By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

READER’S MOTHER NEEDS MODERN INFO ON BABY SLEEPING POSITION

Question: I am expecting my first child – my mother’s first grandchild – in a few weeks. My mother is so excited, but she is also full of lots of advice, and some of it doesn’t seem quite current. Yesterday she told me to put my baby to sleep on its stomach to keep it from getting a flat spot on its head. I know this is wrong. Perhaps if she sees it in writing from you, she will believe me.

Answer: First of all, congratulations on your upcoming bundle of joy. Your mother is well meaning, but you are right not to listen to her on this issue. Babies should always be put to sleep on their backs to decrease the likelihood of sudden infant death syndrome (SIDS). This is a relatively new finding, but there is good data to support the claim.

In the 13 years since American Academy of Pediatrics (AAP) first advocated back sleeping for babies, the number of SIDS deaths in this country has decreased by more than 50 percent. Over the years this advocacy evolved into the “Back to Sleep” campaign, which is now endorsed by a number of agencies concerned with baby-care issues. In addition to the AAP, these include the National Institute of Child Health and Human Development, the Maternal and Child Health Bureau, the SIDS Alliance, and the Association of SIDS and Infant Mortality Programs.

Your mother’s concern about flat spots, while real, is a bit exaggerated. Flat spots generally aren’t a problem if the child is given adequate time out of the crib or carrier seat when he or she is awake.

Some mothers have taken the “Back to Sleep” campaign and morphed it into a “Back at all times” program. These mothers go to the extreme of never putting their babies on their tummies. The truth is that babies need “tummy time” to develop strength in their neck and upper back muscles. This tummy time should be supervised and only occur while the baby is awake.

Though back sleeping is the rule, your doctor may recommend side sleeping in certain situations. However, you must be instructed in proper positioning to assure that the infant will not accidentally roll over onto its stomach.

There are also some other things you can do to make sure your baby’s time in the crib is safe. Here are a few tips: Be sure to keep the crib clutter free -- just the needed blankets, no toys or pillows. Make sure the mattress fits snugly in the crib and never tie objects to the crib that can be pulled down by the baby. Don’t use that antique crib unless the slats are no farther apart that 2 3/8th inches. Use snug fitting crib sheets that won’t pop off the corners. Don’t overdress or over-cover your baby at night. The room should be comfortable for you.

As for the grandmother-to-be, take her to some of your doctor appointments. Buy some baby care books and read them over together. Let her help with outfitting the baby’s room. With this kind of love and attention, she can become an up-to-date grandmother who knows all the latest about baby care.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.