Sunday, January 18, 2009

Why Our Babies Sleep On Their Bellies

In my previous post, a picture of our son sleeping, a concerned blog friend mentioned that the current thinking is that sleeping on belly may increase the risk for SIDS. As with most things, our decision to buck the current medical trend with our children hasn't come lightly, but rather with an extensive survey of the current research and a formulation of my own professional opinion.

That being said, here's some ground rules for this post:

1. This post is being made with the utmost respect for the person who made the original comment. (Every time I'm on your page and see the pictures of your little friend my heart breaks a little--I can't imagine the devastation of losing a child.)

2. This post is a statement of my own opinion. Albeit my professional opinion and soundly backed with current research, it is still just an opinion. And as people say, opinions are like bungholes--everyone has got one, and sometimes they stink.

3. Since this is a hot button issue, I'd love to hear your thoughts and opinions, but please keep it respectful and friendly--no dog-piling allowed. :)

The thing about SIDS is that nobody really knows why it happens. I think this is true for a couple of reasons. The diagnosis is incredibly broad. Any otherwise healthy baby that has an unexplained crib death is labeled with SIDS. My gut instinct is that we are lumping several disease processes together at a minimum. Secondly, I think the true cause of SIDS is probably multi-factorial. I think the quick reversal from back to belly to back as the preferred sleep position in such a short time is also indicative of this lack of true understanding.

Here's why we feel safe with our children sleeping on their bellies:

1. They get regular chiropractic adjustments. Much of the cutting edge research about the mechanism of SIDS shows that many babies have suffered a malposition or abnormal motion of the upper cervical area of the spine--namely the occiput in relation to C1, and C1 in relation to C2. The research shows that the upper cervical vertebrae can impinge on the brain stem in the location of the breathing centers. This is exactly the type of thing I was trained to find, diagnose, and correct in my post-graduate chiropractic work with infants and children. A simple, safe, non-forceful adjustment can eliminate this lesion.

How does this lesion happen? It can be mechanical, possibly from birth trauma--damaged with the forceful twisting and pulling that the modern birth process is known for. Oh and safe with a C-section? Actually, no, C-section delivery is often times more forceful than vaginal. The lesion can also occur in response to toxins in the body or stressful situations--but more about that later.

In a side note, the research is now showing this exact type of lesion in many Shaken Baby Syndrome cases. This type of upper cervical lesion has been demonstrated to cause all the tell tale symptoms of SBS. The strange thing is that it may appear in babies that haven't been shaken, leading to false diagnosis, and false accusations of parents. Also important to note is that many babies that HAVE been shaken do NOT demonstrate the cardinal signs, leading to missed diagnoses.

2. Our kids aren't inflamed, and therefore at a much lower risk. Respiration is a parasympathetic process, and in our insane world we are completely sympathetically over-driven. I hear you now though, "Are you saying even our babies are stressed out?!?" Well, in a word, I'd say, "Yes." But not in manner that you might think. Clearly most babies have it on easy street--eat, sleep, poop, repeat. But mom's lifestyle while carrying baby directly affects the fetus, so unless mom was chillin at the Zen Spa for 9 months, baby starts life stressed out.

Now lets look at diet. Dairy based baby formulas increase inflammation. That's all there is to it. They just do, because they are dairy based. Next, baby gets moved to grain based cereals which is straight up inflammation in a bottle. And then it's on to whole foods that contain preservatives, pesticides, artificial sweeteners, high fructose corn syrup--all inflammatory.

Thirdly, I have to mention immunizations, because the undisputed fact is that the contents of immunizations absolutely increase inflammation. The most common side-effect from vaccines is fever, redness and swelling--3 of the 5 cardinal signs of inflammation.

Inflammation can be a good thing--the body is designed to respond that way to speed healing. The problem is that we never resolve our inflammation these days--it's constant and additive. The inflammatory responses are intimately connected to the sympathetic nervous system, which in itself inhibits the parasympathetic system. This isn't cutting edge science here, it's simple physiology.

So in our case, we work very hard to make sure our kids aren't inflamed. They aren't immunized so they have normal functioning immune systems. They breast feed--which is great in two ways--no formula, and breast milk itself reduces inflammation. When they move to whole foods they eat organic, preservative free food with no artificial sweeteners or high fructose corn syrup.

In a nutshell, that's why we're comfortable with our babies on their bellies. They just sleep better that way, and if the major contributing factors to SIDS are reduced, then I don't see the problem.


  1. Awesome! Thanks for sharing all that. It's hard to change current health trends, but it helps to know a little more. See, I knew that you know what you're doing. :) I agree with so many points you brought up. I'm sure preventing SIDS is not as simple as keeping a baby on his back, and as naive as my first comment might have sounded to you who has so much more knowledge, it has occurred to me that the SIDS diagnosis doesn't actually say much, and that it's what they say when they have nothing else to tell the poor parents. Now I know--it's more about alignment and what happens to the spinal cord (inflammation) than just simply keeping the kid off his tummy. Got it :)

    When your professional work gets published I'm going to ask for an autograph, and I will use it with my future nursing students because you're very easy to understand :)

  2. Andrea--

    Whew! I am so very glad to read your comment. I really hoped you would take what I wrote the way I intended, and it sounds like you did. Thank you!

    I by no means know everything, and I've been wrong my share of the time. I try to keep an open mind and listen to new info as it becomes available. I think it's dangerous to make a decision and then stick by it no matter what, without re-evaluating along the way.

    I think my favorite thing about this whole exchange is the fact that you care enough to say something!! Thank you!!!

  3. Well stated. Thank you.
    My 7 month old has also been adjusted since birth, is breast fed and not vaccinated. She sleeps very well on her stomach and I have always felt safe with her being there.

  4. My kids are older and we were always told to put them on their bellies so the wouldn't choke if the happened to spit up while sleeping. My grandma also blew cigar smoke in my mother's ears when she had earaches. It's a wonder we all made it through childhood!
    p.s. your children are adorable.

  5. Daniel Patrick Moynihan famously wrote "everyone is entitled to their own opinions, but not to their own facts."
    It's early in the morning, but I didn't see one fact in your post, at least not one substantiated by medical literature, just expressions of opinions.
    As C notes, opinion absent facts can produce results that seem absurd once the facts are apparent.
    She also refers to "survivor's bias": those who survive get to tell their story, those who are dead don't. It results in stories about how you're safe if you don't wear seat belts, if your parents didn't use a car seat, and they didn't put you to sleep on your back. Absent facts, all you have is luck. Good luck to you, but more importantly, to your kids.

  6. George--

    Thanks for your comment. From the tone of your writing you certainly seem like a reasonably intelligent person. I guess that's why I'm a tad bewildered. You make a nice sweeping dismissal of my post, stating you can't see a single fact, yet I see that it's rife with them. For example--

    Dairy products cause inflammation--fact.
    Vaccines cause inflammation--fact.
    Breast milk reduces inflammation--fact.
    Inflammation drives sympathetics--fact.
    Birth trauma can result in upper cervical injury--fact.
    Upper cervical injury can lead to anoxic injury--fact.
    Chiropractic is uniquely suited to address upper cervical injury--fact.
    Autopsy of SIDS babies often demonstrate upper cervical injury--fact.

    I'm sure I missed a few there, but that's a good start.

    I think my favorite part of your comment though is where you ominously warn that my children are the ones in need of luck--with the implication that I'm gambling with their lives.

    It's an unfortunate insult--I mean we're not even friends. It's also exactly the type of thing I warned against in the ground rules of this post. You're welcome to present your opinion and supporting thoughts, but personal insults like that will get any further comments rejected rather than published.

    Thank you and have a good day.

  7. Sorry George, one more thought.

    I believe I mentioned what I was posting was an opinion--again I refer you to the ground rules (#2 in fact).

    However, as a healthcare professional, I am entitled to just such an opinion. And the general public, in theory, come to me for that opinion. It's comes with the degrees. To quote a popular movie, you see, "I'm kind of a big deal." ;)

  8. Thought you would be interested in this short omega-3 video:

  9. About a month ago I was on a message board and one woman had this quote in her signature: "No matter what parenting decision you make, there is someone out there just waiting to tell you what an idiot you are."

    You can't win with some people.

  10. A few things:

    That is the cutest freakin' baby! (ahem sorry I lost my man hood for a moment, but really the baby is cute)

    Also, thank you for posting that, I will pass that on to my fiance because for a long time now I have been debating what to do when her and I have children. I am not a fan a vaccinations, I do not like them, nor do I see them absolutely necessary. A lot of hospitals do it automatically at birth...I am assuming this did not happen with your children.

    Also I did not know any of that about the C1 and C2 with babies, believe me I will remember that forever.

    On another note, I am glad you confirmed my thoughts on breast milk vs formula. When I got my first degree I did a lot of studying about early childhood development and this was a debate we had. I said that breast milk would be inherently better for the baby since it came from the mother, was not full of garbage put in by a company, and builds the mother child bond because of the skin contact. Some of my classmates said that it none of that mattered, but the professor largely agreed with me.

    Anyone...great post and I will be sure to pass it on to those who need it (if you do not mind of course)

  11. It appears as though the only reason you want your son to sleep on his stomach is so that he will sleep better (longer). As a father of 4, believe me, I understand.

    But millions of babies sleep fine on their backs (supine). This simple intervention has a protective effect for SIDS, positional asphyxia, etc. with no significant negative effects.

    Why wouldn't you take the steps you already have and combine it with a safer sleep position?

    Supine babies will sleep nearly as well as prone, especially if swaddled properly (do not swddle a prone baby for obvious reasons!) After the first few months, sleep shouldn't be an issue either way.

    Good luck.

  12. Bill--

    It's a good point you make. An ounce of prevention beats a pound of cure, so therefore 2 ounces must be even better, right?

    We're definitely not on a barn-storming crusade to turn all babies to their bellies--far from it. But it is one less thing I worry about, prone or supine, whatever works best at the moment.

    Thanks for stopping by!

  13. Great Post! I'm against the Back to Sleep Campaign for a number of reasons:
    1-It inhibits Slow Wave Sleep (SWS) which is believed to be when most infants die of SIDS. SWS is also when memory consolidation occurs in infants and if you inhibit that you inhibit learning, memory, etc.
    2-The SIDS Task Force is led by Dr. John Kattwinkel who had a 3 day old daughter die in 1966. He's very passionate but I think he's too biased in terms of preventing SIDS and doesn't look at the negative impact.
    3-Infants who sleep supine compared to infants who sleep in the prone position are statistically significantly more likely to have the following:
    - Social skills delays at 6 months (Dewey, Fleming, et al, 1998)
    - Motor skills delays at 6 months (Dewey, Fleming, et al, 1998)
    - increased rates of gastroesophageal reflux (GER) (Corvaglia, 2007)
    - Below norm AIMS scores (Majnemer, Barr, 2005)
    - Milestone delays (Davis, Moon, et al., 1998)
    In addtion supin sleep also increases the duration of sleep apnea episodes during REM sleep at both 2.5 months and 5 months (Skadberg, Markestad, 1997)
    - 6% decrease in sleep duration (Kahn, Grosswasser, et al.,1993)
    - 1 in 300 infants had plagiocephaly in 1974 (Graham, Gomez, et al., 2005)
    - 1 in 60 infants had plagiocephaly in 1996 (Graham, Gomez, et al., 2005)

    Personally, I think in the most severe cases where parents just have their infants on their backs say over 23 hours a day and the child develops emotional problems and motor skills issues it's possible the child may be diagnosed with mild autism. Considering the Autism Epidemic Timeline and Parental Demographics parallels the Back to Sleep Campaign Timeline and Parental Demographics I'm concerned that their may be a conncetion. I know that Correlation does not equal Causation but I also do not believe in coincidences.

  14. TSC--

    Thanks for a very well written and supported comment.

    Aside from all the research you present you also bring up and excellent point about babies that spend the vast majority of their time supine. This absolutely disturbs the formation of the cervical curve, leading to forward head posture and a straight neck. This tractions the spinal cord and irritates the nerve roots--which actually changes the neurology. This improper neurology tends to lower the amount of propioceptive information transmitted to the cerebellum. That's an issue because it's actually trophic to both the cerebellum and in turn the frontal cortex.