Back to sleep all of the time, every time.

What are the 2 most important things to remember about safe sleep practices?

1. Healthy babies are safest when sleeping on their backs at nighttime and during naps. Side sleeping is not as safe as back sleeping and is not advised.
2. Tummy time is for babies who are awake and being watched. Your baby needs this to develop strong muscles.

Remember…Back to Sleep, Tummy to Play

How much tummy time should an infant have?

Beginning on his first day home from the hospital or in your family child care home or center, play and interact with the baby while he is awake and on the tummy 2 to 3 times each day for a short period of time (3-5 minutes), increasing the amount of time as the baby shows he enjoys the activity. A great time to do this is following a diaper change or when the baby wakes up from a nap.

Tummy time prepares babies for the time when they will be able to slide on their bellies and crawl. As babies grow older and stronger they will need more time on their tummies to build their own strength.

What if the baby does not like being on her tummy?

Some babies may not like the tummy time position at first. Place yourself or a toy in reach for her to play with. Eventually your baby will enjoy tummy time and begin to enjoy play in this position.

Doesn’t sleeping on her back cause the baby to have a flat head?

Parents and caregivers often worry about the baby developing a flat spot on the back of the head because of sleeping on the back. Though it is possible for a baby to develop a flat spot on the head, it usually rounds out as they grow older and sit up. There are ways to reduce the risk of the baby developing a flat spot:

1. Alternate which end of the crib you place the baby’s feet. This will cause her to naturally turn toward light or objects in different positions, which will lessen the pressure on one particular spot on her head.
2. When the baby is awake, vary her position. Limit time spent in freestanding swings, bouncy chairs, and car seats. These items all put added pressure on the back of the baby’s head.
3. Spend time holding the baby in your arms as well as watching her play on the floor, both on her tummy and on her back.
4. A breastfed baby would normally change breasts during feeding; if the baby is bottle fed, switch the side that she feeds on during feeding.

How can I exercise the baby while he is on his tummy?

There are lots of ways to play with the baby while he is on his tummy.

1. Place yourself or a toy just out of the baby’s reach during playtime to get him to reach for you or the toy.
2. Place toys in a circle around the baby. Reaching to different points in the circle will allow him to develop the appropriate muscles to roll over, scoot on his belly, and crawl.
3. Lie on your back and place the baby on your chest. The baby will lift his head and use his arms to try to see your face.
4. While keeping watch, have a young child play with the baby while on his tummy. Young children can get down on the floor easily. They generally have energy for playing with babies, may really enjoy their role as the “big kid,” and are likely to have fun themselves.

How do I create a safe sleep environment?

Follow these easy steps to create a safe sleep environment in your home, family child care home, or child care center:

1. Always place babies on their backs to sleep, even for short naps.
2. Place babies on a firm sleep surface that meets current safety standards. For more information about crib safety standards, visit the Consumer Product Safety Commission Web site at www.cpsc.gov.
3. Keep soft objects, loose bedding, or any objects that could increase the risk of entrapment, suffocation, or strangulation from the baby’s sleep area.
4. Make sure the baby’s head and face remain uncovered during sleep.
5. Place the baby in a smoke-free environment.
6. Do not let babies get too hot. Keep the room where babies sleep at a comfortable temperature. In general, dress babies in no more than one extra layer than you would wear. Babies may be too hot if they are sweating or if their chests feel hot. If you are worried that babies are cold, use a wearable blanket such as a sleeping sack or warm sleeper that is the right size for each baby. These are made to cover the body and not the head.
7. If you are working in a family child care home or center, create a written safe sleep policy to ensure that staff and families understand and practice back to sleep and other safe sleep practices in child care, such as those to reduce the risk of sudden infant death syndrome (SIDS) or suffocation. If you are a parent with a child in out-of-home child care, advocate for the creation of a safe sleep policy.

National SIDS Resources

Healthy Child Care America (A former program of the American Academy of Pediatrics)

Visit www.healthychildcare.org/sids.html to download a free copy of Reducing the Risk of SIDS in Child Care Speaker’s Kit, AAP policy and research articles, and more.

Caring for Our Children, National Health and Safety Performance Standards

Visit the National Resource Center for Health and Safety in Child Care and Early Education Web site at http://nrckids.org for more information.

National Institute of Child Health and Human Development Safe to Sleep Campaign

Visit http://www.nichd.nih.gov/sids

CJ First Candle

Visit www.cjfirstcandle.org

Association of SIDS and Infant Mortality Programs

www.asip1.org

Centers for Disease Control and Prevention

www.cdc.gov/sids

Disclaimer

The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

© 2017 American Academy of Pediatrics. All rights reserved.