The mortality rate from SIDS (Sudden Infant Death Syndrome) has decreased since the 1992 revision of the AAP (American Academy of Pediatrics) policy statement on the prevention of SIDS. In that statement, the recommendation was to place all infants under a year to sleep on their backs rather than on their bellies or on their sides. Historically, the prone sleeping position has been associated with SIDS at a much higher rate than the back or side position. In the policy statement revisions since 1992, the side position has been eliminated as a safe sleeping position for infants due to the cases where an infant has turned prone from their side in some cases of SIDS.
There are many contributing factors considered in evaluating the unknown cause of SIDS including a difference in the brain chemistry of SIDS infants on autopsy and a higher incidence of SIDS in preterm infants. The incidence of SIDS drops after the first six months of life, but remains a concern for the first year of life. Since it is not know which infants are at risk, and with the risk of suffocation due to soft bedding, blankets, and especially, sleeping with a parent or sibling on the bed or couch, also considered contributing factors to SIDS, all infants are considered at risk. Excellent information supporting a back to sleep position for all infants at all times for the first year, can be found on the AAP website at the address noted below.
However, all that back sleeping has a consequence. Mothers frequently tell me they cannot get their infants comfortable on their bellies when the infants are awake. Lack of belly time interferes with the baby’s motor development.
Time spent lying on their bellies is an important step in babies’ development of the muscles of their spine and torso. A baby develops the ability to pick up his head from being on his belly.
Lifting her head while prone develops the baby’s muscles along her spine and leads to her being able to sit and balance.
A baby moving while his belly is against a surface stimulates the nerves and muscles along the front of his body and this stimulation leads to the integration of the right and left sides of his brain and body and the baby moves forward to creeping and crawling.
If a baby is carried constantly by the mother throughout her day as in a sling, the baby will get the same stimulation, but even better, since the surface against his body is also moving. This will lead to good coordination in the baby. But the baby’s belly must be against the mother’s body as well as carried in a front sling to get the much needed stimulation along the front of his body. A firm padded surface such as a carpeted floor is a good substitute. However, the baby will look for the mother’s face when the baby is on her belly, to have as lively an interaction as she would have if she were on her back or held upright. As she learns to be easily on her belly, she will develop head balance there and will be content with playing with her toys while prone. For an excellent video on the baby’s development in the first year see resource page.