Babies should sleep on their backs to reduce SIDS risk

What the research found

Reviews of the research link sleeping on the tummy with a higher risk of SIDS. A 2009 systematic review listed prone (tummy) sleeping alongside smoke exposure, soft sleeping surfaces, overheating and bed sharing. A 2021 review noted a dramatic drop in SIDS in many countries after "Back to Sleep" campaigns.

Australian guidance says the same. Both Red Nose and healthdirect list placing your baby on their back to sleep as the first step. Healthdirect says back sleeping lowers SIDS risk, and babies on their backs are less likely to suffocate, overheat or vomit. A 2022 US paediatric recommendation also advises back sleeping.

No trial can ethically assign babies to tummy sleeping, so the evidence is largely observational. Even so, the findings are consistent across reviews, guidelines and national experience. A 2016 review found most safe sleep programs combine several messages, including sleep position.

What it doesn’t mean

• Back sleeping lowers risk but cannot prevent SIDS completely. Other steps matter too: a firm flat surface, an uncovered face and head, a smoke-free environment, sleeping in your room for the first 6 months, and breastfeeding if you can.
• Once your baby can roll both ways on their own, you can put them down on their back and let them find their own position. If they can only roll one way, gently turn them onto their back. Swaddling a baby who is lying on their tummy raises SIDS risk, so stop swaddling when a baby tries to roll.
• Some sick babies are nursed on their tummy in hospital with constant monitoring. This is a temporary medical decision and should not be copied at home. Talk to your GP or child health nurse if your baby has a medical condition or reflux and you are unsure about sleep position.