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When Baby Prefers Tummy Sleeping

By Jeanne Ohm, DC

What is your recommendation about infant sleep position? We have a two month old (our third) who is having a really hard time staying asleep on her back. She seems to be happier on her tummy and seems to have no trouble lifting and turning her head when face down. I know about the medical establishment’s recommendation about back sleeping to reduce the risk of SIDS but wondered if there was more to the story?

When our six children were young, it was still the recommendation to put children on their bellies to sleep. Being Doctors of Chiropractic, my husband and I chose not to. Basically, what we saw in our practice was that our patients who were stomach sleepers had chronic neck problems and even when they began chiropractic care, they did not hold their cervical (neck) adjustments well. From a biomechanical perspective it did not seem right to put our children on their stomachs either. We chose to have them sleep with us, primarily on their sides.

It is true that the American Academy of Pediatrics now recommends that children sleep on their backs to reduce the incidence of SIDS. Since this “Back to Sleep” program was initiated, the incidence of SIDS has been shown to decrease.

Being a Doctor of Chiropractic I am always concerned with “cause”. When I heard about this “Back to Sleep” campaign and its results, I looked at the biomechanics. Why would back sleeping reduce the incidence of SIDS? From a biomechanical perspective it was clear to see that when a baby is placed on his or her back, there is no stress to the baby’s neck or lower cranium. However, when a baby is placed on his or her belly for sleep, the head and neck will be in constant rotation to one side or the other. This rotation along with the pressure and weight of the head holding it in rotation causes continuous irritation to the cervical spinal cord and nerves. This area in the neck is also the area where the respiratory centers are. This continued irritation during sleeping hours may adversely affect that area of the spinal cord and therefore adversely affect proper breathing function. SIDS is defined as a condition where a baby just stops breathing. Although a cause has not yet been defined, most studies relating to SIDS have explored and discovered a malfunction of the respiratory system in the infant.

My question has always been: What then can cause this malfunction? Why would a primary system like respiration just stop? Since it is the nerve system that controls respiration, what could have happened to affect normal nerve function responsible for respiration? Was there any potential injury or trauma to the nerve system causing interference to normal respiratory function?

When you look at the amount of pulling and rotation done by most operators in the majority of births today, there is good reason to believe that this type of pulling has caused irritation and even injury to the cervical spine and therefore the nerves it protects. Even in what is considered to be “natural births” there is often undue pulling and stretching of the infant’s spine.

Now take a baby who has even slight irritation or injury to the cervical nerves because of pulling at birth and picture placing this same baby on his or her stomach for the many hours he or she sleeps. As mentioned, this belly position will force the baby’s neck to be rotated to one side or the other creating what is called “noxious stimulation” to the cervical nerves and spinal cord. The result is additional irritation to a possibly already injured area. From a biomechanical point of view, this spells SIDS.

You mentioned that your child has difficulty sleeping on her back. Is she also arching her spine? Is she sensitive when you touch her neck and the back of her head (the occipital portion)? Does she seem to have a tilt in her neck to one side or the other when you lie her on her back or hold her up in front of you? All of these signs are indicators that she is experiencing spinal nerve stress and would benefit from a chiropractic check up.

I would suggest that you give serious recall as to how “gentle” your child’s birth was, research the safe options and advice about co-sleeping to offer her more comfortable sleeping postures and make a choice that is right for your baby. Additionally, you can locate a Doctor of Chiropractic on our membership directory who cares for infants. Alleviating any spinal nerve stress early in life will have profound effects on your child’s overall health and well-being.

Jeanne Ohm, DC