In plain words
Back to Sleep is the name of a national campaign that began in 1994 to teach parents to put babies to sleep on their backs. Before that, many babies were placed on their stomachs, and the risk of sudden infant death was higher. The campaign's message is simple: the baby sleeps on the back, on a firm, flat surface. Grandparents and friends may remember older advice, from the years when they were parents, that placed babies on their sides or stomachs. Guidance has since grown to cover bedding, , and , but the back position remains the core. The campaign was renamed Safe to Sleep in 2012, and many mothers still hear the older phrase at the hospital and at pediatric visits. Babies sometimes fall asleep on their stomachs after a feed or in a , which is one reason the message is repeated.
The deeper version
The American Academy of Pediatrics task force of 1992 advised non-prone sleep for healthy infants, and the NICHD-led Back to Sleep campaign, launched in 1994, promoted supine positioning. Prone and side positions are associated with higher sudden infant death risk in case-control data. AAP policy statements of 2005, 2011, 2016, and 2022 (Moon and colleagues, Pediatrics, 2022) have since widened the guidance to cover firm flat surfaces, room sharing without bed sharing, avoidance of soft bedding, and avoidance of smoke exposure. Sudden infant death rates in the United States fell substantially after 1992, with much of the decline attributed to supine sleep, though the evidence is largely observational and other factors contributed. A known trade-off is positional plagiocephaly from prolonged supine sleep, which is managed with supervised rather than a return to prone sleep.
Where it comes up
- Newborn sleep and safe sleepBaby Basics
- Tummy timeBaby Basics
- Swaddling: how and when to stopBaby Basics
- Grandparents and in-lawsSupport, Home, and Village
- Days and nights mixed upBaby Basics
- Setting up home for postpartumSupport, Home, and Village
What mothers here say about Back to Sleep
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Sources
- American Academy of Pediatrics — Task Force on Infant Sleep Position and Sudden Infant Death Syndrome, 1992
- Moon RY and colleagues, American Academy of Pediatrics — SIDS and Other Sleep-Related Infant Deaths: Updated 2022 Recommendations for a Safe Infant Sleeping Environment. Pediatrics, 2022