Shhhh  do you want to know a secret? Guest blog by Ann from Birth and Babies Antenatal Norwich – 2015

 

Guest blog by Ann from Birth and Babies Antenatal Norwich, did you know that if you look on any parenting forum you may find people are asking questions about their baby and sleep. Some have discovered through experimentation that their baby will sleep on his side or tummy – but not for long on his back – and are worried about whether this is ok. Other concerns relate to wind, colic, reflux and head moulding.

Mothers know that newborn babies like to sleep curled up, often in a foetal position, and preferably in someone’s arms or very close to them. The breastfeeding mother knows that her baby sleeps really well next to her in bed, often on his side or back, and she curls around him in a protective C position. Fathers know that their babies sleep really well on their tummies, on his chest.

After 40 years as a mother and grandmother, and 25 years as an antenatal teacher, I have my own thoughts and beliefs about what babies like.

However, it is difficult to express them when current advice on sleep position is completely inflexible. I believe many midwives and health visitors have the same problem, they have clear instruction on what can be said. Please read lullaby for more information.

So, what am I to do when parents ask for my thoughts on the fact that the only sleep they’ve had in the weeks since their baby’s birth, is when they sleep propped up with him on their chests? The obvious suggestion is to try the baby on his side or tummy, in his crib, feet to foot with appropriate bedding. They are already doing something that is NOT recommended, so would these alternatives be any more or less risky?

 

 

 

 

 

 

 

 

 

I find myself hesitant in recommending this, and a Health Visitor almost definitely will not. However, if the parents consult parenting forums they may find a whole bunch of parents are saying “it’s fine actually – that’s what we do – just don’t tell”. Is this satisfactory?

SIDS Risk Factors

There are many risk factors associated with SIDS but we still don’t understand exactly what causes it– sleeping position is the easiest message to give in a catchy phrase, I believe that is what makes it seem to be most important, but in fact, it may not be.

Lots of research (click here for a link ) shows the top of the risk list is exposure to smoking before and/or after birth. Others relate to the baby’s general health and well being and the sleeping environment.

 

Baby’s Sleeping Position

The question parents would like answered is “does the prone (tummy lying) position, in the absence of other risk factors, present such a problem?” It is pretty much impossible to say because we are so entrenched in the “Back to Sleep” philosophy that nobody will discuss this, and because research is often unable to separate out all the above.

A little bit of history

It is difficult to find older baby books which give much guidance on how to lie a baby down. Backs, sides and tummies are all variously recommended for different reasons over the years

From the 1950s, one paragraph in The Care of Young Babies by Dr John Gibbens:

“Warm and snug as he was in the womb, he responds best for the first week or two to the snug fit of swaddling clothes, to being wrapped up cosily in a shawl, and tucked up on his side with his fists clenched and his knees drawn well up.”

From 1968 “The Baby Book”, an early version of the Bounty Book, every other page has an advert for formula milk or bottles and breastfeeding is not promoted.

“Quite a number of babies prefer sleeping on their stomachs, and this position often helps when baby has colic pains. It’s also rather safer than sleeping on the back, because a young baby may vomit and choke on it in that position”.

By 1996 NCT’s Becoming a Family gives the topic only one line but still allows side sleeping:

“Place your baby on her back, or her side, to sleep” but does also say “Don’t smoke near her and don’t let anyone smoke in the house”.

So – hang on a minute – in the 60s breastfeeding was not thought important and formulas were not as well modified as now, and we were advising putting babies on their tummies? Also, many people smoked in the house, polyester bedding and central heating arrived, more premature babies survived; one cannot help wondering whether there was an increase in SIDS at this time and whether the dramatic decline from 1992 was due to multiple changes.

Tracy Hogg (Secrets of the Baby Whisperer) in 2001 was obviously giving a nod to the current “safe sleep” advice; however, her Tip in the sleep chapter says:

“I usually suggest putting a baby down on her back. However, you can also put her to sleep on her side by wedging her with two rolled-up towels . . .” she later adds “If she sleeps on her side, make sure it’s not always the same side”

She doesn’t say why, but I assume this was because babies settle better like this and to avoid plagiocephaly (head moulding) which was becoming a real issue since sleeping on backs was introduced.

Side sleeping has since been ruled out after a study indicated it resulted in more infant deaths, perhaps babies were rolling onto their tummies? Dr Sears discusses this sleep problem, but is still happy to recommend parents are not put off using this position to help babies sleep.

 

What now?

In the past mothers and fathers probably had more confidence to experiment and find the position in which their baby slept best. When side and tummy positions were allowed they were said to help with ‘3 month colic’ which was considered normal, with advice on winding and gripe water; however we had never heard of reflux or plagiocephaly. (I need another blog for these two!)

Current advice is detailed and specific, meaning that informed decision making is very difficult for parents; because there is no discussion of alternatives. Anecdotal information from other parents contradicts what the health professionals tell us.

So – what are parents to do?

I might just point them to an article I stumbled upon last week and which prompted this blog; it tries to put the risk of prone sleeping into perspective: Sorting out SIDS and sleep position

My comment was that he should have mentioned side sleeping as that is always going to be my position of preference!!

Ann Roberts -from Birth and Babies Antenatal Norwich

www.aboutbirthandbabies.co.uk

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