Is your baby sleeping safely?

If you don’t settle your baby properly, there could be tragic consequences. Yet many parents deliberately go against best advice. Why? We investigate... 

Cot death.

They’re two words no parent wants to hear – and yet, alarmingly, many of us are unwittingly putting our babies at increased risk of it. A new survey carried out by The Foundation for the Study of Infant Deaths (FSID) has found a worrying trend among new parents, namely that an increasing number of us are going against current advice by not following the ‘back to sleep’ rule, which recommends babies should always be put to sleep on their backs to cut the risk of Sudden Infant Death


Syndrome (SIDS), known as cot death.

According to this new study, too many parents are now putting their babies to sleep in the ‘wrong’ position, which can increase the risk of airway restriction and cause babies to stop breathing.

A baby settled on his front is about eight times more likely to die of cot death than a baby settled on his back, while a baby settled on his side has nearly twice the risk of cot death. So why is are so many of us are still choosing to ignore the experts’ advice?

It’s all in the head

The most likely explanation, according to Professor George Haycock, a scientific advisor to FSID, is that since parents have started following the ‘back to sleep’ rule, there has been an increase in the number of babies with ‘flattening’ at the back of the head (known in medical terms as plagiocephaly).

Doctors estimate that about half of all babies under one are now affected. ‘Flat head syndrome’ is particularly common in premature babies, whose skull bones are softer.

‘Some research shows that the number of babies with flattened heads seems to be connected with the fact more babies are sleeping on their backs,’ says George. ‘And it may be that parents are instead placing their babies on their sides or fronts to avoid this.’

In the first few weeks of your baby’s life, the bone of his skull is soft enough to be moulded. That’s why some babies’ heads often look slightly conical after birth. If your baby always sleeps on his back, the pressure of the cot mattress against his skull can gradually cause the back of his head to become flattened.

It takes a little time to develop and parents usually notice it at around two to three months.

‘Babies’ heads tend to rotate to one side when they are lying down so it’s more common to see flattening to one side of the back of the skull,’ says George. ‘Plus once he starts to get a little flattening on one side of the skull, his head automatically tends to fall to that side.’

Is it harmful?

While plagiocephaly may look alarming, it won’t harm your baby and it won’t affect the development of his brain. Once he starts to roll over and spend more time on his tummy, at about four months, his head shape will start to revert back to normal.
Most cases of plagiocephaly are mild and sort themselves out by the age of one.
If you are at all worried about any flattening to your baby’s head, it’s a good idea to see your GP. He will rule out any other conditions that may be causing it and can give you tips on how to minimise the effect.

These may include putting a mobile on the side of the cot your baby usually faces away from, to encourage him to turn his head, and giving your baby some ‘tummy time’ each day (but remember to supervise him to make sure he doesn’t fall asleep). Physiotherapy can also help babies who have weaker muscles on one side of their necks.

In some countries, babies with plagiocephaly are fitted with helmets or headbands to correct the shape of their skulls but the jury is still out on whether or not these are effective.

Why is back-sleeping so important?

Despite the increase in plagiocephaly, doctors still recommend that parents always settle their babies on their backs to sleep. This is because the benefits far outweigh any risk to your baby of plagiocephaly.

Even though there’s very strong evidence that back-sleeping helps to reduce the risk of cot death, doctors still aren’t sure why this is. One theory is that babies who become victim to cot death may have had an abnormal reaction to bacteria that usually live harmlessly in the airways.

This reaction is more likely to happen when the temperature inside the airways is raised, and it’s thought settling your baby on his back helps to prevent this.

‘The good news is that if you follow all the advice, then SIDS is almost completely preventable,’ says George. Sweet dreams.

Time for bed

As well as putting your baby down to sleep on his back, the FSID recommends you:

• Don’t smoke during pregnancy or around your baby (that applies to dads, too).

• Don’t let your baby get too hot – about 18oC (64°F) is a good temperature for the room he sleeps in.

• Keep his head uncovered, and settle him with his feet against the bottom of his cot so he can’t wriggle under the covers.

• Don’t share a bed with your baby for the first six months, but keep his cot in your room.

• Never sleep with your baby if you are a smoker, have been drinking, taken drugs or if you are extremely tired.

• Don’t put pillows or soft toys in your baby’s cot.

• Use layers of light, cotton blankets rather than a duvet.

• Never nap with your baby on a sofa or armchair.

• See your doctor promptly if your baby seems unwell.