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Babies sleep safer on their backs

Dr. Drew Werner

EAGLE COUNTY – How did you sleep last night? Now that the holiday revelries are over, did you wake as if a titanic struggle took place? Was not a corner of the bed left undisturbed? Or, did you sleep with nary a turn, your spouse checking now and then to make sure you were still breathing? Are you a back sleeper (the supine position), or is one side the only comfortable one for you? Is sleeping on your stomach (prone sleeping) the only way shuteye will happen for you?Dear Doc: I’ve heard that I should put my newborn baby on his back to sleep to reduce the risk of SIDS. I’m afraid he might spit up and choke. What should I do?- Worried about SIDS in GypsumDear Worried: Thanks for the important question. Although it had been suggested as early as 1960 that SIDS, or Sudden Infant Death Syndrome, and the prone (stomach) sleeping position were related, active programs were first put into place in New Zealand in the late 1980s. At that time, in neighboring Australia SIDS caused more deaths in children udner 4 years old than cancer, traffic accidents and congenital anomalies combined. Simultaneous research by the American Academy of Pediatrics led to formal recommendations in 1992 that all healthy infants be placed down for sleep on their backs. Over the next three years as prone-sleeping infants decreased by 75 percent, the rate of SIDS decreased by an astonishing 25 percent. Equally important, while back sleeping increased and SIDS decreased, there was no increased risk of aspiration or choking by those back-sleeping infants.At the time recommendations came out in 1992 to sleep infants on their back, little distinction was made between back and side sleeping. The distinction was really a prone (stomach) sleeping versus a non-prone (back or side) position. Since that time we have learned more about the differences in the risk of SIDS from the three different sleeping positions. The facts are remarkable.Infants who sleep prone (on their stomachs) are four to seven times as likely to die from SIDS as infants sleeping on their sides or backs. At the same time, infants who sleep on their sides are nearly twice as likely as back-sleeping infants to die from SIDS. The reason for that may be as simple as the increased likelihood of side sleeping infants to roll onto their stomachs. While there is no clear reason for why stomach-sleeping infants are more likely to die from SIDS, there is strong evidence that it is related hypoxia and their difficulty turning their heads in that position.Other evidence supports the idea that hypoxia increases SIDS risks. Infants who sleep with mattress bumpers, stuffed animals, heavy blankets or other objects in their cribs are at increased risks. Perhaps not surprisingly, infants in smoking households have a higher risk of SIDS. While babies, like adults have sleeping position preferences, they are generally learned in the first few months of life. The message, then, is clear: Sleep your babies on their backs. Don’t put toys, stuffed animals or heavy blankets in the crib. Use a firm mattress with thin padding.Like everything, however, there are exceptions to every rule. Some premature infants, or infants with severe gastroesophageal reflux, may benefit from stomach sleeping. Rather than make this decision on your own, talk to your doctor about what is best for your bundle of joy.My wish for you and your family is a healthy 2006. May all of you stay rested and get a good night’s sleep!Remember your health is your responsibility. Health is our greatest asset and it doesn’t happen by accident. If something doesn’t seem right, or questions are left unanswered don’t wait, call your doctor.Dr. Drew Werner of the Eagle Valley Medical Center writes a weekly column for the Daily. He encourages health questions. Write him by e-mail to editor@vaildaily.com or c/o Editor, Vail Daily, P.O. Box 81, Vail, 81658.Vail, Colorado


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