Parents are failing to put babies to sleep on their backs

Fewer than half of US infants always sleep on their backs, the position doctors recommend to avoid sleep-related injuries and deaths, a study suggests.

Researchers examined survey data from a nationally representative sample of US mothers.

More than three in four mothers said they usually placed their infants on their backs to sleep, the survey found.

But just 44 percent of the mothers said they planned to place babies to sleep on their backs and then actually did this every time, researchers reported in Pediatrics, online today.

Less than half of the infants in the US are put to sleep on their backs consistently, a new study has revealed. This is despite doctors’ warnings to parents to always put babies to sleep in this position because it decreases their chances of dying of SIDS (file photo)

‘Intention does not always match practice,’ said study author Dr Eve Colson of the Yale School of Medicine in New Haven, Connecticut.

‘While families may intend to place infants on the back to sleep and may eventually do so, they do not always follow these recommendations,’ Dr Colson said.

In 1992, the American Academy of Pediatrics announced that babies should be placed on their backs to sleep, in order to lower their risk for Sudden Infant Death Syndrome (SIDS).

Despite a dramatic decrease in frequency, SIDS still remains a leading cause of infant mortality.

Nationwide, SIDS kills about four babies out of every 10,000 live births, down from about 130 in 10,000 in 1990, according to the CDC.

To prevent SIDS, along with putting young infants to sleep on their backs, the AAP also encourages breastfeeding, pacifier use and firm crib mattresses while advising against blankets, pillows and bed sharing.

For the new study, researchers examined survey data collected from 3,297 mothers of infants from two to six months old.

Overall, 77 percent of the women said they usually put babies to sleep on their backs, while about 14 percent said they typically put babies to sleep on their sides and roughly 8 percent routinely put babies down on their stomachs.

Mothers who were African-American or didn’t complete high school were more likely to put babies to sleep on their stomachs.

While 58 percent of the mothers said they intended to put infants down on their backs all the time, only 44 percent said they followed through each time their baby went to sleep.


In 2015 Sudden Infant Death Syndrome (SIDS) killed about 1,600 babies in the US, according to the CDC.

Among babies that are less than a year old, SIDS is the leading cause of death.

SIDS can occur for a number of reasons, including:

  • suffocation by bedding
  • overlay, which occurs if an adult rolls up against or on top of a baby while the baby is sleeping
  • strangulation, which can occur if a baby’s head gets caught between two posts on a crib
  • wedging, which occurs if a baby gets trapped between two objects such as a mattress and a wall

When doctors explained safe sleep practices, women were 40 percent less likely to report putting babies to sleep on their stomachs and 50 percent less likely to put infants to sleep on their sides, the study also found.

The study was not a controlled experiment designed to show whether or how educating women about infant sleep safety might influence how babies actually went to sleep or their odds of dying during the night.

It also did not explain why some parents did not always put babies to sleep on their backs, said Michael Gradisar, a psychology researcher at Flinders University in Adelaide, Australia, who was not involved in the study.

‘If we can get parents to explain their decision in their own words, then we can begin to understand what factors are more important in their decision making than following recommended safe sleeping practices,’ Gradisar said by email.

Still, the results underscore a need for better education, said Dr Michael Goodstein, a neonatologist for WellSpan York Hospital and a member of the AAP Task Force on SIDS.

‘We still have a lot of work to do and lives are at stake,’ Dr Goodstein, author of an accompanying editorial, said.

‘If we can’t find ways to work with families to achieve behavior change so that parents want to keep their babies supine and believe that it makes a difference then we are not going to see further gains in terms of reducing sleep-related deaths and our postnatal infant mortality rate in the US,’ Dr Goodstein added.