Thursday, May 22, 2008

Infant Sleep Positions

Has anyone figured out the true scoop on infant sleep positions? Of course tummy sleeping is out because of the SIDS risk, although it's crazy that our parents were told to sleep babies on their tummies. Is cosleeping safer or more dangerous than putting a baby to sleep alone? Different parenting philosophies differ here on what seems to be a factual question. And is side sleeping really more dangerous than back sleeping?

With all three of my newborns, I've felt like back sleeping was torture for the baby... they continually wake themselves with that falling/grabbing reflex and sleep hopelessly lightly. So I often side sleep them with sleep positioners. But then I freak out and resolve never to do it again when they manage to roll to their tummies from their sides accidentally. Angelina, my 3 week old, has done this already just by kicking her legs.

We also cosleep some in the beginning if it helps everyone get more sleep.

Is this totally unorthodox? Do you back sleep your babies and not think twice about it? If so, how do you keep them comfortable on their backs?


Right Said Red said...

Augustine sleeps on his tummy. I started putting him on his tummy when he was 4 weeks old, and I did it on the advice of my doctor--gasp!!! My doctor thinks that generally the back or side is safest, he didn't think the back was any better or safer than the side position (the position I used for my first two), but he felt that Augustine was an extremely sensitive baby, a bad sleeper generally, and he had some reflux/gas issues. Augustine was waking every hour, and putting him on is tummy did help. It does still make me a little nervous, but my doctor said the increased risk of SIDS was pretty minimal, especially considering that Augustine was a very large/strong baby, and had no other health issues or SIDS risk factors.

Once a child can roll over, you can put them to sleep on their tummy w/o the increased SIDS risk--so I've read.

But that newborn period is difficult...

I'm wondering if the studies encouraging back/side sleeping controlled for other SIDS risk factors like forumala feeding/having a smoker in the house/prematurity/other lung or health issues?

Mary Alice said...

I am a big fan of swaddling. I realized recently that Lion, at 5 months, is having trouble napping, so today I tried swaddling him again, we hadn't done it in about a month, but he was so happy to be all wrapped up and he took a nice, two hour nap this afternoon.

I have always had my kids sleep exclusively on their backs, and really it has not caused any problems for their sleep. I do notice that my older toddlers all sleep on the side, so perhaps that is most natural or comfortable?

texas mommy said...

I second Mary Alice's comment about swaddling. We are very hardcore about swaddling for ~4 months. We used two standard square blankets or a blanket and a SwaddleMe ( over it. And even after that, I would use a swaddling blanket like the "SwaddleMe" with the arms if necessary. Our first was (is!) a spirited boy and this was the only thing that would calm him.

Swaddling meant no flailing limbs even when our boys were on their backs. I could tell a huge difference in the lightness of sleep if they fell asleep in the car seat and I moved them to our cosleeper without swaddling. They had a much greater tendency to wake up after each 45 minutes sleep cycle.

I was too anxious to cosleep with baby in bed as I worried about rolling over on baby so much that I would wake up sweating, pull the sheets back and turn on the lights, even after we moved Dash out of our room! But I loved having the Arm's Reach co sleeper with Jack-Jack. He was literally inches away, but I could sleep without panick. (our pack'n'play wouldn't really fit in our bedroom by the bed).

Erin said...

Love the questions you guys bring up and many of them we are going through right now and mommy's always like to hear what others have found that works. I have two girls, 24 months and 6 months. With Angelica (my oldest) the doctor and everyone told me so much about the SIDS risk I was terrified to have her sleep any other way than her back.....but she hated it!! Finally I used that SwaddleME wrap and she loved it...slept thru the night like a little mummy in a hard sided cosleeper in our bed becuase I was also afraid to roll over on her. However, she could only sleep swaddled like we ended up getting every size of those wraps until seh couldn't possibly fit into them anymore. My husband kept joking that we were going to have to make them and velcro her to sleep until she was a teenager. After a rough transition, she finally learned to go to bed...but she ended up on her tummy!! I think there is intersting research that isn't completely conclusive of the tummy and SIDS risk....especially considering all the other things to look at...the smoking etc. I also think there is interesting research (althought you won't hear it from docs or SIDS) about the vaccines schedules and the highest rates of when "SIDS" occurs. With my second, I stopped freaking out about the tummy sleep....poeple have done it for ages....Emma only wanted to sleep on her tummy....has since she was born and almost puts herself to sleep!! Such a big difference for us...and I just kept a bassinet in the room this time so we didn't worry about the co-sleeping except of course for all those middle ofthe night feedings and cuddle times where we fall asleep anyways!!

Gail said...

My third child is 8 weeks old now, and I was determined to have her sleep in the basinett next to my bed when we brought her home. That lasted, oh, about 4 hours the first night. After that I realized she just needed to fall asleep nursing lying down on her side next to me and not be moved after that. So she slept in bed with me for the first several weeks (my husband slept in the "baby's" room so we didn't have to worry about him rolling onto her). I periodically tried her in the basinett and it didn't work for us until she was about 5 weeks old. We also use the swaddleme and love it, and she sleeps on her back in the crib in her own room now. She's up to 7 and a half hours in one stretch! I'm very excited about this.

Katherine said...

I'm still trying to master the mystery of infant sleep. I figure by the 12th child or so I should have figured it all out and I tell everyone I will figure it out even if it does take me a dozen kids to get it. LOL

With my first DD, sleep was a nightmare. Period. It was either all night all-you-can-eat Mommy bar in mommy bed or crying.
With second DD, we coslept first couple of months, then gradually transitioned her to crib. The clincher: She will only sleep on her stomach. I figured this out after having her scream at me for an hour and then, deciding to give her a break and have some "tummy time" she simply lay down and slept. She is still the same. Only on her tummy. We had swaddled the first couple of months until she began kicking out of it every 5 seconds. The SIDS thing did worry me. Fortunately when we transitioned her, she was already getting good at rolling over and now is an expert and sits up (she is 6 months) on her own too, so it really doesn't worry me a whole lot anymore. I'm building a library of baby sleep books to read through my next pregnancy to try to solve the baby sleep mystery by the next one. :::sigh::: Why is it so complicated? Surely God didn't make something as basic and necessary as sleep so difficult?

Anonymous said...

After reading about the links between the flame-retardant, and other, chemicals used in manufacturing mattresses, I purchased organic latex mattresses for everyone, and replaced our Eddie Bauer crib mattress with an organic version. The research about off-gassing and the chemicals surrounding the baby was very compelling. I felt much more comfortable with infant belly-sleeping with these mattresses.

I did cosleep with all of my kids for a while - I really think this is a total preference for what gets you the most sleep. For me, not having to get up and check to make sure they were still breathing, and not having to leave the warm bed in winter (when all of my kids were born), was great.

Good luck to all mommies still struggling to get enough sleep! I have only recently left this club!

Mary Alice said...

Anon, thanks for bringing up the flame retardant link, I was going to mention that, but I am getting a reputation as a tree-hugger. Also, I did not know about this before I purchased mattresses and must admit that I am now too cheap to upgrade to organic.

Since we have strayed from the topic of sleep positions to sleep generally,

This is a huge issue for me, as for many parents, but I will try to hit just a few thoughts:

I want to share one thing that has been really helpful for me, and I agree that you should do whatever gets you the most sleep -- for us, co-sleeping was not the answer, in part because I am not good at the lie-down side nurse with a newborn, so I have to sit up anyway, and also because neither of us sleep well with a baby in the bed.

I have never used a co-sleeper, but they seem like a great option.

What we did with the twins and all subsequent, as suggested by our granola post partum doula, is that the crib is in our room. When baby wakes, DAD gets up, gets baby, changes diaper, brings baby to mom. After feeding, DAD returns baby to crib! Usually, I have to wake him to do this, because he is a heavy sleeper, but he is also a better sleeper than I am, I have lots of sleep issues, so he falls back to sleep quickly and easily. He even sleeps in between while I feed for a half hour.

There are two reasons this really helps -- first, I don't feel so alone and tortured, and secondly there is really something draining about that small act of getting out of bed, so I do think it saves me some energy. Also, nursing makes me sleepy so it is best if I can go straight back to sleep post-feeding and not get out of bed and lose that sleepy feeling.

Now that I think of it, my newborns always need a nighttime diaper change with feeding, so I am not sure that a co-sleeper would make life that much easier.

I know that some women don't want to make the dad wake at night because he has to go to work, and I respect this, but I also have to "work" when he leaves. We are respectful of preserving each other's sanity with sleep, so if he is wiped out and I have the energy I can get up myself, but I never feel guilt about asking him. Now that baby is not waking regularily at night I am more likely to put him back to bed myself after a feeding.

I think that the good and sensitive baby books will mention (the LLL does) that sleep deprivation for parents is a serious issue. You can have mood disorders and even become abusive or suicidal if you happen to be one of the many who respond poorly to lost sleep. Mothers and Fathers both need to look at this seriously and sneak in sleep where you can -- go to bed early if you are going to be up at night, nap when your kids nap, hire a sitter just to nap (I have done this!!). I know I sound alarmist, but I think that this is an issue that gets swept under the carpet. While your baby is waking at night, there will be some rough days, but if it gets worse instead of better, be honest with your family about your sleep needs and take care of yourself!

Bethany said...

All of my children slept on their backs until they could roll over. Which was different ages for all of them; my middle one rolled over 1 week after he was born.

The thing to remember about tummy sleeping and SIDS is that the way their sleeping (on their tummy) is not one of the things that causes SIDS. The AAP and most doctors believe that SIDS is caused by an infants' immature brain development resulting in the inability to wake themselves from deep sleep if they begin to overheat or if a respiratory problem arises. Because infants, children, and most adults tend to sleep more soundly/deeply on their stomachs, putting an infant with this immature development on their tummy to sleep increases the likelihood that they will not be able to wake themselves if there is a problem. Once an infant is able to roll over, their brain is considered to have overcome the immaturity and are no longer at an increase risk for SIDS. That is not to say that they couldn't still become overheated and fall risk to SIDS complications.

Always discuss sleeping arrangements with your pediatrician but for some infants and in some situations, tummy sleeping can be beneficial.

Rachel said...

My husband and I were so scared with all the talk about SIDS, we were very strict about only putting our baby to sleep on his back. That being said, the SwaddleMe wrap totally changed our lives and now it is our signature baby gift for first-time parents. As soon as we started using it, Tanner began sleeping 6 hours or more at night. We used this all the way up until he grew out of the largest size -- almost 7 months.

We intended to have Tanner sleep in our bedroom for his first few weeks of life, but changed our mind within the first 2 days of bringing him home. Neither of us was getting any sleep since we BOTH woke up every time he made even the slightest noise. We decided to just put him in his crib in his own room, and that worked well for us. I have to say, if you can afford a video monitor, it is completely worth it and saves you from getting out of bed if you don't have to. If you turn the volume up all the way, you can even hear them breathing! It is just SUCH a great investment, I can't say enough good things about it. It especially came in handy once we started letting Tanner cry himself to sleep. We were able to see that he was safe, just angry!

Kat said...

Bethany, your comment was extremely helpful in explaining the tummy sleeping/SIDS link, thank you so much for clearing up the confusion that surrounds this topic! I had never heard it spelled out that way, but it makes a lot of sense and I really appreciate it! Argh, there are so many things to worry about as a parent! Rachel, I also appreciate the remark about the video monitor...I've been wanting to get one but haven't because of the cost, but now I'm seriously considering it again. In the process of having Maria "cry it out," there have been a couple of times when I have come into the room and her leg is caught in the crib slats, or she's under a blanket, or just in a really strange position - those are the times that you wish you had the video monitor! I know I shouldn't let her sleep with a blanket, but it's so darn cold here in Chicago that I don't know what else to do. We have her in a blanket sleeper, but she still gets very cold at night if she doesn't have a blanket...Now I also wish that I had gotten the Swaddle Me blanket :) Next time around :)

God bless to all of you wonderful mothers, just keep doing what you're doing!

Juris Mater said...

SOOO helpful, ladies. Thank you! I'm already more relaxed about infant sleep positions and ready to buy stock in the company that makes this SwaddleME product. I see they sell them at Target... Target outing tomorrow morning, I think? Sleeping through the night for only $10.99! All thanks be to God, I just gave birth to the most angelic baby ever to grace this earth (hence her blog name Angelina), and we're getting enough sleep. But I'll be delighted to see her extra-comfortable in her little SwaddleMe.

Katherine, PLEASE send us a guest post when you solve the mystery of infant sleep after child 12! : )

MaryAlice, I'm your soulmate in terms of insomnia and (in)sanity. Thanks as always for the advice in this area.

Bethany, thanks for the GREAT explanation.

B-Mama said...

Girls, I am taking copious mental notes in preparation for our third. We've always had pretty smooth transitions into good sleep patterns (I think genetics plays a HUGE role here--I admit to being a very DEEP sleeper and slept through the night at 2 weeks--my mom was a lucky lady). In any event, you can never predict how "good" a sleeper your little one will be... Great to know there are tricks to the trade out there.

Juris Mater, we'll be joining you at Target very soon.

B-Mama said...

Oh and I forgot to mention that our biggest problem with back sleep is that the boys' heads flatten! They must have especially soft skulls. To help remedy this problem, we've had good luck with baby sleep positioners to help prop them more on their sides and give them softer surfaces on which to sleep.

Joanne said...

I can't bear the thought of any added risk of SIDS, so I always put them to sleep on their back until they're one. I was really scared of SIDS with my first, since he was really big and a boy, and those two things made him more likely to be a SIDS victim. Of course, by five or six months they are rolling over anyway, but at least they start on their back. I am a big believer in the swaddle, I LOVE the Amazing Miracle Blanket and I seriously don't think I could have gotten through my son's first year without it. I also used to roll up a receiving blanket and put it on either side of him, after he was swaddled.

Cranberry said...

I am a big fan of swaddling and also use a little wedge thing that keeps the little one propped on their side without fear of rolling onto their tummies. We are currently at 4 mo and starting to wean from the swaddle, just leaving one hand out, but we still put him on his side and use the wedge thingy. I always put on his side as he's always been a big spitter upper, so I don't have to worry about him choking in the middle of sleeping.