Daniela Jovanovska-Hristovska / Getty Images
Ensuring a safe and sound sleep environment is paramount for the well-being of infants. As new parents navigate the maze of advice and recommendations, one common question arises: Can babies sleep on their sides? While it might seem like a comfortable position for a little one, experts strongly advise against it to reduce the risk of Sudden Infant Death Syndrome (SIDS).
While it's natural for parents to be concerned about their baby's comfort during sleep, the focus should always be on creating a secure sleeping environment that minimizes potential risks. If parents have concerns about their baby's sleep position or have questions about safe sleep practices, consult with a pediatric healthcare professional or a sleep expert like Alanna McGinn, founder of Good Night Sleep Site, who answered some key questions about side sleeping.
No. According to the NIH, side sleeping is not recommended because it is unstable. A baby who is placed on their side is more likely to fall onto their stomach. McGinn shares, “When parents are putting a baby down to sleep, especially from zero to four months of age, the safest position is on the baby’s back.”
Placing a baby on their side might seem like a compromise between back and stomach sleeping, but it comes with its own set of risks. Infants are more likely to roll onto their stomachs during sleep if initially placed on their sides. This increases the risk of SIDS, as the prone (stomach) sleeping position is associated with a higher likelihood of respiratory issues.
There are many reasons why babies shouldn’t sleep on their sides. Placing a baby on their side may lead to an uneven sleep surface, which could cause discomfort or strain on the baby's neck and spine. Infants are not developmentally ready to roll onto their sides intentionally, and any change in position should be allowed to happen naturally as they grow and develop the strength and motor skills to do so.
Never place a baby down to sleep on their side, especially during that crucial period between the ages of zero to four months. “We don't want to have any obstacles in terms of baby's breath or baby's breathing,” McGinn says. “For instance, looking at things like impaired breathing, if the baby’s sleeping on their side, they could easily roll on their stomachs where they don't have the mobility yet to roll onto their back or their side which could mean that there's a block of airway.”
Another consideration is rebreathing which can happen when a baby rolls on their stomach and can’t roll back on their side or back. “The baby is breathing in the air they've already breathed out,” McGinn explains. “This can cause a decline in oxygen levels and increase carbon dioxide [resulting] in babies not being able to wake themselves up.”
It is not recommended to place a baby on their side in a swaddle. According to McGinn, “The swaddle doesn’t allow their arms to help them into a better position if they do roll on their stomach. If a baby is swaddled, especially if their arms are constricted, the baby should always be placed on their back and not their side.”
Once your baby starts regularly rolling over, you should stop swaddling them to leave the baby's arms free. If your baby is still sleeping in a bassinet by four months of age, transferring them over to a crib is safest.
The American Academy of Pediatrics (AAP) recommends the "Back to Sleep" campaign, encouraging parents to place their babies on their backs to sleep. This practice has proven to be a crucial factor in reducing the incidence of SIDS since its introduction in the early 1990s. The back sleeping position allows for optimal airflow and minimizes the chances of airway obstruction.
“The safest sleep environment for babies is following the ABCs of Safe Sleep that follows the safe sleep recommendations of the American Academy of Pediatrics and the Canadian Pediatric Society,” McGinn explains. “And that's having babies sleep alone, on their back and in their cribs.”
It’s also important to keep the crib free of soft bedding, toys and loose items and ensure the mattress is firm. This reduces the risk of suffocation and allows for proper air circulation.
Place the baby on their back initially and monitor their sleep closely. If your baby continues to roll onto their side during sleep, consult your pediatrician or a sleep expert for personalized advice. It's essential to prioritize safe sleep practices and create a conducive sleep environment, even as you work towards aligning with the recommended back sleeping position.
To provide the safest sleep environment for your baby, avoid using props or other items in the crib. “We still want to avoid putting things in like positioners or rolled-up blankets that are going to keep babies safely on their side,” says McGinn. “We want the crib clear.”
If your baby consistently prefers sleeping on their side, it's understandable that as a parent, you may be concerned about their comfort and sleep habits. However, it's crucial to prioritize safety by gently and gradually transitioning them to the recommended back sleeping position. “If your baby’s at an age where they are unable to roll back and forth from their back to their front on their own and they roll on their sides, it’s okay for parents to lightly place the baby back on their back,” suggests McGinn.
“As they're getting closer to four months of age, babies are going to start rolling naturally from back to front and front to back. Encourage the baby to have tummy time throughout the day when they’re awake. Don't necessarily swoop in as soon as the baby rolls on their tummy,” McGinn advises.
Keep up with your baby's development, get the latest parenting content and receive special offers from our partners