Back to Sleep & Tummy Time

How should my baby sleep? The simple answer is on their back. Since 1994, the “Back to Sleep” national campaign to Reduce the Risk of Sudden Infant Death Syndrome, has dramatically decreased the number of infant deaths due to SIDS. In Illinois alone, the SIDS rate has dropped 68% since 1993! In keeping with this important downward trend, we are recommending “Back to Sleep – Tummy to Play” as a way to reduce the incidence of positional head molding and acquired torticollis or “wry neck”. The following are a list of guidelines that promote the “Back to Sleep – Tummy to Play” effort.

Tummy time, tummy time, tummy time!

This is very important for any baby. Many babies don’t like this position at first, but you can encourage your baby, by joining him or her, on the floor, for play time. Remember, babies only need to be on their back when sleeping! When awake, we need to hold them and play with them and love them.

  • Parents should give their infants supervised tummy time – even during the newborn period.
  • “Tummy Time” can include short periods of time throughout the infant’s waking time.
  • The parent should make this fun time by providing toys or even better, the parents’ presence as a distraction for the infant. Get down on the floor and play with your baby!
  • Infants often tolerate tummy time more easily in a slightly upright, slanted position.
  • Parents should honor their baby’s cries, but continue to provide tummy time. If the baby is really upset, try short periods, several times every day.
  • Infants that are not yet rolling over, can be supported in the tummy position by a towel roll placed under the baby’s arms. Make sure to remove the towel and put baby on his/her back if they fall asleep.
  • When baby is sleeping, parents should be encouraged to move the position of the baby’s head; one time facing right, the next time facing left. Also, restrict the use of the infant carrier. Babies need to be held in your arms to help strengthen their upper body muscles.

How should my baby sleep?

  1. Always place your baby on his or her back to sleep, for naps and at night. The back sleep position is the safest, and every sleep time counts.
  2. Place your baby on a firm sleep surface, such as on a safety-approved crib mattress, covered by a fitted sheet. Never place your baby to sleep on pillows, quilts, sheepskins, or other soft surfaces.
  3. Keep soft objects, toys, and loose bedding out of your baby’s sleep area. Don’t use pillows, blankets, quilts, sheepskins, and pillow-like crib bumpers in your baby’s sleep area, and keep any other items away from your baby’s face.
  4. Do not allow smoking around your baby. Don’t smoke before or after the birth of your baby, and don’t let others smoke around your baby.
  5. Keep your baby’s sleep area close to, but separate from, where you and others sleep. Your baby should not sleep in a bed or on a couch or armchair with adults or other children, but he or she can sleep in the same room as you. If you bring the baby into bed with you to breastfeed, put him or her back in a separate sleep area, such as a bassinet, crib, cradle, or a bedside cosleeper (infant bed that attaches to an adult bed) when finished.
  6. Think about using a clean, dry pacifier when placing the infant down to sleep, but don’t force the baby to take it. (If you are breastfeeding your baby, wait until your child is 1 month old or is used to breastfeeding before using a pacifier.)
  7. Do not let your baby overheat during sleep. Dress your baby in light sleep clothing, and keep the room at a temperature that is comfortable for an adult.
  8. Avoid products that claim to reduce the risk of SIDS because most have not been tested for effectiveness or safety.
  9. Do not use home monitors to reduce the risk of SIDS. If you have questions about using monitors for other conditions talk to your healthcare provider.
  10. Reduce the chance that flat spots will develop on your baby’s head: provide “Tummy Time” when your baby is awake and someone is watching; change the direction that your baby lies in the crib from one week to the next, and avoid too much time in car seats, carriers, and bouncers.

Babies sleep safest on their backs.

One of the easiest ways to lower your baby’s risk of SIDS is to put him or her on the back to sleep, for naps and at night. Health care providers used to think that babies should sleep on their stomachs, but research now shows that babies are less likely to die of SIDS when they sleep on their backs. Placing your baby on his or her back to sleep is the number one way to reduce the risk of SIDS. Learn more about stocking your nursery and crib here.

But won’t my baby choke if he or she sleeps on his or her back?

No. Healthy babies automatically swallow or cough up fluids. There has been no increase in choking or other problems for babies who sleep on their backs. Spread the word! Make sure everyone who cares for your baby knows the Safe Sleep Top 10! Tell grandparents, babysitters, childcare providers, and other caregivers to always place your baby on his or her back to sleep to reduce the risk of SIDS. Babies who usually sleep on their backs but who are then placed on their stomachs, even for a nap, are at very high risk for SIDS—so every sleep time counts!

For more information on sleep position for babies & reducing the risk of SIDS, contact the Back to Sleep campaign at: