My first daughter was born in the era when stomach sleeping was recommended. I quickly found out that she preferred to sleep on her side or back. She settled faster and slept longer. Of course I was terrified that she would choke in her sleep and worried about her! My refluxer, however, were born after the “Back to Sleep Campaign” and I was instructed to place her in the new, safe back positioning for sleep. After my little refluxer was sound asleep on my shoulder, I dutifully placed her in the crib on her back. The second her little back touched the Winnie the Pooh sheets, she would be awake and screaming. I would repeat this sequence over and over, until I gave up and spent the night holding her over my shoulder while propped up on pillows in bed. As I sat in the dark, I thought, “There must be a better way.”
Right now the best advice seems to be this:
· Always place a baby on her back to sleep to reduce the risk of Sudden Infant Death Syndrome (SIDS).
· Try elevating the baby to a more upright position to avoid reflux.
· Talk to your doctor about your baby’s specific condition to determine the best treatment actions.
Parents’ personal experiences
Parents often tell me that placing their baby over the shoulder after a meal is best for decreasing vomiting and increasing comfort. Unfortunately, some parents end up holding their baby over the shoulder 24/7 if the baby is in a high level of distress.
It may be tempting to place the baby on her stomach in the crib after she had settled on your shoulder so you can both get some rest. There is the very strong evidence that placing a baby on her back for sleep greatly decreases the risk of sudden infant death syndrome so regardless of the severity of the reflux, parents are still instructed to place the baby on her back for sleeping at all times.
As researchers learn more about the pattern of digestion before, during and after meals, and the effect of positioning, treatments can be targeted to the actual causes of reflux and ensure that the treatment is successful.
Meanwhile, parents need to follow the advice of the doctor to develop a treatment plan that is designed to address the needs of each child. In the future, perhaps there will be new positioning recommendations based on larger studies to confirm the results of these studies. In addition, there is some evidence that elevating the baby to a more upright position reduces reflux. More research is needed to study all sleep positioning.
As I was reading the studies this week and reflecting on the sleep patterns of my children, I had a wild theory. What if the Back to Sleep recommendation decreased deaths from Sudden Infant Death Syndrome but increased infant reflux? I guess research will reveal answers to these questions in the future.
