April 5th, 2010
05:51 PM ET

Study: Concerns about comfort and choking prevent some moms from placing babies in safest sleeping position

By Miriam Falco
CNN Medical News Managing Editor

A mom’s beliefs about her child’s comfort and the perceived risk of choking can prevent her from placing her baby on its back to sleep, which increases the child’s risk of dying from sudden infant death syndrome.

A new study finds that the position a baby sleeps in is often determined by the quality and quantity of advice new moms get and whether they believe their child will be uncomfortable or choke.

Researchers interviewed 2,300 mothers. 61 percent of the moms surveyed reported placing their babies on their backs to sleep, which means nearly 40 percent did not, putting their infants at increased risk for SIDS.

74 percent of the moms in the survey were African-American, which was intentional because African-American babies are more than two times as likely to die of SIDS as white babies, according to the National Institute for Child Health and Human Development.

Reducing the number of SIDS deaths is what drove study author Dr. Isabelle Von Kohorn to conduct the research. She is a pediatrician who specializes in treating newborns at Yale University’s School of Medicine.

Von Kohorn found that a mom’s belief that her child was uncomfortable or more likely to choke if placed on his or her back was more of a driving force than any advice about the best position for a baby to sleep in.

Doctors and nurses who take these beliefs into consideration may be in a better position to advise new moms about the best sleeping position.

“We want to be sure that all health care providers are giving clear, unequivocal advice to place babies on their backs.” Von Kohorn said.

But only 56 percent of doctors and 44 percent of nurses are talking to moms about this having their infants sleep only on their backs for the first year of life. Researchers also learned that one in seven doctors and nurses were giving out incorrect advice.

“We want to be sure that all health care providers are giving clear, unequivocal advice to place babies on their backs.

There’s also a need to educate those around the new moms about the safest sleeping position says Dr. Alan Fleischman, medical director for the March of Dimes.

“It’s not intuitively obvious that putting babies on their backs is beneficial.”

Fleishman adds that doing so has saved a tremendous number of babies’ lives.

However, researchers did learn that when moms were advised about the safest sleeping position – from their doctor, nurses or the news media – they were more likely to follow the recommendations.

Von Kohorn says,” this is an important finding. Just getting the word out will save a life. Simply getting the word out through the media –will save a life. To stop babies from dying, that’s my life’s goal.”

The recommendation to put babies on their backs dates back to 1992, when the American Academy of Pediatrics changed their recommendations. In 1994, the National Institutes of Health (NIH) launched the “Back to Sleep” education campaign, to reduce the number of SIDS deaths. According to the NIH, the number of SIDS deaths has been cut in half since the campaign began.

However, according to this new study, about half of African–American babies in the United States are sleeping in positions other than on their backs.

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soundoff (6 Responses)
  1. Maddie

    I was afraid to put my babies to sleep on their backs because my twins had reflux and they kept spitting up in their sleep. I was afraid they would drown.

    April 5, 2010 at 23:28 | Report abuse | Reply
  2. Yolanda Guitar

    do not worry about your babyt choking on his/her back, actually the risk of choking increases if they are on theie stomach. To put it in very simple terms when a baby is on their back their air tube is on top and food tube on is the bottom. It is difficult for the spit up to get up over the tube. When they are on their belly the air tube is below the air tube and food – spit up can easily get lodged in the air tube. Also a persons natiurally reflex is to torun your head to the side this will allow the contents of your mouth to spill out, when a baby is on their stomach and their mouth fills it is more difficult to get the contents out especially is they do not have good head/nck control.

    Hope all this made sense.

    I lost my son in 2004 because a baby sitter put him on his stomach and I always put him on his back, he died the first sleep of the day the first time he was on his back. ABC Always on my back in my crib.


    April 6, 2010 at 11:24 | Report abuse | Reply
    • Wzrd1

      We went through the same kind of event. The only thing was our youngest daughter was on her back and stopped breathing.
      What alerted us to the fact that she stopped breathing was our new cat, who suddenly and out of character, kept going up and down the top 4 steps meowing the loudest we ever heard her.
      I decided to see what she was going on about and followed her upstairs where she ran into the baby room and jumped into the crib and sat on the baby's chest.
      Get off of the-BLUE BABY!!!
      I'll not repeat the word I said THEN, but it is spelled like ship, with a slightly different last letter...
      I awakened her with a fair amount of effort and she started breathing.
      A few days later, after much doctor time, she was diagnosed with SIDS and we got to try out the newest technology in infant monitoring equipment.
      The equipment alerted about 90 seconds AFTER the cat did. Every time!
      I wasn't a cat person before, I tolerate them QUITE nicely now!

      June 25, 2010 at 20:36 | Report abuse |
  3. modmomofwis

    A couple of weeks ago my premature grandson almost died from his reflux because he was on his back and his nose and mouth filled with fluid, he was rushed to emergency and his parents have now been told by his doctors that it is okay for him to sleep on his tummy because he is at greater danger of choking to death because of his reflux than suffocating. He can also be put on his side. They were given battery operated aspirators that they keep in every room and he doesn't even ride in the car without an adult in the backseat with him. Today his adjusted age is just over 2 months and he has battled more in his 4.5 months of life than you can even imagine. If a newborns reflux is severe they should discuss it with their doctor before a tragedy occurs.

    April 6, 2010 at 14:14 | Report abuse | Reply
  4. Know your heart

    Yolanda, I am so, so sorry for your loss. Thank you for sharing your story here, I hope others read it and are educated.

    modmomofwis, I'm sorry to hear about the near-miss with your grandson. I hope he's better now and is sleeping soundly and safely.

    Moms and others who care for infants should always know their heart, and trust intuition. While there are some exceptions, like babies with reflux for example, it is PROVEN that it's safest for infants to sleep on their back.

    On a related note, co-sleeping isn't recommended for infants, either. I did a LOT of reading about baby sleep recommendations while pregnant & after birth, to try to decide the best course of action for my little man. Fourteen months later, he's a strong healthy boy, I'm proud to say.

    Please, listen to the NIH, doctors, and your own gut feelings... too many precious little ones are lost to old wives' tales and misinformation. Let's watch over them, until it's their turn to watch over us. 🙂

    April 7, 2010 at 22:14 | Report abuse | Reply
  5. Claire

    I have serious problems with breathing when I lie flat on my back due to acid reflux causing asthma. I have to use a wedge in order to sleep that way. My first baby and grandbaby both had acid reflux too. I was terrified that my daughter would drown when she spit up in her sleep, I did not even know about the asthma problem. I was told to put her to sleep on her side or on a wedge the fit the crib properly. She is now grow and a mom herself. Her baby could not sleep lying flat on her back either. I understand that back to sleep is best for most babies, but I still think you need to consider each child's needs. Knowing how I can't breathe laying flat on my back, I would not hesitate to put a baby to sleep on his/her side. I also needs to be made clear that babies should never sleep on their stomachs because it obstructs the airways. Stomach sleeping isn't good for older children or adults either.

    September 29, 2010 at 20:37 | Report abuse | Reply

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