Back sleeping for babies: Understanding the Recommendation

Place your baby on their back at the start of every sleep, during naps and at night. This remains the recommendation throughout the first year. A short sleep, a different caregiver or a baby who seems to prefer another position does not change the starting position.

The side is not a safer compromise

Side sleeping is unstable: a baby can move from that position onto the stomach. Propping the baby with rolled towels or a positioner introduces another hazard rather than solving the problem.

Use a firm, flat, clear surface and put the baby down fully on their back. Our sleep space guide explains how the position works together with the mattress and bedding. Back sleeping reduces risk, but it is not a reason to keep pillows or soft objects nearby.

Reflux usually does not change the advice

Parents often worry that spit up will be more dangerous when a baby lies on their back. For healthy babies, airway anatomy and protective reflexes help clear fluid, and back sleeping does not increase the risk of choking on spit up. Babies with reflux should also sleep flat on their backs.

Do not raise the cot mattress or add a wedge. An incline does not reliably treat reflux and can allow a baby to slide into a position that interferes with breathing. Discuss persistent vomiting, feeding pain or poor growth with the clinician instead of altering the sleep surface yourself.

A specialist may give an individual plan for an unusual medical condition. Ask them to explain it clearly; advice used under hospital monitoring should not be copied into home care without that instruction.

Separate starting position from independent rolling

Continue placing your baby on their back even when they begin learning to roll. Once they can roll from back to tummy and from tummy to back independently, they can usually remain in the position they move into themselves.

Our rolling during sleep guide covers the transition. Do not use straps, pillows or tighter wrapping to keep a rolling baby in place. Stop swaddling at the first signs of trying to roll, as explained in the swaddling guide.

Make tummy time an awake activity

Tummy time helps babies practise movement while an awake adult watches them. It is different from placing a sleeping baby on their stomach. If your baby falls asleep during tummy time, move them to their usual sleep space on their back.

If you notice a persistent head turning preference or a flattening area, ask your care team about positioning during awake time. Do not buy a sleep pillow or change to stomach sleeping to reshape the head.

Give every caregiver the same instruction

Before someone else handles a nap, show them where your baby sleeps and say explicitly that sleep starts on the back. You can acknowledge that advice has changed since they cared for a baby. The important point is having one current plan that everyone follows.