I put my 5-month old baby to sleep on her back but during the night shs flips over onto her stomach. Should I worry about SIDS? Should I check her frequently during the night and flip her back to her back?

We sympathize with your plight. Many worried parents contact us when their infants refuse to sleep on their backs. The advice we are going to give you comes from the American Academy of Pediatrics (AAP), the National Institute of Child Health and Human Development (NICHD), the Association of SIDS and Infant Mortality Programs, and the SIDS Alliance (a SIDS parent organization). These organizations developed the brochures and other materials for the Back to Sleep campaign. According to the AAP in their 1996 position statement on infant sleep positioning "When infants are able to easily turn over from their backs to their stomachs, they should still be put to sleep on their backs, but allowed to adopt whatever position they prefer." In response to the question "Do I need to keep checking on my baby after laying him or her down for sleep in a nonprone position?," the AAP recommends "that parents do not need to keep checking on their baby after he or she is laid down to sleep. Although the infant's risk of SIDS could be increased slightly if he or she spontaneously flips onto her stomach, the risk is not sufficient to outweigh the great disruption to the parents, and possibly to the infant, by frequent checking" (BTS professional brochure). By about 6 months of age most infants have the ability to turn over, and those who prefer to sleep on their stomach usually do. The AAP knows that it is very difficult, even impossible, for parents to stop their infants from turning over once they have the ability to do so. There is still a risk of SIDS for older infants (those 6 months and older), but the risk is very, very low. Research shows that about 95 percent of SIDS deaths occur under the age of 6 months. Even though you have lost control over your infant's sleeping position, you will always have control over the kind of sleeping environment he or she is in. It is extremely important that the sleep environment is safe because infants can accidentally suffocate in soft bedding or on a soft sleeping surface (e.g., bean bag or sheepskin); they can suffocate after becoming wedged between an adult bed and the wall (children under 2 should not sleep in adult beds or on sofas, waterbeds, or sheepskins); and they can hurt themselves in a defective crib, etc. The Consumer Product Safety Commission (CPSC) has recently published media alerts on a safe sleeping environment for infants that you may wish to read.

As a reminder, this information should not be relied on as medical advice and is not intended to replace the advice of your child’s pediatrician. Please read our full disclaimer.