Should infants sleep on their back or tummy?
A simple piece of advice in 1992 cut the death rate from sudden
infant death syndrome (SIDS) by more than half. That was the year the American Academy
of Pediatrics (AAP) told parents to put babies to sleep on their backs.
"Now, the experts have some new advice to reduce the odds of flattened heads, a
possible result of babies spending so much time on their backs.
No one's sure how common flat heads are. Statistics vary a great deal, "from one
in five cases for a mild form to one in 500 to 600 cases," says AAP spokesman John
Persing, M.D., a professor and chief of plastic surgery at Yale University School
of Medicine. But doctors have seen a "significant increase" in flat heads in the
past decade, says a 2003 article Dr. Persing wrote in Pediatrics.
"It's very important for infants to get some tummy time when they are awake and
supervised," says John Kattwinkel, M.D., chairman of the AAP Task Force on SIDS
and a pediatrics professor at the University of Virginia School of Medicine.
To avoid a flat head, Drs. Persing and Kattwinkel offer these tips:
• Parents should still place babies on their backs for sleep.
• When babies are awake, put them on their tummies for a while. This eases pressure
on the back of the head and helps babies build shoulder and neck strength. "This
time must be supervised, 100 percent of the time," Dr. Persing says. "Don't even
run to the bathroom and leave an infant on the tummy."
• Relieve pressure on the back of the head when you lay an infant down for sleep
"by very gently turning their head 45 degrees to the left one night, then 45 degrees
to the right the next night," says Dr. Persing.
• Change the crib's position a few times a week. As your child looks around the
room, the head will be in a new position because of that change.
• Don't overuse car seats when the child is not in a car. When in a car, move the
car seat often from one side to the other.
• If your child develops a flat spot on the head, see your doctor. Such flat spots
usually form on the back or side of the head.