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Back to Sleep Baby

The Back to Sleep Programme was introduced in 1992, and aimed to encourage new parents to place their baby on its back to sleep at night. Midwives and Health Visitors are well versed in the Back to Sleep Campaign and new mothers are offered a wide range of help and support to get babies sleeping happily on their back. But what exactly are the benefits of putting babies to sleep on their backs, and how much time should babies spend on their backs when they’re awake?

Benefits

Since the introduction of the Back to Sleep Programme in 1992, infant cot death has reduced by an incredible 50%.

Drawbacks

Since 1992 there has been an increase in Positional Head Deformity (PHD) which comes from babies lying on their back for too long. PHD is an asymmetry of the baby's head, usually flattening at the back of the head and bulging out at the front.

Why does this happen?

When babies are born, their skull bones are soft and the joints between them are loose. This helps them pass through the birth canal during labour smoothly. After the baby is born, the skull bones take a little while to harden and remain relatively soft for about 5 months. This means if a baby spends a long time in one position, the skull will mould and change shape to match. Babies who sleep on their back, and then spend a lot of time during the day lying on their back or sitting in a car seat, can end up with flattened areas on the back of their skull, causing the front to bulge outwards.

It has also been noticed that babies who spend a lot of time on their back often have a delay in learning how to lift the head, push themselves up on their arms, rolling over and crawling, which are important skills to learn in the development of the nervous system.

Tips for preventing PHD:

1. Tummy time!

This reduces time spent on the back, but also encourages your baby to learn new motor skills and develop the nervous system. Begin with 15 minutes per day and increase by 1 minute per week.

If your baby does not initially like being on his/her tummy, try the following tips to get them used to it: 

  • Place blanket roll under the chest so that your baby can see beyond the floor and then decrease the thickness over time as they get stronger.
  • Lie on the floor on your back, then place your baby on your chest to allow some interaction.
  • Put interesting objects (e.g., toys, pictures, or even goldfish in a bowl) in your baby's visual field. Remember that the most interesting object to any baby is mum or dad's face.

2. Throw in some variety by changing sides in some of the following activities 

  • Try feeding from different sides, or in a different position (rugby ball, upright woodpecker).
  • Change the position of your baby's head throughout the day to prevent pressure to same side.
  • Change the position of your baby's moses basket relative to the door in order to encourage the infant to look in the opposite direction.
  • Provide visual stimulation to your baby from various angles.

3. Limit the amount of time your baby spends on his/her back in the car seat, swing, and baby carriers.

4. See a chiropractor to ascertain if there's any underlying cause, such as tension in the neck, jaw or upper back

Summary: 

  • Babies should be placed on their backs to sleep, to reduce the risk of cot death.
  • During the day, babies should have regular supervised tummy time to reduce the risk of PHD and help the back and shoulder muscles develop so babies learn to sit and roll.
  • Vary the position of the cot in the room so your baby is encouraged to look to both sides.
  • Visit a chiropractor to correct any underlying neck problems which may be causing the PHD.
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