Sleeping on its Back Gives Baby Fewer Fevers, Stuffy Noses, Ear Infections
(HealthDay News) – The practice of putting infants on their back when they sleep has long been associated with helping to reduce the onset of sudden infant death syndrome (SIDS).
But for the very young child, there's an added benefit. Research shows that a baby who sleeps on its back has fewer fevers, stuffy noses and ear infections.
"There's no price to pay by having infants sleep on their back," says Dr. Carl Hunt, lead author of the paper that appeared in the Archives of Pediatrics & Adolescent Medicine , which he researched while at the Medical College of Ohio in Toledo . He is now director of the National Center on Sleep Disorders Research at the U.S. government's National Institutes of Health.
Several studies have shown that placing infants to sleep on their back reduces the risk of SIDS, which is the death of a baby that remains a mystery even after an autopsy and a thorough medical history. Children up to the age of six months are at greatest risk for SIDS.
In 1992, the American Academy of Pediatrics (AAP) recommended that infants be placed to sleep on their side or back to reduce this risk. The National Institute of Child Health and Human Development (NICHD) followed suit in 1994, and both strategies appear to have been successful. The number of U.S. infants being placed to sleep on their stomach decreased from 70 percent in 1992 to 17 percent in 1998. And death rates from SIDS in the United States decreased by about 40 percent during the same time period.
Despite this demonstrated benefit, some parents still choose to place their infants on their stomach out of fear the child will choke and a belief that children on their stomach sleep better.
The study on other benefits from placing a baby on its back to sleep was the first in the United States to look at health issues related to sleep position of infants. Smaller studies in the United Kingdom and Australia have found similar, positive results, the researchers say.
The researchers analyzed information on 3,733 infants who were part of the Infant Care Practices Study conducted in eastern Massachusetts and in Toledo , Ohio , between 1995 and 1998. All the mothers reported that their children were always placed to sleep in the same position -- the majority on their back, followed by side and then stomach.
The mothers were surveyed when their babies were one, three and six months old, to see if the infants had had any symptoms in the prior week, such as fever, cough, wheezing, stuffy nose, trouble breathing, trouble sleeping, spitting up, diarrhea and vomiting. Outpatient medical visits and visits to emergency rooms or clinics were also assessed for the prior month.
"We were able to show that there was a decreased probability of fever at one month, stuffy nose at six months and trouble sleeping at six months, as well as ear infection at three and six months" for infants sleeping on their backs, reports Marian Willinger, a co-author of the study and special assistant for SIDS at the National Institute of Child Health & Human Development.
"That's a real bonus because ear infections are a source of morbidity in young children. It's painful to the child, and it means missed days of work for parents. It's a whole slew of things," Willinger says.
"There is always the caveat that we're not measuring everything. This is based on parental report," Willinger adds. "[But] for the ear infection, we did ask for outpatient visits, so it wasn't just parents, and very often the maternal report is quite accurate and we were asking in relative real time."
The study, Willinger says, is "reinforcing. It's saying there aren't any major, adverse health effects, so we feel quite comfortable."
The researchers aren't sure why sleeping on the stomach might increase the risk of some health problems. Some scientists have speculated that infants who sleep on their stomach have higher temperatures in their mouth and throat, which may be conducive to the growth of bacteria.
On the other hand, children sleeping on their back also swallow more frequently, indicating they may be clearing their passages more effectively and thereby reducing the chance for blockage.
Whatever the reason, the message is clear. "It's very important that babies are always placed on their back for every sleep by every caregiver," Willinger stresses.
On the Web
For more on "Back to Sleep" SIDS campaigns, visit the National Institute of Child Health and Human Development .
SOURCES: Marian Willinger, Ph.D., special assistant for SIDS, National Institute for Child Health and Human Development (NICHD), Bethesda, Md.; Carl Hunt, M.D., director, National Center on Sleep Disorders Research, National Heart, Lung, and Blood Institute, Bethesda, Md.; May 12, 2003, Archives of Pediatrics & Adolescent Medicine
Author: Amanda Gardner, HealthDay Reporter
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