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When is It Safe for Baby to Sleep on His Tummy or Side?

Legs of a sleeping baby on his abdomen in his crib. Infant's feet.

by Kailee Noland, PT, DPT

Pediatric Physical Therapist

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The first time I read an article like this, it was the middle of the night. My first baby girl had just rolled to her tummy in her sleep for the first time. I panicked like never before (okay, probably like 2 hours before, but #firsttimemomproblems). We had worked hard to establish good sleep habits, and I didn’t want to go in and flip her over, but I also stared at the monitor all night to be sure she was still breathing, quickly scanning every internet resource I could find on whether or not she was safe to sleep on her belly. Maybe you’re there, too. Or maybe your baby has… Read More

The first time I read an article like this, it was the middle of the night. My first baby girl had just rolled to her tummy in her sleep for the first time. I panicked like never before (okay, probably like 2 hours before, but #firsttimemomproblems). We had worked hard to establish good sleep habits, and I didn’t want to go in and flip her over, but I also stared at the monitor all night to be sure she was still breathing, quickly scanning every internet resource I could find on whether or not she was safe to sleep on her belly.

Maybe you’re there, too. Or maybe your baby has started to roll during playtime, and you know it’s only a matter of time before it happens at night. Or perhaps you’re desperate for better sleep and hoping for reassurance that tummy sleeping is okay.

A Word of Caution

Before we get into all the details, I need to tell you something. My advice is just that: advice. While I am a Doctor of Physical Therapy and have been through this whole mom thing twice now, I am in no way offering medical advice. I urge you always to consult your pediatrician and check in with your “mom gut” before making any decision regarding your baby.

Let’s also clear up something else while we’re at it. You should always, always put your baby on their back to sleep—bottom line. No exceptions. Research shows this is one of the best ways to prevent SIDS (Sudden Infant Death Syndrome) and is a simple routine for safer sleep. Your baby should also be placed on a flat, firm surface free of loose items like stuffed animals, bumpers, or blankets.

It’s Okay When They Start to Roll Themselves

So now you’re still wondering: when is it safe for my baby to sleep on their tummy?! Okay, okay, I’m getting there. In short, when they can roll there themselves.

According to the National Institute of Child Health and Human Development, studies show that if your baby rolls themselves to their tummy during sleep, you do not have to go back in and roll them over. At this point, they are strong enough musculoskeletally and neurologically to protect their airway during sleep adequately. Some doctors also suggest that your baby should be able to roll from tummy to back consistently before allowing belly down sleeping. Again, consult your pediatrician before making any decision for your baby.

But There’s an Exception

The caveat to this rule is if you are still swaddling your baby. When you see early signs of rolling back to belly, such as rolling to their side, it is safest to begin the process of transitioning out of the swaddle. Trust me, you don’t want that whole hot mess that happens if you have to ditch the swaddle and deal with middle-of-the-night rolls all at once. I recommend the Love to Dream Swaddle Up Transition Bag. It continues to decrease the effects of the startle reflex while also allowing for ditching the swaddle one arm at a time. I find that baby’s hands being near their face and mouth in this swaddle are also soothing to them and helps ease this big transition.

If your baby is rolling to their belly but not yet from tummy to back, consider using the Merlin’s Magic Sleep Suit. It will encourage safe back sleeping while you continue to work on rolling tummy to back during playtime.

Tummy Time is Always Good for Play

While you shouldn’t put your baby on their tummy to SLEEP, always remember that it is crucial to their development to put them on their tummy to PLAY. With the dawn of the Back to Sleep campaign in 1994 came a rise in developmental delay due to parents fearing the tummy down position. As long as your baby is awake and supervised, tummy time play is not only okay, but it is vital to them cruising through their motor milestones with ease.

So whether you’re here to be prepared or low key middle-of-the-night panicked, I’m giving you a virtual hug around the neck. You got this!

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