Baby Sleeping Face Down?

Baby Sleeping Face Down

Are you finding your baby sleeping face down? 

Finding your baby sleeping face down is a terrifying feeling.  The founders of SafeSleep® know too well.  They lost loved ones to SIDS who were found face down on a fiberfill mattress.  At the time,  one is 4 months and the other is 7 1/2 months.  Two seemingly healthy infants found sleeping face down and unresponsive on their mattress. 

The AAP has No Clear Guidelines to Address the Situation “When a Baby Begins Rolling Over”

Current recommendations and guidelines from the American Academy of Pediatrics (AAP), and other sources for infant safety, do not address the situation of the infant who rolling over in the middle of the night with no supervision.  Too often, these babies end up in a straight-down position.  Unfortunately, when the baby is sleeping face down, he or she is at a significantly increased risk of SIDS, positional asphyxiation, and suffocation.¹

Using Scientific Data, We Provide the Best Solution for a Baby Who is Sleeping Face Down.

Since one of the founders of SafeSleep® is a pediatrician, using scientific data was a must in creating a solution for infants who are rolling over and sleeping face down. 

Finally!  We can now successfully answer the question that the Back to Sleep campaign does not!  What do I do if my baby starts rolling in the middle of the night and is sleeping face down?  (FIND OUT MORE ABOUT THE SAFESLEEP® BREATHE-THRU CRIB MATTRESS)

First, we use scientific research for a better understanding of the real risks involved when infant’s are rolling over or, worse, are sleeping face down.

Infants Rolling Over and Sleeping Face Down

Researchers from New Zealand show that more than a quarter of infants who died of SIDS in their study are last placed in a back position and rolled to a stomach position.²  These researchers are suggesting an infant’s ability to escape potentially fatal situations during prone sleep may be impaired by inexperience in prone (stomach) sleep.  Later, their findings are supported by Dr. Moon and colleagues in their review of infant sleep related deaths in child care settings.³ 

Unfortunately, infant inexperience in stomach sleeping is now a common unintended consequence of the successful back-to-sleeping campaign.  Notably, we have no way of keeping young infants from rolling,  Far too often, we are finding them sleeping face down.

SIDS Risk and Baby Rolling Over and Sleeping Face Down

The fact is, infants under six months of age represent about 90 percent of all SIDS-related deaths.  The belief is SIDS risks is peaking between 1-4 months of age.  Notably, this is the age infants are beginning to roll over.

In a study on infant sleep, 6% and 12% of 16 to 23-week-old infants placed on their backs or sides are found in a vulnerable (face-down) position.  Additionally, 14% of infants aged 24 weeks or older are in the prone (stomach) position.  Lastly, 18% of those placed on either their right or left or sides, are found in the prone position.4

Nothing to Do with Good Head and Neck Control

Parents are often falsely assured when their infant rolls on their  own or has good head control, they are no longer at risk of SIDS or suffocation.   

In contrast, scientific test results tell us differently.  According to SIDS researcher Dr. Bradley T. Thach, “The first times babies who usually sleep on their backs or sides roll or are put on their tummy have a 19-fold increase in the risk of sudden death,” Thach says. “We wonder if these babies, who find themselves face down, do not turn their heads to breathe easier.  If so, that is because their reflexes haven’t developed far enough or because they simply don’t wake up?  Many parents believe if a baby can lift its head, he or she is okay to sleep on their tummy, but that is a false assurance,” Thach says.5

Repositioning Baby Who is Sleeping Face Down

Some physicians encourage parents to move an infant who is sleeping face down back to the supine (back) position.  However, turning a baby back over is unrealistic with several position changes per night.  Furthermore, a baby sleeping on his tummy and repositioning him to the back position is disruptive.  Some medical professionals believe repositioning an infant who is sleeping on their tummy can completely discourage parents from using the back position. 

According to a study published in the Journal of the American Medical Association, there is insufficient data on specific recommendations on when infants can sleep in a stomach position.4   Consequently, it is hard for parents to determine the appropriate age when it is safe for their baby to be sleeping on their stomach. 

Carbon Dioxide and Baby Sleeping Face Down

Currently, the AAP recommends a firm crib mattress with a tight-fitting sheet.  However, the firm mattress with tight-fitting sheet shows posing a high risk of rebreathing of carbon dioxide.  In fact, according to a 2000 study published in Pediatrics, the findings reveal  firm mattresses pose a high risk of rebreathing  while infants sleep prone.6   Further, these findings may be of relevance to recent studies showing that unaccustomed prone sleepers, i.e., infants who typically sleep supine (back) but are inadvertently placed or roll prone (stomach), have an increased risk of SIDS.   For example, these studies show from 43% to 71% of SIDS victims, unaccustomed to prone sleep, were discovered in the face-straight-down position.” 5

Carbon Dioxide Rebreathing and SIDS

Rebreathing carbon dioxide, also known as rebreathing, is caused by an infant lying face-down or near-face-down on his stomach and air is trapped around the baby’s nose or mouth.  Consequently, this trapped exhaled air causes the baby to breathe more carbon dioxide than oxygen.  Specifically, if the baby does not wake up or respond appropriately, it leads to death.7

Example of what is happening when a baby is sleeping face down on a fiberfill crib mattress

David Greenblatt, Faculty of Mechanical Engineering, Flow Control Laboratory, demonstrates Infant Suffocation Caused by Rebreathing Carbon Dioxide.

Unfortunately, conventional crib mattresses with fiber fill, vinyl covers, and quilted toppers can cause carbon dioxide to accumulate.  According to Dr. James Kemp and Dr. Brad Thach, these bedding materials act to retard the dispersal of exhaled gasses (carbon dioxide), retaining the gasses near a face down infant’s nose and mouth.  Consequently, with each subsequent breath, the infant takes in an air mixture which is progressively less adequate to sustain life. Further, the more conducive an item is to rebreathing (retaining carbon dioxide), the more hazardous the item is.8

Peer-Reviewed Studies

Based on multiple peer-reviewed studies, SIDS experts agree, infants sleeping on the following surfaces show increased suffocation and the risk of rebreathing of carbon dioxide.

  • fiberfill crib mattresses
  • quilted surfaces
  • soft surfaces
  • pillow-like surfaces
  • vinyl pads
  • mattresses filled with tea tree bark and other natural and artificial loose fibers

The Solution to Baby Sleeping Face Down

Finally!  There is now a scientifically proven solution to bridge the safety gap not addressed by the back-to-sleep campaign – what to do when a baby starts rolling over.  A solution that keeps a baby sleeping face down safe

There is a now a crib mattress that addresses the concerns associated with conventional crib mattress should an infant roll.  A crib mattress that allows an infant who is sleeping face down to to breathe normally all night long.  It’s called the SafeSleep®.

By design, the SafeSleep® eliminates safety risks associated with crib mattresses should your baby end up sleeping face down.

Eliminating Suffocation and Rebreathing Risks

Peer-reviewed published research tells us infants rebreathing carbon dioxide (CO2) is a known danger of stomach sleeping.  Another danger is suffocation.  Rebreathing CO2 is actually a form of suffocation.  Rebreathing CO2 leads to hypoxia which is a lack of oxygen to human organs.    

Crib mattresses with fiber fill are known to trap carbon dioxide.  They can also cause suffocation.  Therefore, the design of the SafeSleep® eliminates both suffocation risk and the risk of rebreathing CO2. 

No Fiberfill or Core

To protect babies from suffocation risk, it’s important they can breathe normally when face down.  In order to accomplish this, a crib mattress must be completely breathe-through.  In order to make a crib mattress completely breathe-through, there can be no fiberfill or core material.  Fiberfill and core materials prohibit airflow and they are known to retain CO2.  Consequently, the SafeSleep® has no core or fill material of any kind.  Instead, the base of the mattress is a hollow box with side openings, allowing constant airflow.

Air-Permeable Breathe-Through Surface

Next, the surface has to be air-permeable.  It’s important the surface a baby is sleeping face down on be completely breathe-through.  Remarkably, the SafeSleep® tests for 100% oxygen-rich air while a baby is breathing through the surface.  To be completely breathe-through requires a surface that is made from an open-weave material.  A material that allows air to pass through it at a significantly high rate of airflow.  The SafeSleep has an air-permeability rate of over 330 times other crib mattresses tested.  That’s a lot of air-flow!

A Real Solution for a Real Problem

Developed by People with Real KnowledgeOur Story!

The SafeSleep® breathable crib mattress  is designed to keep an infant who is sleeping on their stomach, or is sleeping face down, safe.  There is no fiberfill or core to trap carbon dioxide. Instead, the SafeSleep® breathable crib mattress has a hollow center, side openings and a firm, air-permeable topper.  This revolutionary design creates an oxygen-rich environment, even when an infant is face down all night.   As an added safety feature, we removed the use of crib mattress sheets and replaced it with a 100% easily washable crib mattress surface.

Safest Crib Mattress

Scientific Data on Air-Permeable Crib Mattresses

Scientific evidence shows some air permeable mattresses have a “significantly” reduced risk of rebreathing of carbon dioxide.9,10  For instance, the SafeSleep® Breathable Crib Mattress has been tested for carbon dioxide retention and has a tenfold decrease in carbon dioxide retention compared to a fiberfill mattress with a tight-fitting sheet.  For example, it takes 120 seconds for carbon dioxide to dissipate from a firm crib mattress with a tight sheet.  However, it takes less than .5 (1/2 a second) for it to dissipate from the SafeSleep® Crib Mattress.10

In conclusion, an infant takes a breath 40-60 times per minute or every 1-2 seconds, meaning carbon dioxide (poisonous gases) on the SafeSleep® Breathable crib mattress disappears before the infant takes his next breath of air – even if their face is straight down.

Is your baby sleeping face down?  Give your baby the safety they need.  When you’re not there, SafeSleep® is.  

Study References:

  1. Carleton, James N.,  Donoghue, Ann M.,  Porter, Warren K. Mechanical model testing of rebreathing potentialin infant bedding materials.  Arch Dis Child 1998;78:323–328
  2. Mitchell EA, Thach B, Thompson J, Williams S. Changing infants’ sleep position increases risk of sudden infant death syndrome. Arch Pediatr Adolesc Med. 1999;153:1136–1141
  3. Rachel Y. Moon, Kantilal M. Patel and Sarah J. McDermott Shaefer. Sudden Infant Death Syndrome in Child Care Settings. Pediatrics 2000;106;295
  4. Willinger M, Hoffman HJ, Wu KT, et al. Factors associated with the transition to nonprone sleep positions of infants in the United States: the National Infant Sleep Position Study. JAMA. 1998
  5. Paluszynska DA, Harris KA, Thach BT. Influence of sleep position experience on ability of prone sleeping infants to escape from asphyxiating microenvironments by changing head position. Pediatrics, Dec. 1, 2004.
  6. Patrick L. Carolan, William B. Wheeler, James D. Ross and RCP*; and James S.Kemp, Potential to Prevent Carbon Dioxide Rebreathing of Commercial Products Marketed to Reduce Sudden Infant Death Syndrome Risk, Pediatrics 2000 105;774
  7. Patel, Aloka L., Harris, Kathy, Thack, Bradley T. Inspired CO2 and O2 in sleeping infants rebreathingfrom bedding: relevance for sudden infant death Journals.Physiology.org/doi/pdf/10.1152/jappl.2001.91.6.2537
  8. Kemp, James S., Nelson, Verna E., Thach, Bradley T.,  Physical Properties of Bedding That May Increase Risk of Sudden Infant Death Syndrome in Prone-Sleeping Infants.  Journal of Pediatrics,July,1994,Vol.36,no.S1
  9. Bar-Yishay E, Gaides M, Goren A, Szeinberg A. Aeration properties of a new sleeping surface for infants. Pediatr Pulmonol. 2011;46(2):193–198 342. Colditz PB, Joy
  10. William W. Fox, MD and Thomas H. Shaffer, Carbon Dioxide Rebreathing Assessment of SafeSleep® Crib Mattress Sample.  Intertek., wouso7330

More information on crib mattresses and baby sleeping face down, can be found here.