Study Confirms Infants Should Sleep on Back

Since 1992, the American Academy of Pediatrics has recommended that babies be placed on their backs to sleep to help reduce the risk of SIDS, a condition that claims about 3,000 infants per year in the United States. A number of studies have shown that sleeping on the back, the supine position, is safer for infants than sleeping on their stomachs, the prone position.

Based on these findings, the federal government launched the “Back to Sleep” program, a major public-health effort to educate parents and other caregivers about the importance of placing infants on their backs to sleep.

The program has been credited with reducing SIDS deaths by 38%.

While sleeping on the back is associated with a reduced risk of SIDS, some experts have questioned whether this position could slow babies’ development. To answer that question, British researchers surveyed the mothers of more than 10,000 infants.

Questionnaires were sent at regular intervals to mothers of children born between April 1, 1991, and Dec. 31, 1992. Mothers were asked about their babies’ sleeping habits and developmental milestones at 4 to 6 weeks of age, at 6 months and again at 18 months.

The study, conducted by researchers at the University of Bristol’s Institute of Child Health in England, found no long-term developmental differences related to sleeping position.

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While researchers found that infants at 6 months of age who slept on their backs had slightly weaker motor skills, social skills and overall developmental scores compared with those who slept on their stomachs, the effects had disappeared by 18 months of age.

“It is conceivable that the prone (stomach) sleeper is stimulated to move and explore because the position itself is inherently boring and the child must do something to change his/her circumstances,” Claire Dewey and her colleagues report in this month’s issue of the Pediatrics electronic pages, a medical journal on the World Wide Web. “Conversely, many non-prone sleepers have many stimulating features to watch and be distracted by so that movement is not a necessity.”

But because of the “now-certain increase in SIDS risk” with placing babies on their stomachs to sleep, Dewey and her colleagues said the brief delay in development associated with placing babies on their back to sleep is more than balanced by a reduced SIDS risk.

“There is no convincing reason therefore to change the current advice” about placing babies to sleep on their backs,” they concluded.