Dr. Elías Jiménez F.

The most frequent question asked by parents: how should their baby sleep, is still a motive for controversy. This obviously refers to babies who are a few months old. Usually when children get to their fourth month, they assume the sleeping position that is more comfortable for them and change it frequently during their sleep.

A few years ago it was believed that the best way to sleep for babies was on their tummy. This was due to the steadiness of this position, and also because in the case of vomiting or regurgitation it would be easier for a child to defend himself.

But, looking for the causes of the Sudden Death Syndrome (apparently healthy young children who die suddenly in their sleep), it was found that this Syndrome occurs more frequently in babies who sleep on their tummy. This is why the American Academy of Pediatrics recommended that healthy children should be placed on their back or side to sleep.

The reasons why we pediatricians recommended that children were placed to sleep on their belly were very clear: reduce the risk of aspirating in the case of vomit or gushing back, increase the child's commodity, less agitated sleep, decrease colic frequency, better motor development specially of the neck, less "squeezing" of the head and the fact, still effective today, that the oxygenation on premature children was better. Despite all these reasons the Academy recommended to change the child's sleeping position for healthy children, and the controversy remains.

Most of us now recommend that the child should be placed to sleep on his side. Although it's an unsteady position and it's difficult to maintain. Only 53% of children who are 1 month old remain in this position, and this percentage increases as the baby grows older, being common for the child to end up sleeping on his back. It seems then that the risk of sleeping on the back and aspirating vomit is less than the risk of sleeping on the tummy and suffering from sudden death.

The manufactures of children's apparel have become aware that they can obtain benefits out of this controversy and you can already find accessories that allow the baby to keep the sideways position.

It is a shame that the leading actor in this dispute, the baby, can not give his opinion during the first months of age. What we adults have to understand, is that when he gives his opinion and he decides to take another sleeping position, we have to respect his decision, like we also have to respect many other of the decisions he'll take during his pleasant process of development and maturing.