Did You / Will You Sleep Your Baby on His/Her Stomach? (and the SIDS debate)

[DomanMom]

I am wondering in what position all of you slept your babies, and also what you thought about Glenn Doman's recommendation for babies to be placed on their stomachs to sleep (to aid in physical development).

Hunter, my first born, slept on his back because of the SIDS prevention recommendation I was given at the time.

But with this new baby on the way, I am debating the recommendation and doing a lot more thorough and questioning research.


Glenn Doman's Position (and others') Against Back-Sleeping:

In Glenn Doman's book How to Teach Your Baby to Be Physically Superb, which was first published in 1988 before the Back to Sleep campaign, his recommendation for stomach sleeping was mostly based on common sense and research showing the benefits of stomach sleeping, and SIDS was not yet in the argument. However in his more recent book on newborn development, How Smart is Your Baby, the apendix includes a scholarly paper entitled A Reassessment of the SIDS Back to Sleep Campaign.

The article can be found here:

http://www.thescientificworld.co.uk/TSW/toc/TSWJ_ArticleLanding.asp?ArticleId=1785

(Click on the red and white "PDF" icon to download the full article)

The article argues against the questionable statistics that show "a decrease in SIDS by 50% since the campaign began". The actual data shows that SIDS was decreasing before the campaign began (a 26% decrease from 1989 to 1992, when campaign started) and also, the actual "decrease" is up for debate since the definition of SIDS has been changing to be more selective since that time. For example if the baby's face was covered by a comforter and dies, it may no longer considered SIDS but may be more correctly identified as suffocation. There is also an increasing trend worldwide to classify many infant deaths as "unknown" or "undetermined" instead. I have heard more than once that it is up for debate whether or not SIDS has been decreasing at all, since even today what one medical technician considers SIDS another may consider something else, and the varying "measuring stick" per se leaves a lot of room for error in reporting the numbers. Even with the 50% "decrease" taken into consideration, the rate went from about 1.3 SIDS cases per every 1000 live births to .5 SIDS cases per every 1000 live births since 1992. That is the difference of less than one baby not being labeled as "SIDS", and it is more than questionable whether or not this decrease has anything at all to do with the BTS campaign or simply differences and changes in reporting procedures.

The article also argues (and gives substantial evidence for) the premise that the Back to Sleep campaign is also more about human experimentation than confirmed preventive theory. I would highly, highly recommend taking a look at this article for anyone considering their decision in the matter, and I know I haven't come close to doing it justice in my choppy summary.

In doing further research into the subject, it has been extremely difficult for me to get the actual numbers on how many actual SIDS deaths occurred in the prone (stomach) position versus the supine (back) position. It seems that the most often used "proof" has been the chart showing the "50% decrease" since the BTS campaign. In one report of case studies I was able to find conducted in a California area of SIDS deaths over a given time showed that only about 50% of babies were in the prone (stomach) position at the time of SIDS, which is not much higher than the national average of American infants who regularly sleep in the prone position (about 25%-30%). It should also be noted that about 88% of SIDS deaths nation-wide had at least two or more known risk factors going on at the same time (for example, sleeping in the prone position while also being on a bed with soft bedding, or sleeping in the prone position while in a room with second-hand smoke, etc.). So, looking at those numbers, the actual number of babies who died from SIDS simply while sleeping on their stomachs with no other risk factors involved is, to say the least, extremely minute.


Risks versus Benefits

The article also discusses a few of the risks of supine (back) sleeping, and apparently there are many more. According to this wikipedia article on Sudden Infant Death Syndrome (yes, I know it's wikipedia, but I read up on the references used and it is a legitimate summary):

"Additional studies have reported that the following negative conditions are associated with the back sleep position: increase in sleep apnea, decrease in sleep duration, strabismus, social skills delays, deformational plagiocephaly, and temporomandibular jaw difficulties.[99] In addition, the following are symptoms that are associated with sleep apnea: growth abnormalities, failure to thrive syndrome in infants, neurocognitive abnormalities, daytime sleepiness, emotional problems, decrease in memory, decrease in learning, and a delay in nonverbal skills. The conditions associated with deformational plagiocephaly include visual impairments, cerebral dysfunction, delays in psychomotor development and decreases in mental functioning. The conditions associated with gross motor milestone delays include speech and language disorders. In addition, it has been hypothesized that delays in motor skills can have a negative impact on the development of social skills.[103][104] In addition, other studies have reported that the prone position [stomach sleeping] prevents subluxation of the hips, increases psychomotor development, prevents scoliosis, lessens the risk of gastroesophageal reflux, decreases infant screaming periods, causes less fatigue in infants, and increases the relief of infant colic.[105] "


So in the end I don't really write all this to try and convince anyone one way or the other to stomach sleep their infant for it's physical and social development benefits, since even I am not yet all the way convinced. This is more of an assortment of miscellaneous thoughts and findings on the subject that are hopefully going to lead me to a conclusion.

As I mentioned before in another thread this is an extremely difficult subject for me since, earlier this year a baby that I was very close to (one of my daycare babies who I cared for for 11 hours a day since he was a couple weeks old) died of SIDS while on vacation. While I never did find out the surrounding events to his death (i.e. where and how he was sleeping at the time), it affected me and my family a lot and I am still left shaken up about it. This of course makes me more insecure about going the "unconventional" way, as I am inclined to do anything to prevent this from happening to my own baby.

So, what do you think? How do you / did you / do you plan to sleep your infants?

Your thoughts on the matter are appreciated as I try and figure this out for myself!

[waterdreamer]

Elizabeth I am so sorry for your loss. *Hugs* as a home daycare owner/operator that would shake me up too.
I have wondering the same thing. My son was back to sleep as well but that was before I knew about Doman's program. Perhaps if you call the iahp yourself and talk to someone about this subject it might help you make your decision one way or another. I plan to do the same next year when we try for baby number 2.

[Kimba15]

I have been personally debating this to with my litttle no 2 on the way. I was thinking maybe a combination of both. During the day (if im not tooooo tired and in need of a sleep myself)  I will put no 2 on their stomach where I can continually keep and eye on them and on their back at night.

Sophia as soon as she could roll slept on her stomach. I rang the SIDS council as I was horrified something would happen to her and they said the risk decreases as they learn to roll as they are able to get themselves in and out of the stomach position. If you are still very frightened about stomach sleeping then maybe wait until baby can roll and you know that bubby can get in and out of the stomach position?

Hope this helps!!!

[AussieMumofOne]

Thanks for the research DomanMom, I read this recommendation in Doman's book and was quite worried as it really is drilled into us that back is best! I look forward to hearing about your decision and experience with stomach sleeping (Kimba too) as I expect this is something I will have to consider for when we're lucky enough to have a second baby!

[nic31600]

I had my daughter sleep on her back while she was a newborn and let her sleep on her stomach only during the night once she had steady head control but she would cry if she wanted to be turned over so I knew when she wasn't comfortable.

[DomanMom]

Thanks everybody for your input. I still have been doing a lot of research on the topic before I eventually decide. One thing I want to know, which is so impossibly hard to find, is the actual numbers on this supposed association between stomach sleeping and SIDS. It seems that the only thing I can get a hold of is these educational websites that lists off all the things you're supposed to do and not do to prevent SIDS. But finding the actual numbers and studies behind those things has been very, very difficult.

One thing I thought I would add to this discussion is something I found on the National Institutes of Health website on frequently asked questions about the Back to Sleep campaign (they are the originators of this campaign).

http://www.nichd.nih.gov/sids/sids_qa.cfm

"There may also be other specific infants in whom the risk/benefit balance favors prone sleeping. The risk of SIDS increases from approximately 0.86 SIDS deaths per 1,000 live births to 1.62 when babies sleep prone* (that is, 998 of every 1,000 prone-sleeping babies will not die of SIDS). This relatively small increased risk may be reasonable to accept, when balanced against the benefit of prone sleeping for certain babies. Health professionals need to consider the potential benefit when taking into account each baby's circumstances.

If it is decided to allow a baby to sleep prone, special care should be taken to avoid overheating or use of soft bedding since these factors are particularly hazardous for prone-sleeping infants."

I was actually shocked to find that the whole substance behind this campaign is a "relatively small increased risk". 0.76 increase per 1000? That is it? You definitely won't hear those numbers advertised on their campaign adds. With the way that the danger of prone-sleeping is touted as the #1 thing parents can do to prevent SIDS, it definitely surprised me to see this.

I also have to take into consideration whether or not this increase in risk has to do with an actual danger in prone sleeping in and of itself, or if it is the COMBINED factor that prone sleeping exaggerates - for example, sleeping prone on soft bedding, or sleeping prone after being exposed to second hand smoke, etc., as noted in this statement and also in noted in the fact that 88% of SIDS cases have at least two or more risk factors going on at the same time, as mentioned in my original post.

It seems like the more I look into it, the more the numbers convince me, but it is hard to get past the propaganda that has been drilled into my head!

[Gilma]

A friend bought "AngelCare Baby Monitor" and they installed in the baby bed. You can maybe looking for more information about that product.

[waterdreamer]

A friend bought "AngelCare Baby Monitor" and they installed in the baby bed. You can maybe looking for more information about that product.

I had one of those. They are a piece of mind. However make sure if your husband gets up at night to change the baby that he turns it off because if the baby is not in the crib and it's on it will go off. It is a very rude wake up call when you think your baby has stopped breathing.

[DomanMom]

Gilma (and waterdreamer),

It looks like a great monitor, and although I have been indoctrinated by the SIDS campaigns not to trust products meant to prevent SIDS because "none of them have been proven to work", this monitor looks significant.

One Amazon reviewer, who is a nurse, said, "A good number of babies who die of "SIDS" are believed to die from some unexplained sudden apnea, whether it be too many blankets smothering the child or whether the baby simply "forgot" to breath, as some doctors believe. If a child suffers some sudden period of apnea, a person who is there immediately MAY be able to save them through waking the child or through mouth to mouth breathing. That is medical fact based on years of research. Hospital don't use $5000 infant apnea monitors for no reason. If they did no good no one would use them. This product, when used correctly, functions as a very suitable apnea monitor, and at a cheaper price."

My concern is, do you think the monitor would work if the baby was moving, or I guess a better word would be crawling, a lot in their sleep? From reading Doman it seems that one of the main reasons to put baby on their stomach to sleep, and in a crawling track (he recommends building one that wraps ALL the way around the parents' bed) is because often newborns move more in their sleep than they do when they're awake. I know that texaslady mentioned this with her two children (she stomach slept them in a wrap-around crawling track), that they were all over the place at night. I couldn't get any specifications on how big the monitor pad was.

Thanks for the recommendation, though, this will definitely be something to consider!

[waterdreamer]

There is no way this machine would work with a crawling track. Once my son was old enough to roll around the crib we had lots of false alarm because he was not close enough to the sensor pad. Even the newer versions with two pads would not cover a whole track

[Wolfwind]

Thank you so much for bringing up this topic!  I was very worried when I read Doman's reccommendation because it made perfect sense, but the Back to Sleep propaganda freaked me out.  My compromise at the moment, as someone else said, is to let her nap in her track when I'm awake and checking on her (every five minutes - I'm still scared), and have her sleep on her back in a crib at night.  But the additional research is fascinating.  Maybe I'll let her sleep on her stomach more, or at least without checking so often.  She can already roll from her stomach to her back (at six weeks) and has amazing head control, so I bet she could get herself out of a rebreathing situation,  Apnea is still scary, but it looks, from the research in this thread, that if stomach sleeping increases the risk of apnea at all, it's marginal.  This is really interesting.  Thank you for the discussion!

[Nikita]

My last 2 babies refused to sleep on their backs from the moment they got a choice in it - the moment they could roll over. And they slept better on their tummies, so I got better sleep as did they. During the day even as little babies before they could roll over I would sleep them on their tummies some of the time while I was around to keep an eye on things. I picked on how much better and longer they slept that way very early on.

[annisis]

Josiah was a very spoiled baby (asif!) and was usually rocked to sleep on someone's chest or... in his swing. Although we occassionally managed to put him down in his cradle on his back, he seemed to sleep more peacefully on his stomach. His naps would last much longer. A happy baby is a rested one! He would also startle more easily when placed on his back. And once he could turn over, there was no convincing him to sleep supine. He had to be on his belly, or chest and knees rather as his butt was stuck up in the air!....?

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