Which position should my baby sleep in?

Is there anything that new parents discuss more than sleep? Is your baby sleeping through night yet? How often are you up to feed? Are you sleeping when the baby’s sleeping? We seem to all be chasing the elusive ‘perfect sleep’ scenario. Whilst no two babies are the same, and the experiences of one family to the next cannot be fairly compared, there are some common practices and guidelines around sleep that professionals recommend adhering to. These practices don’t guarantee a good night’s sleep (unfortunately!), but they do promote sleep safety, which is the most important thing to consider.

The current guidelines recommend that babies are placed on their back to sleep at all times. This may be in an age-appropriate sleeping bag, or with blankets tucked firmly into a cot or bassinet, with the baby placed with their feet at the bottom of the cot so they can’t wriggle down under the covers. In the past, many babies were placed on their side or even on their stomach to sleep, but this has gone out of practice because the risk of SIDS (Sudden Infant Death Syndrome) and SUDI (Sudden Unexpected Death in Infancy) has been found to increase in these sleeping positions.

Further to this, it is not recommended that babies share a bed with their parents, no matter how easy and comfortable this may feel. The risk of babies suffocating alongside their parents, being rolled on, or rolling under pillows or blankets is simply too high. Instead, it is suggested that babies sleep in an appropriate bassinet or cot beside the parent bed. Research has shown that sleeping in the same room, but not the same bed as their parents for the first 6-12 months has a protective effect, so is encouraged where possible.

Following these important guidelines can lead to some minor issues that we see commonly in osteopathic practice- babies with flat spots on their heads, and babies who hate tummy time! Luckily, these are things we can deal with!

Flat spots (plagiocephaly) are pretty common in babies who sleep exclusively on their backs- infant skulls are relatively pliable, and they can become moulded into shape with repeated exposure. For most babies, this is purely a cosmetic issue, and will resolve by about 12 months, as by this stage babies can roll, sit, crawl etc and are no longer confined to back sleeping. Osteopaths may help to re-mould flat spots using very gentle techniques, and try and prevent them worsening, as well as alleviating any contributing factors such as tight neck or back muscles and restricted joints. In some cases, flat spots can be severe or stubborn, and babies may need to be fitted with a temporary helmet to help re-mould their skull.

Tummy time can be fun for some babies, and despised by others. The amount of time that babies are spending on their backs to sleep means that there are lot more babies who are unfamiliar with the sensation of lying on their tummies, and it takes a lot of effort to hold their heads up. Tummy time is vital for development of the postural muscles for sitting, crawling and walking, and a delay in their strengthening can also delay things like solid food introduction, as babies need to be able to control their head to safely eat solid foods. Experts recommend that supervised tummy time be part of every day, multiple times a day, to help normalise the feeling and promote strength. Games, toys, books and faces at baby’s eye level can help keep them entertained to stay doing tummy time for longer, as can lying the bub on your own chest to look at each other, and water-based play where baby is supported under their chest and tummy.  If your baby seems to hate tummy time no matter what you try, they may have some discomfort that needs to be addressed. Tension in the back, neck and ribs is common, as is a tendency to only look to one side. These issues may be easily resolved with osteopathic treatment, which is gentle and promotes relaxing of the tissues and restoring range of movement.

If you need any more information regarding infant sleep positions, please see the links below. In the meantime, if you have any concerns regarding your baby’s head movement, tummy time or any flat spots developing, bring them in for an osteopathic assessment! Happy sleeping everyone!




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