When a baby who has learned to roll over settles in on the tummy, parents often wonder whether to turn them back. Even if a baby looks comfortable, sleep position and the sleep space are linked to the risk of sleep-related infant death, so it helps to know the basics.

Why the Sleep Environment Matters

Sleep-related infant deaths, including sudden infant death syndrome (SIDS) and accidental suffocation, are risks mainly in babies under 1 year old. Soft bedding or sleeping face down can make it hard for a baby to breathe or turn the head. The AAP’s updated 2022 policy statement in Pediatrics, Sleep-Related Infant Deaths, gathers recommendations aimed at lowering these risks.

How It Changes as Babies Grow

The AAP recommends placing infants on their backs for every sleep, naps and nighttime alike, and says that side and stomach positions are not safe. The first months are generally considered the highest-risk period. Once a baby can roll both ways on their own, you can put them down on the back and do not need to keep repositioning them if they roll over by themselves. The AAP does advise stopping swaddling as soon as a baby shows signs of trying to roll over. Risk drops substantially after the first birthday, though a safe space remains important.

Setting Up the Sleep Space

  • Use a firm, flat surface with only a fitted sheet. The AAP considers sleeping on an incline of more than 10 degrees unsafe.
  • Keep the crib or bassinet bare: no pillows, blankets, bumper pads, stuffed toys or weighted blankets or swaddles.
  • Room sharing is recommended without bed sharing: the baby sleeps in their own crib or bassinet in the parents’ room, ideally for at least the first 6 months according to the 2022 update.
  • Avoid letting a baby sleep on sofas, armchairs, in car seats or strollers when not traveling; move the baby to a flat bed afterward.
  • Supervised tummy time while the baby is awake can begin soon after hospital discharge and supports motor development.
  • Keep the baby’s space smoke-free during pregnancy and after birth.

Common Misunderstandings

  • Many parents think tummy sleeping helps with reflux, but the AAP says stomach sleeping is not recommended even for babies with reflux.
  • Giving in because a baby sleeps longer on the tummy can turn into a habit, so it is easier to correct early.
  • Soft mats and inclined sleepers may seem comfortable, but they are not considered safe sleep products.

When to Call 911 or Go to the Emergency Room

Call 911 right away if a sleeping baby seems not to be breathing, has blue or gray lips or face, or is limp and does not wake. Talk with a pediatrician if your baby often spits up and has noisy breathing, or if you notice repeated pauses in breathing during sleep. This information is based on U.S. (AAP, CDC) guidance; if you live elsewhere, check with a local pediatrician for country-specific recommendations.

This information isn’t a diagnostic tool and doesn’t replace advice from a medical professional.