I have been following closely the discussion on sleep position as it interests me greatly.  I home visit mothers and their babies for 6 weeks postpartum.  As a health professional (midwife) I am obliged to promote the back sleeping message and certainly I cannot argue with the evidence. However it is the timing of the message that interests me.  Babies lie in the fetal position in utero held firmly by the walls of the uterus, when born they startle unless held tight or are wrapped in the fetal position. Why then would we expect them to be happy when lying unsupported and supine in a bed all on their own.  These babies then cry, mothers lose confidence and guess what gets blamed.  You guessed it - breastfeeding.  We are seeing many babies presenting to GP's with gastric reflux and later plagiocephaly.  Both of these seem to be more common with mothers who desire schedule feeding (just my observation).

But getting back to the newborn and back sleeping.  The only babies I see comfortable with this position are the postdates babies who probably have stronger muscle tone and more maturity to cope with the big wide open space back sleeping gives them.

If the highest risk time for SIDS is 1 - 4 months of age, why can we not promote back sleeping after the first two weeks of life when the baby is coping better with extrauterine life. I have asked this question of the "experts" and the answer usually relates to the optimal capture time of hospital admission for the postnatal stay.  This seems to include premature babies as well (with their really soft skulls).

I wonder if we are going to look back on this in future years and wonder if we did the right thing.

Just my thoughts....

Karen Palmer
Midwife 


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