Dear Mr. Dad: Our baby boy was born just a month ago and, although we were told at the hospital to put him down to sleep on his back, my wife says that it's safer for him on his tummy because it will keep him from choking. Who's right? Please help.
A: You are. In their first year, babies should go to sleep on their back, period.
In 1994, after looking at a huge amount of research on sudden infant death syndrome (SIDS) that identified tummy sleeping as a major risk factor, the government (along with the American Academy of Pediatrics) launched the "Back to Sleep" campaign. The SIDS rate immediately dropped by more than 50 percent. I remember exactly when this happened, because my two older kids were born in 1990 and '93 and I felt fortunate that they survived.
Sadly, your wife is far from alone in wanting to put your baby to sleep on his tummy. A recent study published in the journal Pediatrics found that while 77 percent of mothers "usually" put their babies on their back to sleep, only about 47 percent said that they "always" do. African-American moms and those who didn't finish high school were the most likely to put their babies face down. I'm puzzled (okay, actually offended) that this study completely excluded fathers.
Why are more than half of moms making precisely the wrong decision when it comes to putting their baby down to sleep? According to the study, those moms thought that their babies would be more comfortable and/or that they'd be less likely to choke. One particularly disturbing piece of information from the study is that among the biggest predictors of whether babies are put to sleep on their back is the healthcare provider's recommendation. Based on the data, one can assume that only about half of pediatricians and providers are recommending back sleeping, and the other half are either not saying anything at all or are making the wrong recommendation. That's pretty scary, considering how much weight providers' recommendations carry and the undeniable safety benefit to babies of back sleeping.
So, what can you do to reduce your baby's SIDS risk?
--As we've discussed, until your baby's first birthday, always put him to sleep on his back. This is especially true for naps. According to the Centers for Disease Control and Prevention (CDC), babies who are used to sleeping on their back but are then switched to tummy sleeping have an especially high risk of becoming victims of SIDS. Side sleeping isn't much better, since it's easy for babies to fall over face down.
--Your baby should sleep on a firm, flat surface. Aside from a fitted sheet, there should be nothing else in the crib. Toys, blankets, comforters, and stuffed animals are all potential smothering hazards. Sleeping in a crib or bassinet in your room may cut the risk of SIDS by 50 percent.
--Your wife should breastfeed (or feed the baby with pumped milk) for at least six months.
--Don't smoke -- and don't let anyone else do it either -- around your baby. Exposure to smoke is a major SIDS risk factor.
--Supervised "tummy time" (having your baby on his tummy) is okay only when your baby is awake. This will give your baby a great opportunity to strengthen his neck and upper body muscles.
--If your baby likes a pacifier, give him one at night or for naps. This has been shown to reduce SIDS. If the pacifier falls out, there's no need to put it back.
(Read Armin Brott's blog at www.DadSoup.com, follow him on Twitter, @mrdad, or send email to email@example.com.)
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