What to Do With a Baby Who Won’t Sleep on His Back?

Hi Amy!

I’m a mother of 2 boys (8yo and 2mo). I’m 30, falling apart physically, and just trying to do the best I can to raise my boys to be good men.

I’m at a loss about what to do about my little one’s sleeping habits. He’s not really much of a baby who enjoys sleeping on his back. My fiance insists that he sleeps so much better on his tummy and puts him that way ALL THE TIME! I try, repeatedly, to tell him that we can’t keep doing things that way…he needs to be on his back to reduce the risk of SIDS. I don’t want to wake up one morning and have a dead baby nearby. Do you have ANY tips on transitioning the baby back to his back?? I value my sleep as much as the next mom, but not at the expense of having a SIDS baby. My fiance and I take turns w/ night feedings and I really need to have some cohesiveness with his and my nights.

When I was growing up, it was ok to put the baby on their back. Even my first son didn’t sleep on his back too often…more often than not, he was on his side b/c of the reflux he was blessed w/ at birth. They don’t know what causes SIDS so fear is struck in the minds and hearts of every parent that if they put their babies on their bellies they will die. I’m guilty of the fear but at the same time, I wonder, what’s next…will the moms and dads of the future be advised to hang their children upside down to reduce the risk even further?? I’m just at a loss as to what to do. If he’s on his back, he’s literally awake every 1.5-2 hours. If he’s on his belly he will sleep through the night and seems to be pretty gosh darn happy the next day!

Although you are undeniably busy, I’m begging for some advice. I’m not a fan of going on some forum where a bunch of people are offering their opinions (which vary from highly intelligent to OMG what are you thinking, seriously?!?!) Do I know you, um, no…but upon stumbling across your work, I find myself eager to read everything you write. I can relate to some of the things you write about and the way you go about it.

Thank you for your time and (hopefully) your advice.

T

What We Know About Babies and Sleep Safety

Obviously — and I think you already know this — I absolutely 100% cannot at all tell you that letting a two-month-old sleep on his stomach is okay or safe or wink wink nudge nudge something we all do but don’t talk about.

The Back To Sleep Campaign — the huge push towards back-sleeping babies that started in the 1990s — effectively cut SIDS rates by more than 50 percent. Sudden Infant Death Syndrome is still the leading cause of death for babies between one month and one year of age, though, and while the EXACT reasons why it happens are still fuzzy (the latest research points to a genetic brain defect), the link between SIDS and stomach-sleeping is absolutely undeniable at this point. 2,000 babies still die of it every year, and many of those babies were placed on their stomachs, either by parents in communities that the campaign did not effectively reach (African American and Native American babies are close to three times more likely to die of SIDS than Caucasian babies), or by grandparents or caretakers who were simply “doing things the way they’d always done it.”

I’ve made jokes already about how many of the “expert guidelines” have changed in just the THREE YEARS in between the births of my children — from vitamins to solid food to pacifiers — and I’ve thrown up my hands in frustration over all the conflicting studies about co-sleeping, which was encouraged three years ago but has once again fallen out of official favor. (For every study that finds a link to co-sleeping and SIDS, another swears it prevents SIDS and claims that those other studies included families that made other, unrelated mistakes, including loose bedclothes, over-dressing or…letting the baby sleep on its stomach.) I fully own up to the fact that I am lecturing you about safety while admitting that we don’t necessarily follow every sleep guideline either, that a middle ground and common sense has to exist in all of this somewhere…and yet I break out in hives when I picture my teenage self casually plopping my infant babysitting charges down on their stomachs and covering them with a blanket and then walking downstairs to raid the fridge.

But. Joking aside, back- vs. stomach-sleeping is an argument that’s pretty much been put to rest (rimshot!), as you know. We all make our decisions the best way we can — we read and research and possibly compromise because lordy, we all want some damn sleep, but not (like you said) at the expense or risk of a dead baby. (In fact, while doing my research for these sleep-related questions, I found several ways to up our own sleep-safety factor.)

And at two months, your baby is at his most vulnerable. The risk of SIDS is the highest between two and four months of age. I know I’m not telling you anything you don’t already know, but reiterating the scary growly facts because your fiance needs to stop putting your son down on his stomach. None of us like being the neurotic nagging partner, but this one might need to be non-negotiable, even if you have to sacrifice your “off” feeding at night and flip the baby back over. (And do this with bare feet, which you will then shove all ice-cold against his butt back in bed.)

Help Your Baby Sleep Comfortably on His Back

You are not alone, though, with a baby who hates to sleep on his back. Neither of my boys particularly loved it either, unless they slept right next to me with their heads propped on my shoulder or upper arm. By six months, Noah could roll over in his crib and that was pretty much the end of the back sleeping, no matter how much I fretted about it. (The SIDS websites admit that once your baby is rolling over, there’s not much you can do about it — no one is expecting you to hold a vigil at the crib and flip a seven-month-old over multiple times a night. Instead, simply purge the crib of all blankets, bumpers and toys and make sure the crib sheets are tightly and properly tucked in.) But until your son is rolling over, you need a solution that will get you through the next four months or so.

One possibly solution is side-sleeping, like you did with your first son. We were told by the hospital to always keep Ezra on his back OR side, and a few of the less screechy SIDS-related organizations out there believe this is a perfectly acceptable option. A baby on his side can pull up into the all-comforting fetal position, but won’t have the problem of “re-breathing” his exhaled air or smushing his face against the mattress and not waking enough to turn his head.

Another is swaddling. And I don’t mean wrapping him up in ill-fitting square receiving blankets. I’m talking the fancy special swaddling blankets that look like little baby straitjackets, like the Miracle Blanket, the SwaddleMe or even just large muslin baby wraps. A tummy-sleeping baby likes that position because it feels safe, secure, constricted. We never had much luck with the SwaddleMe with my oldest, Noah (he was seriously strong enough to pull apart the velcro tabs), but the Miracle Blanket has indeed been miraculous this time around. Ezra will sleep and nap on his own, on his back, for many hours provided he is tightly swaddled up. At nearly 13 pounds, he’s starting to outgrow the foot pouch, but it seems to be his arms that need the binding up more anyway. (Note, however, that overheating is perhaps just as big of a SIDS risk as stomach sleeping, so there’s rarely a need for any heavy fleece blankets or anything underneath the blanket other than a onesie or t-shirt, if that.)

But look, I don’t want you to lose your mind over this, or anything. An hour and a half stretch of sleep will increase your risk of all dying in a car accident when you pass out and drive headfirst into a nail salon. So I get your frustration.

You and your partner need to get on the same page when it comes to safe choices for your baby. You certainly have the experts on your side, so don’t feel like you’re being neurotic by insisting that he respect your fears. Try to make your baby’s sleep environment as safe as you can — tightly tucked-in sheets, no loose blankets, no toys. If you can get him to sleep on his side, add a pacifier — research has found that they reduce the risk of SIDS as well. I couldn’t tell from your email if your son is in your room or not — room-sharing IS all-around recommended, and would possibly reduce some of the risk for a confirmed tummy sleeper if mom and dad are RIGHT THERE to notice any changes in his breathing and intervene if necessary.

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