if I lay my child on his/her back they are more likely to startle and wake themselves vs. laying them on their tummies. I'm willing to take that risk... I know not everybody is and that's ok but it surely doesn't make you a bad parent if you place your baby to sleep on their belly.

Mine really only napped by themselves, usually in the same room as me. I found it much easier to bed share at night, we were all better rested that way.


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## eclipse (Mar 13, 2003)

My oldest was a horrible sleeper, and I really wish I'd not been so paranoid about letting him sleep on his stomach. I think it would have saved us both a lot of grief. DD slept anywhere, anyhow, so she always went to sleep in her back. My youngest, though, whoo boy. He did not sleep for more than 20 minute stretches unless he was on his stomach. I was paranoid because he was preterm and didn't want to have him on his belly, but the truth was - it was much more dangerous for him to not get any real sleep. I was at a serious breaking point from sleep deprivation and someone was going to get hurt unless a change was made (not necessarily that I would purposely hurt him, but that I would not be coherent enough to make proper decisions or even trust that I wasn't going to drop him while walking across the room or trying to bathe him or something). In any case, I finally let him belly sleep and his sleep improved - he still wasn't a great sleeper, but i could get a couple of hours out of him rather than 20 minutes.


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## Gemini529 (Oct 11, 2009)

Here is a link to an abstract that was written about this. You are on to something, Demeter, with the idea that they have actually just changed the coding and that perhaps SIDS hasn't really declined that much due to this BTS campaign.

http://pediatrics.aappublications.or...full/109/2/274

Here is a quote from the abstract: "Classification of possible SIDS cases to unknown cause may have increased with more death scene investigations or fatality reviews that use more precise definitions of SIDS.13 Combined with increased state activities to review all sudden, unexpected child fatalities, increased numbers of US deaths with unknown cause may result in national underascertainment of SIDS or unintentional, intentional, or undetermined intent injury classifications."


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## ErinYay (Aug 21, 2008)

V was (and is) a tummy sleeper. I read over all the big SIDS studies, esp the Swedish one and the one from Hong Kong, and decided that tummy sleeping isn't the magic bullet of SIDS. She slept in our room from day one, and, frankly, if she'd been in a crib in her own room, I would have put her on her back, as I feel strongly that room-sharing helps a lot in setting breathing patterns, and I strongly doubt a healthy baby will silently die in the night. (When she coslept in our bed, she was on her back, though.)

V was also particularly strong, and could hold her head up at birth. If she'd been weaker, I would have thought about back sleeping. We had no other risk factors for SIDS (smoking, smoking in the house, having the baby sleep with someone other than us, etc).

I think there are definite benefits, both motor skill and overall growth and development-wise, to tummy sleeping- they NEED good, deep sleep to grow and learn, and they really do sleep better on their bellies. Motor development-wise, she's way ahead of today's curve- I've yet to meet a baby her age who is doing half of the physical stuff she is (crawling since 6 months, sitting since 4, etc).

While I'm all for tummy-sleeping for this one child, I'd never recommend it to anyone else, though I would encourage people to do their own research on the matter. The year back-to-sleep went into action, there was a 50% reduction in "SIDS" deaths, but there hasn't been a decline since then. This suggests to me that 50% of "SIDS" deaths were actually asphyxiation and/or smothering deaths caused by a bunch of junk in the crib. I'd also never recommend this because the media has created a culture of fear, and people tend to react VERY badly to the idea of deliberately putting a baby on his or her belly. I actually lost a very good friend over this matter- she was at the hospital when V was born, but couldn't get over the idea that we were somehow laughingly putting our daughter in danger.

It's a touchy matter, and one to really do the research on yourself.


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## blessedwithboys (Dec 8, 2004)

i've given this lots of thougth over the years, heres how i see it...

before the "modern age" people did what came naturally: mothers and babies co-slept. some babies died in the family bed, most didnt.

then came formula feeding. babies started throwing up from the artifical milk. along with artificial feeding came detachment parenting, ie, put the baby in the crib and only interact with it every four hours to give a bottle. so babies were left alone in the crib, probably on their backs so they could stare at a mobile or some other mother-substitute, and some babies threw up and choked and died.

so tummy sleeping was born. but babies were still being left alone in their cribs for long periods of time. not just for CIO at bed time, but during the day as well. add to this the increase in toxins in the home and an increase in AC usage which meant fewer open windows and babies were still dying in their cribs.

so the tide turned once again to back sleeping. i had my 1st child in 1994 and determined that i would be a good mom and only let him sleep on his back. well, he didnt sleep. my mother (who had kids in 77, 79, and 86) repeatedly told me to put him on his tummy so we would both get some rest. i did it once, and he slept.

but i continued to worry, and honestly, he didnt sleep so much. it was only a change from maybe 15 minutes to an hour. so one night, out of utter desperation, i took ds into my bed to nurse as usual, but this time i didnt return him to his crib. i just snuggled down in to my bed with him latched on and we slept for 5 hours. he was about 2 or 3 months old and my days of fighting to keep him asleep in the crib were over. back or tummy, it made no matter as long as he was next to me in the bed.

so i think that is the key: proximity to the nursing mother. i think the safest sleeping arangement by night is in the crook of the arm of the sober lactating mother, in a bed that has a reasonable amount of blanketing and firmness.

by day, i think the safest sleeping arrangement is either in a sling or other carrier. if it is necessary, or just desirable, to lay the baby down, i think any hard, firm, safe surface can be used, so long as the mother is near. what worked for me was a "stroll-a-bed", a stroller that layed down completely flat like an old fashioned pram. i got it new with ds1 and used it again with ds2 7.5 yrs later. it was great for me bc i could lay them on the tummy but wheel them from room to room as i did housework so i was always able to keep and eye and ear on their breathing.

so thats how i did it, but if for any reason i needed to put my child in a crib and leave the room, it would be on their back. ymmv


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## Anastasiya (Jun 13, 2006)

All my kids have slept on their tummies during the day, in a place where I could see them (pack n play, cosleeper, floor, bassinet, etc.), and on their sides at night. I never put them down on their backs.

With my non cosleepers, when I put them on their sides I would push their backs up against the side of the crib and pull both their arms out so they were perpendicular to their body (prevented rolling). Then I would take a receiving blanket and roll it up, place it between their legs and tuck it a bit under their bellies, up to their chest, to further prevent rolling.

I would switch sides every so often with them.

My cosleepers slept on their sides, facing my breast.

We also never did tummy time because we didn't need to, and all my kids have lovely round heads.


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## sapphire_chan (May 2, 2005)

The fact that she sleeps better on her tummy or reclined makes me wonder if you're dealing with reflux at all?

DD slept on her side next to the last boob she'd nursed on for the first few months.

The biggest SIDS risk is 2-4 months, which corresponds with a lot of babies going through a phase of sleeping through the night. So I'd say don't worry about how your baby is sleeping, instead make sure to encourage nursing at regular intervals.


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## marinak1977 (Feb 24, 2009)

Quote:


Originally Posted by *blessedwithboys* 
so i think that is the key: proximity to the nursing mother. i think the safest sleeping arangement by night is in the crook of the arm of the sober lactating mother, in a bed that has a reasonable amount of blanketing and firmness.









I feel very convinced by the cosleeping studies that mother's breathing and blood flow help regulate the baby's breathing. From day 1 we slept skin to skin and DS was usually on his side cradling me. I kept blankets and pillows away from his head. I found that I got attuned to him so much that the couple of times the blanket went over his head I woke up. Recently I woke up just before he was about to fall off the mattress (it's a small drop to the floor but still -yay for super mommy sense)
DS slept in the crook of my arm and it was hard on my shoulders for a while but now he likes a little bit of space and we're much more comfortable. When he was (is) napping and wasn't in the carrier I would lay him on his side, and use the video monitor and check on him all the time. Now he's over 6 months and I have a lot more confidence that he can get himself out of trouble so if he falls a sleep on his tummy I let him be. I still check on him frequently though. It's funny though - DS is turning out to be a back sleeper I think.









So yeah - I love our family bed and so does DH. We feel that our little one is meant to be near us and safe and we find it so bonding.


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## Marsupialmom (Sep 28, 2003)

My son absolutely hated being on his stomach and swaddled. My other children I never tried it.

Honestly with my children co-sleeping they slept on their sides or back. Rolling over to their stomach wasn't something they did until they were able to roll over on their own, which was after the highest risk period for SIDs. They would nurse on their side, when they unlatched they either stayed on their side or rolled to their back, never to their stomach.


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## transylvania_mom (Oct 8, 2006)

Quote:


Originally Posted by *Gemini529* 
I wonder if babies were "meant" to be sleeping on their tummies and sides and we are going against nature by forcing them to sleep on their backs?

Maybe, but I don't think babies were "meant" to sleep in "containers" either...
I used to put my babies to sleep on their side.


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## Ldavis24 (Feb 19, 2009)

I think you need to do what is best for your baby and in this case if it a no-sleep vs. sleeping well thing I would try the tummy sleeping and just be extremely aware that there were no pillows, blankets etc around your LO. I too like other PP's was extremely aware of DD's sleep, I always wake the minute she stirs or even just sighs loudly sometimes.

My mother was horrified when I told her DD "had" to sleep on her back because it was safer. She could not believe that it was safer and was terrified that DD was going to die. I was only born in 86, not too long ago and even then everyone was still doing tummy sleeping I believe.

Honestly from 3 months on DD was on her tummy and that was it. She wanted it that way and I spent a couple of weeks watching her sleep half the night totally paranoid and then we all relaxed and found our co-sleeping groove.

She is now 13 months old and I am not ashamed to say that she has been sleeping in her side-carred crib on a PILLOW (gasp) since she was 11 months. The reason she has her very own pillow is because every night I'd lay down with her and then get up once she was asleep and I'd go check on her and she had crawled up onto our soft down pillows and was sleeping on them on her tummy with just her legs on the bed. She loved it. So now she gets put on her own (very firm) pillow, on her tummy, and falls asleep better than when I try to nurse her to sleep!


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## Gemini529 (Oct 11, 2009)

Quote:


Originally Posted by *ErinYay* 

While I'm all for tummy-sleeping for this one child, I'd never recommend it to anyone else, though I would encourage people to do their own research on the matter. The year back-to-sleep went into action, there was a 50% reduction in "SIDS" deaths, but there hasn't been a decline since then. This suggests to me that 50% of "SIDS" deaths were actually asphyxiation and/or smothering deaths caused by a bunch of junk in the crib. I'd also never recommend this because the media has created a culture of fear, and people tend to react VERY badly to the idea of deliberately putting a baby on his or her belly. I actually lost a very good friend over this matter- she was at the hospital when V was born, but couldn't get over the idea that we were somehow laughingly putting our daughter in danger.

It's a touchy matter, and one to really do the research on yourself.

Yeah I know what you mean. I know several people, including my MIL who would be astounded and alarmed if I told her I let him tummy sleep sometimes. She already questioned me about it and told me I should always put him on his back no matter what. A few friends have mentioned that too and I feel like I have to keep it a secret, which makes me feel like I'm doing something horribly wrong. I doubt any of them have actually looked into it much, though, since the media took the BTS campaign and scared everyone to death about it.

The pediatricians are now also saying that pacifier use will help reduce SIDS. The way I see it is, if a baby is sucking on a pacifier, they probably aren't sleeping very soundly, which can't be all that good. That deep sleep that they all say is so dangerous is where all of the good restoration happens in their bodies and minds!

The more I research this, the more I find that actually leads me to believe that back sleeping might be worse for babies, especially mine because I'm starting to think more and more that he might have reflux. I'm going to ask his ped about it this Friday at his next appt.


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## ErinYay (Aug 21, 2008)

Quote:


Originally Posted by *Gemini529* 

The more I research this, the more I find that actually leads me to believe that back sleeping might be worse for babies, especially mine because I'm starting to think more and more that he might have reflux. I'm going to ask his ped about it this Friday at his next appt.

Our ped and NP have known since her first visit at 48 hrs old that she was a tummy sleeper. As I breasfeed, don't smoke, room-share, etc, and they were confident that we'd done the research on the pros and cons, they're were and are very supportive.

Things like flat heads and torticollis are a direct result of back sleeping- torticollis almost always self-corrects in tummy sleepers, but not in back sleepers. There was no need for tummy time when everyone slept on their bellies or sides; when my 6 month old started crawling, everyone who wasn't my immediate family FREAKED out that she was soooooo advanced, but it wasn't too long ago that 6 months for crawling, 10 months for walking, etc, was the *norm.*

For us, with this one baby (if our next one isn't as strong right out of the shoot, we'll probably put him or her on his or her side for the first few weeks), tummy sleeping was an obvious choice.


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## danbee (Nov 3, 2009)

DS sleeps on his tummy on DH's chest. I read that sleeping chest to chest stimulates & regulates breathing for LO. This is the only way he would sleep deeply and I agree w/most of the OP's comments about sleep. I read a few studies that linked "back to sleep" to cognitive delays and attributed it to the lack of quality sleep. Made sense to me.


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## Ruthe (May 31, 2005)

This article (pertaining to baby carriers) has a bit in it about baby positioning and what happens to the curve of their spine when on their backs:
http://www.sleepywrap.com/Research/uprightposition.pdf

Seems a little unnatural to me to put them on their backs (unless it's the rare baby who does seem most comfortable that way.)

I have kids from age 21 on down to "not quite born yet." When my first two were born, if you let them sleep on their back people thought you were killing them because they'd choke. Then it suddenly all changed to, "If they sleep on thier tummies they will die of SIDS."

My nephew had plagiocephaly and wore the helmet for 5 months. The sudden increase of plagiocephaly diagnoses, definitely correlates to the beginning of the back to sleep campaign. My sister says, "Plagiocephaly is fixable, death from SIDS is not" but her son WAS treated, and she feels that he still shows signs of plagiocephaly... and has feelings of guilt over that (obviously though it is NOT her fault, she did everything she could... some parents don't notice, don't get treatment at all.)

Just some points to ponder.


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## lalemma (Apr 21, 2009)

I totally support parents making an informed choice about this, but the numbers pre- and post-backsleeping campaigns seem pretty convincing to me. I will say that as with so many parenting things, although SIDS is really scary, the risk is really low to begin with. So I totally understand parents who decide to put the baby on its back, but I also understand parents who assess the risk for their individual situation and decide to go with stomach-sleeping.

That said, like a PP, I don't think it's "natural" for babies to sleep apart from their moms (I am not judging people who don't do family bed.) I think babies evolved in an environment where they slept very close to their moms and didn't go into the very, very deep sleep phases as tiny babies because their mom's breathing regulated theirs, their sleep phases synced up, and of course they nursed throughout the night. I don't know if they would have slept on their tummies - it seems like it's easier to latch on if you're on your side facing the boob. But maybe ur-babies slept face down on their mom's chest?

Anyway, for my way of thinking, once you've moved the kid out of the parental bed, you've already altered what's going on with the baby's sleep. At that point I think you're playing catch-up with trying to regulate the infant's sleep in "safer" ways.

FWIW, our kid mostly slept on his side (now he rolls around the bed and kicks us all night, sigh) - he and I faced each other. When he was very little he sometimes slept face-down on top of me.

OP, I know you said your baby doesn't like being swaddled, but have you tried the double swaddle? It's pretty much impossible to break out of, and if you use really light fabrics and put the baby to bed in just the swaddle and a diaper, not hot. I am a total swaddling fan - just a thought.


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## Hannah32 (Dec 23, 2009)

Quote:


Originally Posted by *danbee* 
DS sleeps on his tummy on DH's chest. I read that sleeping chest to chest stimulates & regulates breathing for LO. This is the only way he would sleep deeply and I agree w/most of the OP's comments about sleep. I read a few studies that linked "back to sleep" to cognitive delays and attributed it to the lack of quality sleep. Made sense to me.

My baby sleeps very well this way too, in a recliner we have. I think that's different from putting them on their tummy in a crib or bed.


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## alegna (Jan 14, 2003)

Sleeping with a baby in a recliner or on a sofa is supposedly one of the most dangerous ways to sleep.

-Angela


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## Hannah32 (Dec 23, 2009)

Quote:


Originally Posted by *alegna* 
Sleeping with a baby in a recliner or on a sofa is supposedly one of the most dangerous ways to sleep.

-Angela

I can see why the couch would be a problem, but why a recliner? My husband's back is blocking any cushions and he holds the baby onto his chest. Baby is upright as well, as it doesn't recline all that far. I don't really see how it's different from falling asleep in a rocking chair or a glider.

ETA: We're not putting baby to bed there, but you know how it is. You fall asleep while holding baby.


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## ErinYay (Aug 21, 2008)

Quote:


Originally Posted by *alegna* 
Sleeping with a baby in a recliner or on a sofa is supposedly one of the most dangerous ways to sleep.

-Angela

My guess is that those are seen as dangerous because they're sometimes how inadvertent cosleeping happens; meaning caregivers fall asleep with the baby outside of the bed without meaning to, and likely have other risk factors (drug/ alcohol use, not being the mother or father, etc). So, like, it's not the couch or recliner's fault, it just happens to be where people doze off without knowing how to keep a kiddo safe.


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## Hannah32 (Dec 23, 2009)

Gah! Just when I think I've got all the hazards figured out, something throws me for a loop. Now, I'm paranoid again.

I hate being a first time mom. Everything is so frickin' stressful.

Hubby is very aware of our baby and holds him quite close. If baby were to fall from position they are in, he would fall on the floor. That would be bad, but I make sure there's no cushion hazard for him to suffocate in.


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## treeoflife3 (Nov 14, 2008)

Quote:


Originally Posted by *alegna* 
Sleeping with a baby in a recliner or on a sofa is supposedly one of the most dangerous ways to sleep.

-Angela

It was literally the only way my kiddo and I got any sleep for a week or two. Even putting her on her tummy didn't work then... but it was a big recliner and I only dozed. I think the risk can be assessed on a person/situation by person/situation basis. In general, yes it is unsafe but usually because people don't know of the risks or fall asleep accidentally. Not so much for people who know the risks and take precautions and do it on purpose.


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## savithny (Oct 23, 2005)

Quote:


Originally Posted by *fruitfulmomma* 
I've never purposely put my kids to sleep on their backs. I've heard from several pre-back-to-sleep moms that they didn't do it because of the fear that the baby would choke on their own vomit since they couldn't move their heads early on. I usually feel comfortable with my babies on their sides until they are old enough to move and choose their own positions, which is often their tummies.

My grandma's 1940 copy of Dr. Spock tells moms NOT to put babies on their tummies because if they spit up, they could drown in the puddle of vomit in front of their mouth/nose.

I'm thinking the "Choke on barf" argument is old and has gone both ways.

Personally, I think that the "too deep a sleep to self-rouse on their tummies" theory is probably on the right path.

I think that babies that young are not SUPPOSED to sleep long and deeply. When they're tiny and nursing every 2 hours, it just doesn't make sense that they'd need the capacity to conk out for long stretches.

Further, if you were a Primitive Mama, sleeping with your child in a nest of leaves or on a cave floor, would your baby be sleeping on his/her belly in the traditional "Put them in the crib on their belly to sleep" position? No. If they were on their belly, it would be because they were belly-to-belly with you and you were on your back -- and sleeping in physical contact with an adult (or even in very close proximity) has been shown to help babies regulate their breathing and sleep depth/arousal.

So: I would not put a baby alone in their own bed on their stomach until they were old enough to flip themselves over (which is about when brain/nervous system development catches up and they become able to regulate their breathing even during deep sleep). And from my experience cosleeping, putting my babies tummy-down in bed with me would have been very unsafe, given our bed and bedding. Plus, they slept curled in the crook of my arm, mostly.


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## Gemini529 (Oct 11, 2009)

Quote:


Originally Posted by *lalemma* 
I totally support parents making an informed choice about this, but the numbers pre- and post-backsleeping campaigns seem pretty convincing to me.

OP, I know you said your baby doesn't like being swaddled, but have you tried the double swaddle? It's pretty much impossible to break out of, and if you use really light fabrics and put the baby to bed in just the swaddle and a diaper, not hot. I am a total swaddling fan - just a thought.









I guess that's what I'm questioning. I am not convinced just by the numbers decreasing like that. I don't believe that correlation equals causation...just because the time frames match up doesn't convince me that it is the cause of the decrease. I think that the campaign itself brought so much awareness to SIDS that it caused people to cut back on other risk factors. I have yet to see a study that shows what the odds are of a SIDS death with no other risk factors besides just tummy sleeping. I think a lot of infant deaths before this whole campaign were probably labeled SIDS even if they were caused by perhaps suffocation against a large teddy bear or from lying face down in a fluffy pillow or parents constantly smoking around a baby.

And while the numbers have gone down, SIDS still exists and babies placed on their backs still die of SIDS. So perhaps two babies are saved from being put on their backs, while one other baby dies because in his situation, he would have been safer on his tummy. This is why parents need to be really aware of their particular situation and not just blindly follow what "scientists" tell them to do. There are studies that show that a baby's risk of dying on its tummy goes up very significantly if they don't have experience sleeping that way. Babies who naturally want to be on their tummies, but are being forced onto their backs will eventually end up where they want to be in their sleep once they learn to roll over. At that point, they will be at an even bigger risk than they would have been if we had just let them sleep the way they wanted from the beginning.

Back sleeping has been proven to cause sleep apnea in babies. Boys are at particular risk for sleep apnea while on their backs due to differences in how their bodies and lungs are built. Boys are also at an increased risk of having autism/autistic symptoms. The ratio is 4:1 for both coincidentally. My concern is that babies' brains are being deprived of oxygen at a crucial growth phase in their life (infancy). Certain babies are probably more at risk on their backs than others. One concern I have about my son is that he snores. From what I understand, people who snore are at an increased risk of sleep apnea. On top of the fact that he seems pained and spits up on his back, I see all of the risk factors in him that lead me to believe he would be one of the babies safer on his tummy.

Back sleeping also irritates babies with reflux and sometimes even causes it. Many autistic kids also have digestive issues so perhaps that is another possible link.

Some studies have shown that autistic kids can benefit from being in a hyperbaric chamber. That would imply that extra oxygen can help their brains...

Anyway, I'm no doctor and I understand how people can be scared when they look at the raw data and listen to their doctor's advice. I'm just trying to bring to light that there is another side to this issue, and that sometimes statistical data can look one way but when further analyzed, it is not actually as simple as it appears.

I also teach at a high school (kids of all abilities) and work with a lot of kids who were born post BTS campaign and many are autistic. This is part of what makes me so passionate it. I have two autistic family members as well and I always perk up when I hear new or interesting studies done on the subject or if I see a possible link. I just never really stop looking for possibilities kwim?

Also, on the swaddling thing, I don't have AC and it really is too hot for me to be wrapping him up in blankets. I feel bad even when I have him in a light onesie. Also, if he doesn't want his arms restricted, I don't see a point in doing it to him. He did like being swaddled when he was first born, for about 3 weeks, and then he just didn't like it anymore. I think he probably knows better than I do what he wants and seems to really like to stretch out his arms and legs.

Please understand that I am NOT looking to offend anyone or start an argument. I work with plenty of kids who are extremely intelligent athletic, and on their way to prestigious universities who no doubt also slept on their backs! I appreciate any insightful comments that anyone would like to add and in no way consider myself an expert. I am a first time mom and paranoid about everything!


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## lalemma (Apr 21, 2009)

Why did you say "scientists"?


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## Masel (Apr 14, 2008)

I wonder if there is a bit of "well my kid is like this so every kid must be". Both of my girls were fine back sleeping when tiny. By the time they could roll over themselves I let them though both tended to stay on their back or side. Both were in the cosleeper or sidecared crib. My youngest is almost 10 months and she occasionally cosleeps with me.

I was especially concerned with DD1. She had a brother in her birth family who died of SIDS at 6 weeks old. Had she not been happy to sleep on her back I would not have slept at all. Her birthmom made very few requests of us but "back to sleep" was one of them.

Neither of my girls had a flat head either. I think because they spent little time in baby holding devices when awake.


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## smellyann82 (Feb 6, 2006)

i didn't read through all the responses, but we had the exact issue. dd did sleep in her swing (one of those cradle swing papasan looking things) sometimes, but what i'd do elsewhere is tightly roll a flannel baby blanket and lay her on her side with that pressed firmly against her back. that kept her from flopping on her back and she seemed to sleep fairly well on her side. at 4 months she started rolling from belly to back, and shortly after from back to belly, so then i just let her flop herself over onto her belly....


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## Gemini529 (Oct 11, 2009)

Quote:


Originally Posted by *Masel* 
I wonder if there is a bit of "well my kid is like this so every kid must be". Both of my girls were fine back sleeping when tiny. By the time they could roll over themselves I let them though both tended to stay on their back or side. Both were in the cosleeper or sidecared crib. My youngest is almost 10 months and she occasionally cosleeps with me.

I was especially concerned with DD1. She had a brother in her birth family who died of SIDS at 6 weeks old. Had she not been happy to sleep on her back I would not have slept at all. Her birthmom made very few requests of us but "back to sleep" was one of them.

Neither of my girls had a flat head either. I think because they spent little time in baby holding devices when awake.

I didn't mean to come across that way at all. The whole point of my post was that while back sleeping might save some kids who could have died, it might also be bad for other kids. My point was that all kids are different and each situation must be looked at differently.

The reason I say "scientists" is because a lot of people do their research online and pretty much anyone with a blog can make themselves seem like a well educated researcher, when they might not be. From there, information on websites tends to be contagious in a way until people start regurgitating it as fact.

And, IMO, a lot of research done by reputable scientists is extremely biased and serves only to profit large corporations. Any time I see a study, i take it with a grain of salt, especially when it comes to health recommendations.

I do not mean to offend people who work in the field of science. Sorry if I came across that way!


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## lalemma (Apr 21, 2009)

While I certainly agree that:

a) every parent must make an informed choice that's best for their family, and
b) it's good to be skeptical and not take things people tell you at face value

I'm hard-pressed to think of what kind of corporate interest could be behind SIDS researchers. The powerful sleepsack lobby?


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## sapphire_chan (May 2, 2005)

Quote:


Originally Posted by *Hannah32* 
I can see why the couch would be a problem, but why a recliner? My husband's back is blocking any cushions and he holds the baby onto his chest. Baby is upright as well, as it doesn't recline all that far. I don't really see how it's different from falling asleep in a rocking chair or a glider.

ETA: We're not putting baby to bed there, but you know how it is. You fall asleep while holding baby.

Well, my SIL wants me to help her work out a sling specifically for keeping her future next baby up on her when nursing in the recliner because she had a few scares with her ds getting wedged down between her and the recliner. Whereas with a rocking chair, it would've bonked his head and he would've screamed about it and woken her up, instead of quietly slipping down and being "fine".


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## Gemini529 (Oct 11, 2009)

Quote:


Originally Posted by *lalemma* 
While I certainly agree that:

a) every parent must make an informed choice that's best for their family, and
b) it's good to be skeptical and not take things people tell you at face value

I'm hard-pressed to think of what kind of corporate interest could be behind SIDS researchers. The powerful sleepsack lobby?









Ha, you got me there. In this case I think it's more that they wouldn't want to admit they could have 1. Been Wrong, and 2. Possibly harmed thousands of kids by jumping to conclusions. The BTS campaign itself was basically a very large scale experiment on infants, since they didn't know what the results of it would be before starting it.

I could delve into deeper conspiracy theories but I don't think this is the right website for that! I spent several years working for a large financial company before I started teaching and saw how manipulative and inhumane people can be when money is involved. I don't think the SIDS studies are money driven but I think many are, which makes me skeptical of anything put out or recommended by the AAP, etc. And then the media blows everything out of proportion to get their share of the money, too.

Masel, if I were in your situation I would no doubt put the baby on her back, since her birth mom felt so strongly about it, and as a precaution since her brother was a victim of prone sleeping SIDS.









Also, I'm sure there are babies that sleep well and soundly on their backs. I think girls in general tend to breathe better than boys on their backs and again, every baby is different.

You not using other baby "containers" as I called them earlier probably helped, too. I know several moms who used them all the time, and basically gave up on tummy time because their babies were so resistant to it. (My SIL is one of them). Her second baby developed the flat spot and went bald on the back of her head and does not crawl or walk at 12.5 months. If she were more vigilant about awake tummy time, that might not have happened.


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## AugustLia23 (Mar 18, 2004)

I put my babies on their tummies without reservation. We had term babies, breastfed 100% don't vax, don't smoke, and co-sleep at night. The risks couldn't be much lower for us. Plus like an above poster said, the back to sleep campaign felt like just another commercialism ploy.

Back to sleep did lower the risk of SIDS by 50%, but that really only means 1/1000 instead of 2/1000.


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## greenemami (Nov 1, 2007)

ds is 4months old and sleeps on his tummy. He has done this since at least 2 months old-I honestly don't remember at what point I decided to try it (isn't it funny how those first few months are a big blur, lol) He sleeps either in the cosleeper or pack and play right next to me. I was nervous about it at first, but he sleeps SO much better this way and I feel like I am very attuned to him even when I am in a deep sleep. Sometimes he sleeps in bed with me and then he sleeps on his side mostly, but sometimes on his back or tummy. He started sleeping through the night almost right after I turned him on his tummy on a regular basis.

I have to wonder if dd never slept because we always tried to keep her on her back and wish I would have tried it with her. She coslept and nursed frequently at night until about 2-1/2 years and didn't sleep through the night until closer to 3 years old.

I agree that I would never leave a tiny baby on their belly in their own room or in an unsafe environment (parent is drinking/rx drugs, etc.), but I really believe we can sleep and still be very aware of our babies.


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## Anastasiya (Jun 13, 2006)

Quote:


Originally Posted by *Hannah32* 
Gah! Just when I think I've got all the hazards figured out, something throws me for a loop. Now, I'm paranoid again.

I hate being a first time mom. Everything is so frickin' stressful.

Hubby is very aware of our baby and holds him quite close. If baby were to fall from position they are in, he would fall on the floor. That would be bad, but I make sure there's no cushion hazard for him to suffocate in.

I (accidentally) did some recliner cosleeping with our babies, and yes, there were times I woke to a scare - baby would have pushed himself down or over, and then rolled into the crook of my arm (or the chair) face first, or I'd wake to baby lying on his back in my arm, with his head hyperextended back, making it hard for him to breathe.

I'm not comfy doing it intentionally.

I think another poster's idea of a sling is a great idea, though - I've wondered myself if this would work.


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## Baby~Braatens~Mama (Apr 21, 2010)

Quote:


Originally Posted by *savithny* 
Further, if you were a Primitive Mama, sleeping with your child in a nest of leaves or on a cave floor, would your baby be sleeping on his/her belly in the traditional "Put them in the crib on their belly to sleep" position? No. If they were on their belly, it would be because they were belly-to-belly with you and you were on your back -- and sleeping in physical contact with an adult (or even in very close proximity) has been shown to help babies regulate their breathing and sleep depth/arousal.

So: I would not put a baby alone in their own bed on their stomach until they were old enough to flip themselves over (which is about when brain/nervous system development catches up and they become able to regulate their breathing even during deep sleep). And from my experience cosleeping, putting my babies tummy-down in bed with me would have been very unsafe, given our bed and bedding. Plus, they slept curled in the crook of my arm, mostly.

I don't have my baby here with me yet, but I have been following this thread closely. I really felt that if baby is more comfy on his belly then it must be natural. It never crossed my mind that it would be natural if cosleeping! You did a beautiful job with your primitive momma story! I







it! It makes so much sense to me, the way you wrote it here. Thank you!


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## RomanGoddess (Mar 16, 2006)

There's no question that baby's sleep less deeply on their back so the fact that they are less likely to forget to breathe and then die when htey are in that position makes sense.

That being said, my son would not fall asleep on his back and I didn't even think twice about putting him to bed on his tummy. He always slept in our room next to me (in a cosleeper) and I stayed nearby and checked on him during naps.

The other reason I preferred putting him on his tummy is that i have seen so many babies with completely flat heads as a result of sleeping on their backs and I wanted to avoid that happening. Sometimes the head and even face remain permanently disfigured as a result of the baby always being on his or her back.


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## Louisep (May 1, 2009)

Quote:


Originally Posted by *savithny* 
I think that babies that young are not SUPPOSED to sleep long and deeply. When they're tiny and nursing every 2 hours, it just doesn't make sense that they'd need the capacity to conk out for long stretches.

Further, if you were a Primitive Mama, sleeping with your child in a nest of leaves or on a cave floor, would your baby be sleeping on his/her belly in the traditional "Put them in the crib on their belly to sleep" position? No. If they were on their belly, it would be because they were belly-to-belly with you and you were on your back -- and sleeping in physical contact with an adult (or even in very close proximity) has been shown to help babies regulate their breathing and sleep depth/arousal.

So: I would not put a baby alone in their own bed on their stomach until they were old enough to flip themselves over (which is about when brain/nervous system development catches up and they become able to regulate their breathing even during deep sleep). And from my experience cosleeping, putting my babies tummy-down in bed with me would have been very unsafe, given our bed and bedding. Plus, they slept curled in the crook of my arm, mostly.

This. Exactly.

OP, you say that you wonder if for some children it might be better for them to sleep on their bellies. For what reason? Young babies don't need and aren't wired to have consecutive hours of sleep at a time. I can't think of a reason other than helps mama get more sleep









We were another side-lying cosleeping family with a very terrible sleeper in the first 6 months. Then I'd let him do whatever he pleased, not that it helped his sleep LOL. In fact, even at 18 months he wakes 1-4 times a night but he's ahead of the curve on physical and cognitive developmental milestones. I've personally, always aimed for cumulative hours of sleep.


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## Tom321 (Mar 1, 2008)

Regarding those who remarked about milestone delays here are some quick facts:

Since 1998 there have been several studies published which report that infants placed to sleep in the supine position lag in motor skills, social skills, and cognitive ability development when compared to infants who sleep in the prone position.(1,2) A 1998 study (2) reported that prone sleeping infants slept an average of 225.2 hours more (8.3%) in their first 6 months of life than the supine sleeping infants and had statistically significant earlier milestone acquisition for creeps, crawls, pulls to stand, rolls prone to supine, and rolls supine to prone. In addition every other milestone tested was acquired faster by prone sleepers but the results were not statistically significant.

1.Majnemer A, Barr R. Influence of supine sleep positioning on early milestone acquisition. Developmental Medicine & Child Neurology. 2005;47:370-376
2.Davis B, Moon R, Sachs H, Ottolini M. Effects of Sleep Position on Infant Motor Development. Pediatrics. 1998;102:1135-1140

Regarding what are considered the "norms" another study concluded:

"&#8230;it may be necessary to re-normalize infant developmental assessments."
(3)

3.Majnemer A, Barr R. Influence of supine sleep positioning on early milestone acquisition. Developmental Medicine & Child Neurology. 2005;47:370-376

Regarding SIDS Statistics

I compared the rate of Accidental Suffocations from 1992 to 2004 with the supine sleep rate from 1992 to 2004 and found that there was a positive correlation between accidental suffocation deaths and the supine sleep position (r=.80).(82,83) Infant suffocation rates had a 14% average annual increase between 1996 and 2004(84).

In addition, there was a 38% reduction in maternal smoking between 1990 and 2002 (85) and it should be noted that a pregnant woman who smokes is 2-6 times more likely to have an infant who dies of SIDS than a nonsmoking pregnant woman.(86,87)

A recent analysis of consecutive SIDS deaths contained the following comments of independent medical examiners who examined 5 (21%) of the 24 UK infants who were listed as having SIDS as the cause of death(88):
"Minor congenital abnormailities and VSD. Numerous fresh bruises."
"Undernourished. Numerous healing scratch abrasions."
"Bruises on face consistent with slap."
"Mother had psychiatric history. Found dead with pillow over face."
"Sibling died of "SIDS" at 6 months"

Check out the article entitle "The Case of New York" regarding SIDS Statistics by Thomas Hargrove for Scripps News Service.

Studies have also shown that changes in U.S. SIDS investigations protocols likely impact the statistical reporting and may be partly to explain for SIDS rate changes.89 In addition, a recent Editor's Note in an article regarding the SIDS "Back to Sleep" campaign stated the following(90):
"I wonder how many of the infants placed in the prone (and presumably quieting) position would have been at high risk for child abuse if left in the supine position"

82.Shapiro-Mendoza CK, Kimball M, Tomashek KM, Anderson RN, Blanding S.US Infant Mortality Trends Attributable to Accidental Suffocation and Strangulation in Bed From 1984 Through 2004: Are Rates Increasing? Pediatrics 2009;123;533-539
83.National Infant Sleep Position Household Survey. Summary Data 1999. updated: 09/04/07
84.Shapiro-Mendoza CK, Kimball M, Tomashek KM, Anderson RN, Blanding S.US Infant Mortality Trends Attributable to Accidental Suffocation and Strangulation in Bed From 1984 Through 2004: Are Rates Increasing? Pediatrics 2009;123;533-539
85.Centers for Disease Control. Smoking & Tobacco Use - Morbidity and Mortality Weekly Reports (MMWRs) - Smoking During Pregnancy - United States, 1990-2002 - October 7, 2004 / Vol. 53/ No. 39 http://www.cdc.gov/tobacco/data_stat...highlights.htm
86.Haglund B, Cnattingius S. Cigarette smoking as a risk factor for sudden infant death syndrome: a population-based study. Am J Public Health. 1990 January; 80(1): 29-32.
87.Mitchell EA, Scragg L, Clements M. Location of smoking and the sudden infant death syndrome (SIDS). Internal Medicine Journal. Vol. 25 Issue 2, p. 155-156
88.Yukawa N, Carter N, Green MA. Intra-alveolar haemorrhage in sudden infant death syndrome: a cause for concern? J Clin Pathol. 1999;52:581-587
89.Shapiro-Mendoza CK, Kimball M, Tomashek KM, Anderson RN, Blanding S.US Infant Mortality Trends Attributable to Accidental Suffocation and Strangulation in Bed From 1984 Through 2004: Are Rates Increasing? Pediatrics 2009;123;533-539
90.Ottolini MC, Davis BE, Patel K, Sachs HC, Gershon NB, Moon RY. Prone infant sleeping despite the "Back to Sleep" campaign. Arch Pediatr Adolesc Med. 1999 May;153(5):512-7
91.Fleming PJ, Gilber R, Azaz Y, Berry PJ, Rudd PT, Stewart A, Hall E. Interaction between bedding and sleeping position in the sudden infant death syndrome: a population based case-control study. Br Med J. 1990;301;85-9

Regarding the "Back to Sleep" Lobby. Many companies make lots of money when women don't co-sleep and/or breastfeed and blindly "follow the rules". These are formulary companies and they spend a lot of money giving to Back to Sleep campaigns:

This is from a letter to the AAP by Dr. Melissa Bartick of Harvard:

"The AAP's credibility is eroding already, with heavy
donations from the formula industry, selling the rights to
the AAP breastfeeding book to Ross, and now these
recommendations and the way their publication was
handled. The publication of these SIDS articles shows a
serious lack of rigorous scientific oversight. The articles,
as a whole, may be valuable, but the recommendations
drawn from them are seriously flawed."

Pediatrics 2006;117;992-993
Melissa Bartick
Infant Death Syndrome: To the Editor
Bed Sharing With Unimpaired Parents Is Not an Important Risk for Sudden

In the exact same Letter to the editor of the AAP another group of doctors questioned the safety of the pacifier recommendation:

"However, from the perspective of the field of pediatric
sleep medicine, the policy statement's laudable but narrow
focus on SIDS prevention raises a number of important
issues that need to be addressed. In particular, the
revised recommendations regarding cosleeping and pacifier
use have the potential to lead to unintended consequences
on both the sleep and the health of the infant.
The potential implications of a SIDS risk-reduction strategy
that is based on a combination of maintaining a low
arousal threshold and reducing quiet (equivalent to or
slow-wave sleep) in infants must be considered. Because
slow-wave sleep is considered the most restorative form
of sleep and is believed to have a significant role in
neurocognitive processes and learning, as well as in
growth, what might be the neurodevelopmental consequences
of chronically reducing deep sleep in the first
critical 12 months of life?"

Regarding Flat Heads. Here is a quote by Peter Fleming regarding moms and flat heads.
According to the Bristol University Website he has saved the lives of over 100,000 babies worldwide.

But Peter Fleming, the professor of infant health at Bristol University, who is an expert in cot deaths, is dismissive of the "syndrome". He is concerned that parents will start to put their babies to sleep on their fronts again. "This dramatically increases the risk that they will die by 10 times," he says. "This problem only exists in a health care system where they get paid to carry out work - so plastic surgeons will be involved.

"It is not something which is happening in the UK or Europe. In the UK babies will get slightly flatter heads from sleeping on their backs but there is no evidence it will do them any harm. It really is not a significant problem. My major concern is if people start putting babies to sleep on their side or tummy it will increase the risk they will die.

"I do not think it is a medical problem - it is more of a cosmetic one. Mothers may feel it is a syndrome and a problem when it really is nonsense."

However, he recommends that babies do not sleep in the same position every night and there is some variation in how they are placed to sleep.

According to Professor Fleming, in some Asian cultures a slightly flattened baby's head is considered to be attractive.

The Foundation for the Study of Infant Deaths is also concerned about the US report. A spokeswoman says: "This is a temporary problem which will correct itself. It would be absolutely appalling if parents stopped putting their babies to sleep on their backs. It is literally a matter of life or death.

Flat outBabies sleeping on their backs reduces the risk of cot death but may flatten their heads. Should we be worried, asks Helen Carter
Tweet this
Helen Carter The Guardian, Tuesday 8 July 2003

BTW, Peter Fleming is the same doctor who was part of the baby organ stealing inquiry in the UK although he was cleared it's quite interesting:

"The families of cot death victims were facing fresh agony last night after it emerged that hospitals kept organs from their babies' bodies.
They were used, without the families' knowledge or consent, in research by world expert Professor Peter Fleming.
The revelation has left hundreds of parents wondering whether or not they buried their baby's complete body. The scandal has just been uncovered through dogged inquiries by one mother, Sally Savage.
Mrs Savage, who became suspicious after reading about organs being taken at Alder Hey hospital in ********* and elsewhere, said last night: 'Words cannot describe how it feels to lose a child.
'But to be told their organs have been taken from them is like losing the baby all over again.'
It has now emerged that organs or tissue were taken from 88 babies who died between May 1985 and April 1989 in the Avon area.
They were used for Professor Fleming's study of Sudden Infant Death Syndrome published in 1992."

Doctor kept baby body partsby CLARE KITCHEN and JENNY HOPE, Daily Mail

Biases by Dr. Kattwinkel - the head of the U.S. SIDS Task Force since 1992:

Here are some additional quotes that show other people are also concerned about the negative effects of the Back to Sleep campaign:

"Since the implementation of the 'Back to Sleep' campaign, therapists are seeing increasing numbers of kindergarten-aged children who are unable to hold a pencil."
Susan Syron, Pediatric Physical Therapist

"There are indications of a rapidly growing population of infants who show developmental abnormalities as a result of prolonged exposure to the supine position."
Dr. Ralph Pelligra regarding the impact of the Back to Sleep Campaign

"The increasing incidence of deformational plagiocephaly is likely related to the recommendation of the American Academy of Pediatrics (AAP) and others that infants be placed to sleep on their backs."
Persing J, James H, Swanson J, Kattwinkel J, Committee on Practice and Ambulatory Medicine, Section on Plastic Surgery, Section on Neurological Surgery. Prevention and Management of Positional Skull Deformities in Infants

"With regards to the mental developmental index scores, none of the infants with deformational plagiocephaly were accelerated, 90 percent were normal, 7 percent were mildly delayed, and 3 percent were severely delayed. With regards to the psychomotor development index scores, none of infants were accelerated, 74 percent were normal, 19 percent were mildly delayed, and 7 percent were severely delayed."
Kordestani R, Patel S, Bard D, Gurwitch R, Panchal J. Neurodevelopmental delays in children with deformational plagiocephaly. Plast Reconstr Surg. 2006 Jan;117(1):207-218; Note: Plagiocephaly is also referred to as "flat head syndrome"

Sign my petition and read more here:

"More Research on SIDS and Plagiocephaly"

on Petition Spot website


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## Tom321 (Mar 1, 2008)

Here's a bit more. I don't have the Internet working at the moment so I may not be able to reply in a timely manner until I get it fixed. Sorry for writing the book. I really feel the biases by kattwinkel, Fleming, Jean Golding, Rachel Moon, etc. are fascinating. In addition the lobbying by the Formula Corporations is also quite interesting. here's some more food for thought:

"A lot of us are concerned that the rate (of SIDS) isn't decreasing significantly, but that a lot of it is just code shifting,' said John Kattwinkel, chairman of the Centers for Disease Control and Prevention's special task force on SIDS."
Scripps Howard News Service Interview
http://www.shns.com/shns/g_index2.cf...=SIDS-10-08-07

"Federal records show a dramatic decline in reported cases of SIDS, dropping from 4,895 cases in 1992 to only 2,247 in 2004, the most recent year for which complete data is available. The records reviewed by Scripps showed that cases of SIDS virtually disappeared in some states and cities over the last several years, but closer examination of the data makes it evident that thousands of those lives have not been 'saved,' but rather lost under another name. Coroners and medical examiners said SIDS was responsible for nearly 80 percent of all sudden infant deaths 15 years ago and only 55 percent in 2004. What increased during this time were diagnoses that CDC statisticians labeled as "threats to breathing" and 'other ill-defined causes of mortality.'"
Bowman and Hargrove, Scripps Howard News Service

Regarding John Kattwinkel (Chairperson of the U.S. SIDS Task force since 1992):

Many parents say they would be "devastated" if their infant died. To me that seems like it would also create an inherent bias.
Dr. John Kattwinkels infant daughter died at 3 days of age and now he's the biggest zealot advocating the SIDS Back to Sleep Campaign.
This may be noble but it undoubtedly skews and biases his perspective. He does not think so.
I personally think he should resign from the U.S. SIDS Task Force but I doubt he will.

From the Dartmouth Alumni Magazine article entitled "The Reluctant Doctor":

"He was doing his residency at Duke when he decided to specialize
in neonatology. Sadly, the impetus was the death of his infant daughter.
She had a congenital heart defect-hypoplastic left heart syndrome,
in which the left side of the heart is underdeveloped-and
died when she was just three days old. 'It was an emotional time for
me," Kattwinkel says. "Why should she be a beautiful, healthy-looking
girl and be dead two days later?'"

Later on in the article he says they chose him to be the head of the SIDS Task force in 1992 because he didn't have "an agenda." If my child died at 3 days of age I would definitely be devastated and definitely have an agenda. He's likely in denial that he doesn't have an agenda or a bias:

"'About 6,000 infant deaths a year were attributed to SIDS in the early
1990s. No one understood what caused it. But doctors had been advising
parents to have babies sleep on their stomachs so if they happened
to throw up, they'd be less likely to aspirate their vomit.
I was not involved with SIDS before,' Kattwinkel says.
'The Academy was looking for someone
who didn't have an agenda.
So they chose me.'"

To sum it up, I question the statistics reporting that the supine sleep recommendations has caused a 40% (123) reduction in the U.S. SIDS rate considering that there was a 38% reduction in maternal smoking between 1990 and 2002 (124) and infant suffocation rates had a 14% average annual increase between 1996 and 2004 (125). It should be noted that a pregnant woman who smokes is 2-6 times more likely to have an infant who dies of SIDS than a nonsmoking pregnant woman (126,127).

123.American Academy of Pediatrics: Changing Concepts of Sudden Infant Death Syndrome: Implications for Infant Sleeping Environment and Sleep Position . PEDIATRICS Vol. 105 No. 3 March 2000, pp. 650-656
124.Centers for Disease Control. Smoking & Tobacco Use - Morbidity and Mortality Weekly Reports (MMWRs) - Smoking During Pregnancy - United States, 1990-2002 - October 7, 2004 / Vol. 53/ No. 39 http://www.cdc.gov/tobacco/data_stat...highlights.htm
125.Shapiro-Mendoza CK, Kimball M, Tomashek KM, Anderson RN, Blanding S.US Infant Mortality Trends Attributable to Accidental Suffocation and Strangulation in Bed From 1984 Through 2004: Are Rates Increasing? Pediatrics 2009;123;533-539
126.Haglund B, Cnattingius S. Cigarette smoking as a risk factor for sudden infant death syndrome: a population-based study. Am J Public Health. 1990 January; 80(1): 29-32.
127.Mitchell EA, Scragg L, Clements M. Location of smoking and the sudden infant death syndrome (SIDS). Internal Medicine Journal. Vol. 25 Issue 2, p. 155-156

Here are some final facts:

Prone Sleep Physiology1:
Infant Age: 2 ½ months (n=30)
Prone+Head Cover (Common method prior to Back to Sleep campaign)
•Post sigh apnea duration, non-REM (seconds)=4.8
•Post sigh apnea duration, REM (seconds)=2.6
•Apneas 3 to 10 seconds, REM/20 minutes=6.3
•Episodes of periodic breathing, non-REM/20 minutes=0.1
•Episodes of periodic breathing, REM/20 minutes=0.2
•Heart rate (beats/min)=131.1
•Respiratory rate (breaths/min)=36.3
•Pearson Correlation Coefficient: (r)= -.611

Supine Sleep Physiology1:
Infant age: 2 ½ months (n=30)
Supine+No Head Cover (SIDS Prevention "Back to Sleep" Campaign)
•Post sigh apnea duration, non-REM (seconds)= 10.5 (119% Increase)
•Post sigh apnea duration, REM (seconds)= 7.6 (192% Increase)
•Apneas 3 to 10 seconds, REM/20 minutes= 15.1 (140% Increase)
•Episodes of periodic breathing, non-REM/20 minutes= 0.3 (200% Increase)
•Episodes of periodic breathing, REM/20 minutes= 0.7 (250% Increase)
•Heart rate (beats/min)=119.4 (9% Decrease)
•Respiratory rate (breaths/min)=27.6 (24% Decrease)
•Pearson Correlation Coefficient (r)= .702

1.Skadberg BT, Markestad T. Consequences of Getting the Head Covered During Sleep in Infancy. Pediatrics 1997;100;e6


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## quantumleap (Apr 13, 2006)

Whoa. There's a heap of info here. I've only gotten through the last page, but thought I'd share one of my professor's theories about SIDS/Back to Sleep. Apparently the apex of deaths during tummy sleeping coincided with the widespread practice of dousing crib mattresses and bedding in flame retardant chemicals. The theory my professor had was that tummy sleeping put babies that much closer to the toxic chemicals, and that the Back to Sleep campaign distanced babies just enough from the crap that death rates fell due to decreased chemical exposure/proximity.
I haven't investigated the facts that may or may not support this theory, and it was just a theory, but it does make a certain amount of sense to me.
I, too, think that many SIDS deaths from "back in the day" of tummy sleeping are more likely to have been caused by factors other than simple sleep position.
We are comfortable with tummy sleeping in our family, though dd was typically cradled in a side-lying position or in a tummy to tummy position for the first month or two. She's been a belly sleeper for a good long while though.


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## JollyGG (Oct 1, 2008)

The people who believe that the back to sleep campaign just coordinated to other changes and didn't actually help are forgetting that the back to sleep campaign is ongoing and studies are ongoing.

I know of ongoing SIDS research that is ongoing. Researchers are working with populations that have the highest SIDS rates hear and abroad (including the Native American population). As part of their research as to what could be causing the higher SIDS incidents they are also educating parents about the ways to reduce SIDS risks that we have all heard (firm surface, back to sleep, etc.) They have found that the education alone is reducing the number of SIDS cases in these high risk groups. So if the campaign back in the 70s that reduced the number of SIDS cases was coincidentally caused by something else that had similar results then that same coincidental cause is happening in modern cases where parents are being counseled about SIDS risks.

The current thinking is that SIDS is the result a failure of the serotonin brain stem "alarm" system resulting in an inability to wake up to dangerously low levels of oxygen and/or dangerously high levels of carbon dioxide during sleep. On the stomach positioning allows more re-breathing of carbon dioxide in a pocket in front of the mouth and nose. In the vast majority of children as the brain stem matures this "alarm" system part of the brain also matures which is why the highest risk period is the 1st year of life. The peak incidence of SIDS occurs during a period of major reorganization of the autonomic nervous system. Of course, all babies do not have this problem, but it is impossible to know if your child does or not therefore back to sleep is still recommended for all children.


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## RomanGoddess (Mar 16, 2006)

Quote:


Originally Posted by *JollyGG* 
The current thinking is that SIDS is the result a failure of the serotonin brain stem "alarm" system resulting in an inability to wake up to dangerously low levels of oxygen and/or dangerously high levels of carbon dioxide during sleep. On the stomach positioning allows more re-breathing of carbon dioxide in a pocket in front of the mouth and nose. In the vast majority of children as the brain stem matures this "alarm" system part of the brain also matures which is why the highest risk period is the 1st year of life. The peak incidence of SIDS occurs during a period of major reorganization of the autonomic nervous system. Of course, all babies do not have this problem, but it is impossible to know if your child does or not therefore back to sleep is still recommended for all children.

This could all be completely true and yet always putting a baby to sleep on its back might nevertheless also slow motor and cognitive skills development. The two are not mutually exclusive.

Plus there is the flat head problem, a problem that I do not believe to be insignificant. Health professionals are basically telling us that it is okay to permanently disfigure our baby's heads and faces (yes, faces - the flattening in the back of the head can cause the facial features to go asymmetrical) in order to prevent the small (tiny and possibly completely genetic anyway) risk of SIDS. That's just twisted.


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## ErinYay (Aug 21, 2008)

Quote:


Originally Posted by *Tom321* 
All that wonderful data

It is somewhat interesting (okay, a lot interesting) that room-sharing and breastfeeding are both also big SIDS "preventions," but back-to-sleep is what Americans cling to as the saving grace.


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## Gemini529 (Oct 11, 2009)

Quote:


Originally Posted by *ErinYay* 
It is somewhat interesting (okay, a lot interesting) that room-sharing and breastfeeding are both also big SIDS "preventions," but back-to-sleep is what Americans cling to as the saving grace.

Yes! Isn't it interesting that we hear soooo much about back to sleep in the news and all over the internet, but we never hear about how research has shown that breastfeeding can reduce your risk of SIDS by 50% as well. How much money do you think the formula companies pay to keep that as quiet as possible? Even on websites, "back to sleep" gets the main headline, while breastfeeding is mentioned as a side note at the bottom.

My son sleeps on his tummy right next to me. He is breastfed and he still wakes up every 1.5-3 hours to eat. The only difference is, when he sleeps on his tummy, he looks content and like he's getting good sleep in between feeds. When he's on his back, he kicks around and seems really restless the whole time, startling awake and fussing.

Perhaps a formula fed baby is more likely to just continue to sleep on their tummy because they don't wake up hungry as often and therefore remain in that deep sleep for too long during that critical 2-4 month time frame? Maybe formula fed babies would be better off on their backs but BF'd babies are ok on their tummies.

But if this is the case, would formula companies want you to know this? Especially given the info that Tom so kindly brought to light in his post about how back sleeping could be potentially dangerous. If every baby were breastfed and laid to sleep on their tummy, would that have lowered the SIDS rate by the same amount as BTS while at the same time eliminated the risks associated with back sleeping? Which corporations would have a vested interest in keeping that kind of information a secret?

Personally, I think babies were "meant" to sleep either on their tummies on their parents' chests or side facing in the parents arms. But flat on their backs with their arms flailing and the backs of their heads pushed against a firm surface doesn't look quite right to me. This is obviously my opinion.

And no, this is not about me wanting more sleep for myself! My main concern is about the quality of sleep my baby is getting.

Tom, thanks so much for weighing in on this! It is clear you have put a lot of time and effort into researching this and I appreciate you sharing what you've come up with!


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