October 18, 2005

"Do you want your child to be uncomfortable or dead?"

That's one way of posing what has become a hot question. Experts have been telling parents to put babies on their backs to sleep, but babies really like to sleep on their stomachs. (So do I!) There is some correlation between sleeping on the stomach and Sudden Infant Death Syndrome. SIDS is rare, but so terrible that the hope of cutting the risk in half seems to justify putting your baby to sleep in a position it finds uncomfortable.
[M]ost pediatricians concede that when babies are placed on their stomachs, they tend to sleep better, they are less apt to startle and they often sleep through the night sooner.

And despite the warnings, a growing number of parents - exactly how many is impossible to quantify- are turning their backs on the Back to Sleep campaign. Postings on child-rearing Web sites also indicate a trend.

"The Web consensus is that it is O.K. to do," said Sarah Gilbert, a mother in Portland, Ore., and the editor of the popular Web log bloggingbaby.com.
The web consensus -- what a concept! (Are we supposed to capitalize web?)

This reminds me of the story I posted about last week about single women who seek to have children by artificial insemination and use the web to connect with those who support them and contradict the opposition they find in their immediate environment. It's important to see that the web is working this way, allowing people to escape the set opinions that surround them in the physical environment.

It works that way for me, by the way. I live in Madison, Wisconsin, an insular place, with a lot of fairly like-minded people. By blogging, I can leap beyond this place and get affirmation for saying things that would only otherwise have gotten me glares and shunning.

There is good and bad to this phenomenon. You can find support for all sorts of genuinely bad things on the web. But there's a very high end to the positive side. I think first of people in repressive countries getting inspired about freedom and individual rights. And there's every sort of thing in between.

Anyway, about stomach sleeping. I'm sure it's what I wanted as a baby, because I've never stopped (except when pregnancy made it impossible). To sleep on your stomach as an adult is not as looked down upon as putting your baby to sleep on its stomach, but it's something I find occasion to deny. I don't need my chiropractor scolding me and explaining to me about all the damage I'm doing to my spine and my neck. Get off my case! It's a great pleasure to sleep and to sleep face down is the best!

UPDATE: Lots of comments from parents, most of whom favor the comfortable baby, one of whom is grieving over the loss of a child to SIDS. You know, reading these comments, I suspect that the connection between SIDS and back sleeping is that the back-sleeping baby is sleeping less deeply and waking up a lot. The very thing parents don't like about back-sleeping is what protects from sudden death. But there should also be a question of what is lost if the baby isn't sleeping well. Perhaps the brain does not develop in the same way without solid sleep. Maybe the statistics about the increase in ADD and autism ought to be correlated to the back-sleeping trend.

28 comments:

Dustin said...

Ditto on the face down sleeping!

Our baby (7 months old now) started sleeping through the night when she was 2 months old. We'd put her on her back, and she'd just slide over on her side. Once she learned how to roll over, it was all over.

We're still kind of paranoid about it, after the 'shock and awe' back to sleep campaign, but she seems to have done fine.

Laura Reynolds said...

Ann: I find in your comments section, various points of views, I would not see in the normal course of life, even on the web for the most part. Often well thought out and respectful, whether I agree with them or not. Its nice to see common ground in the manner of discussion more so than the position on a topic.

As for sleeping on the stomach, before the concern about it re SIDS, that's how we got our oldest to sleep, something we were hesitant to do with our next two. Ironically she still sleeps the best of the three.

k said...

My "baby" is now 14, and all four of mine were put to bed the old fashioned way, on their bellies. But as Poet says, once they start rolling about on their own, they choose their own sleeping position anyway, and even some of mine ended up sideways or whatever. Oriental cultures have always, and continue to put their babies to bed faceup. But they also often swaddle, which is something I rarely see anymore beyond the newborn period. The weirdest thing to me is that still no one understands why or how the sleeping position contributes to the incidence of SIDS.

Freeman Hunt said...

Another ditto on the face down sleeping.

What if you decided to let your baby sleep on his stomach, and he died?! Ack! But then the idea of making the baby uncomfortable every night isn't agreeable either.

All these tricky little parenting issues make me nervous about becoming a parent.

Rick Lee said...

Yes, you can find affirmation for any sort of craziness on the web. This reminds me of a friend who told me some ridiculous conspiracy theory. When I challenged his wild assertion, he just looked at me like I was naive and said "It's all over the web, man!".

Ann Althouse said...

Dave: Some of the things chiropractors claim they can do are silly, but my chiropractor's ability to correct things in my neck and back is just brilliant. My back used to lock up and hurt me for days on end. Now, I just get an adjustment and any problem is nipped in the bud. It's great! I don't believe any of the silly stuff. But I can clearly see that he finds the bad spots and pops them into proper alignment. People who take pain medication or get surgery -- they are smarter, in your opinion?

goesh said...

- sleeping on the stomach causes back problems for adults

goesh said...

I use a Chiropractor on occasion too. There is more than one MD who refers patients to Chiropractors. The mild protrusion of a disc that is impinging on a nerve will not with the aid of a pill realign itself, and if in the course of our activities and pill-popping the disc does not align, then manipulation can align it. We do not hesitate to have the front end of our cars aligned, yet we look askance at the thought of the same principles of physics and mechanics being applied to the spinal column.

Ann Althouse said...

Cat: From the linked article:

Not only do many infants sleep better on their stomachs, they are much less likely to develop plagiocephaly, a deformation of the skull that leaves infants with flattened heads.

Dr. Jeffrey H. Wisoff, an associate professor of neurosurgery and pediatrics at New York University Medical Center, said that since the Back to Sleep campaign began, the head condition had "become an epidemic."

Dr. Wisoff, although he does not dispute the evidence linking supine sleeping to the lower SIDS rates, said that a decade ago he saw only a handful of plagiocephaly cases a year.

"Now we see up to a dozen kids with asymmetric heads a week," he said. "It drives parents nuts." The pediatrics academy, Dr. Wisoff said, should do a better job of telling parents to turn infants 180 degrees in their cribs occasionally and to place them on their stomachs while they are awake (a practice known as "tummy time").


So the post title should read: "Do you want your child to be uncomfortable and misshapen or dead?"

Tristram said...

Well, my 5 month old solved this problem about a month ago: I put him down on his back, and he promtply rolls on to his side or stomach. Unless I strap him down, he isnt' sleeping on his back.

My wife worries more than I do, because the chance of SIDS is so remote, and we spent time tomake sure the bed was safe.

Dustin said...

Cat wrote:

"My neice starting at about 6 months decided she preferred to sleep face down, knees to chest, butt up in the air...."


Yes, the Praying Bunny Fighting style! My Lucy does the same, while using her secret Ninja Snoring skills to scare away would-be attackers. Quit an advanced form of self-defense really. Ours adds in the Corner Fortress position to further thwart any advances. Sometimes even clinging through the bars for extra leverage.

She makes us laugh and gives me a never ending stream of Grandparent writing material.

Bruce Hayden said...

A nice collection of SIDS links can be found at MedlinePlus which is a service of the U.S. Nat. Library of Medicine and the National Institutes of Health (NIH).

The latest thing that may be of some use appears to be the use of pacifiers at night. Of course, when my daughter was that age, we were of the school that pacifiers were the mark of inferior parenting.

Also, remember that although SIDS can strike throughout a child's first year, it is much much more common during the first four months of life. Thus, by the time that babies are able to flip themselves over onto their stomachs, they are probably mostly out of danger.

Unknown said...

My cousin is an Ob-Gyn and all her babies sleep on their belly. She knows how to interpret studies: Beware the (assumed) causal link. This type of thing does feed the paranoia of the times.

reader_iam said...

Oh. My. The. Memory.

My now-5-year-old figured out how to roll over before two months. First-time-Older-Mom Panic! I had read all the stuff about SIDS and listened to my (wonderful) pediatrician. So for the first few days thereafter, I'd turn my son back over (waking him back up in the process--waah!) each time he flipped during the night and stay with him until he went back to sleep (a looooooonnnnnnng time). No sleep for me, or him, and this was a colicky baby who didn't really nap during the day (really--he got semi-predictable about at about 11 months at which time he went down to one nap only. Never slept in a car, either. Gave up naps altogether by age 3.).

Anyway, then I tried one of those harnesses the doctor recommended--velcroed pads you attach to the baby so that he can't roll over. For days, I tried it in all the recommended positions, but sure enough, he'd wriggle a good way out and I'd put him back in, with a new fear--that he'd smother in the darn harness.


The final straw (and the return of common sense) came when I went into the room only to find my son ON HIS TUMMY at one end of the crib and the whole harness thing-ee tossed in one corner--I swear to you, the one farthest from where he was sleeping--for all the world as if it had been flung with deliberate precision and contempt.

That was it. I called the pediatrician's office the next day, explained what had been going on, and said that unless the Doc was going to suggest that I tie the poor child to the crib slats, he needed to let me off the guilt train (I was still very hormonal and sleep-deprived: normally I don't require that kind of validation).

Greatest words ever from the kindly older nurse, "Dear, sometimes you can't fight nature: You have a child who will forever have a mind of his own, so go with it. And get some sleep."

Ahhhhhhhhhhhh. ZZZZZZZZZZZZZZZ. For both of us ....

(All that said, if I had another one, I would start out trying the back-sleeping approach, but I wouldn't torture either myself or the child, if it just didn't work.)

Bennett said...

Looking forward to my second being born in the spring. Our experiences have greatly tempered our susceptibility to all the alarmism on SIDS and a myriad other parenting issues.

There are thousand potential sources of paranoia for parents - vaccinations, co-sleeping, choice of day care, and SIDS, to name a few. But at the end of the day it's just you and the kid(s): no media or internet or stastical studies.

As a new parent of a newborn, you don't want to hear the blithely dismissive statement "it's a dangerous world", even though you know (a) it's true and (b) you've possessed the instinct, skill, and luck to make it so far. But face it. Any decision you make could potentially lead to tragedy. But (a) fear is not in itself a decision, and (b) even in the guise of a decision may have little effect (e.g. kid rolls over every five minutes anyway) and (c) many forms of tragedy are much more close by and tangible than SIDS. So if any of this "advice" prevents you from looking, listening, and feeling your way through parenting decisions, minute by minute and day by day, you're losing out.

There's no way to rack up experience except through some risk. As a parent I know that feeling of sometimes wanting to stop time - no more dangers, no more growing up. But you can't jump off the conveyor belt to go look for peace of mind - it has to be cultivated on the fly.

No phenomenon - whether infant death, high cholesterol, teen violence, etc, is driven by one factor alone. But, unfortunately complexity can't be handily wielded to induce fear in the media-dependant public. Complexity isn't news.

Ann Althouse said...

Dave: Yes. The fixes work and last a long time and I used to go through painful periods that lasted weeks and were getting more frequent. I would like to take personal responsibility for the alignment of my bones, but I've learned from experience that I can't. And I'm pretty skeptical about any sort of medical treatment.

goesh said...

Ms. Ann - please delete this whole section. Insurance companies have been duped into offsetting the cost of Chiropractic care. If any Execs from my company are reading this section of your blog, I'm screwed and will have to foot the whole bill.

bill said...

For the first few months, if she made too much noise while sleeping, we'd check on her. If she didn't make enough noise, we'd poke to make sure she was breathing.

My daughter naturally slept on her back, then when she could rolled over it was into the Praying Bunny Fighting style. Now at four, she’ll fall asleep in either the “signaling touchdown position” or “Jesus on the cross” before rolling to her side.

As for chiropractors, I have much the same opinion as Lou and Dave. This is mostly colored by my proximity to Life College (Marietta, GA), just about the biggest bunch of ambulance chasing, subluxation spouting, anti-vaccine preaching, “doctors are evil” morons around. I am aware that there are backscratchers with medical backgrounds who don’t think science is evil and don’t think chiropractics cures cancer, still I’d rather just see a physical therapist for a chronic condition. If my physician ever recommended a chiropractor I’d be looking for a new doctor.

Let’s get back to the real question: should Web be capitalized?

Answer: It depends. It depends on your preferred style guide - you do have one, don’t you? - and your audience.

The more academic resources, such as CMS will insist on capitalizing Web, Web page, Web browser, etc. Less academic and more technical resources are split, but I see the trend moving towards lowercase.

The Microsoft Computer Dictionary uses uppercase when Web is short for World Wide Web, and lowercase when web refers to “a set of interlinked documents in a hypertext system...See also World Wide Web” OK.

On the otherhand, The Apple Publications Style Guide uses lowercase for all instances. And in a move I heartily endorse and support in my department, they also combine forms into a single word: webpage, website, webcast.

I think this single form, lowercase is where the language is evolving. Much like Electronic mail became E-mail became e-mail, so the preferred form is changing to email. Certain institutions are slower to change and will claim “E-mail” is proper and correct long after email itself is dead and we communicate by blinking.

Should Web be capitalized? If writing for yourself, use whichever you prefer. For publication, check their standards. I would suspect that for most academic and formal writing, uppercase will be preferred.

Tristram said...

My daughter naturally slept on her back, then when she could rolled over it was into the Praying Bunny Fighting style. Now at four, she’ll fall asleep in either the “signaling touchdown position” or “Jesus on the cross” before rolling to her side.

Lol, love the descritions / names for sleeping position. My wife and I actaully called out boys initial sleeping position (on his back) 'Chicken Mode' because he'd sleep with his knees up to his chest and arms flung up next to his head, with his plump little belly, I swear he looked like a trussed chicken...err...except for that melon head of course.

Bennett said...

I am not too familiar with Palmer but know a contingent of Japanese students who came to Davenport to study at Palmer and are there now.

Asked whether they like it, they are pretty reticent, but seem to like it okay. They came for Palmer's reputation, most of them speaking very little English. It must have quite a rep.

Bennett said...

...although the contingent of Japanese students does seem to have become fairly ubiquitous among American learning institutions of virtually any stripe.

reader_iam said...

Yep, Tom, it's quite the kerfuffle. And it's one that, if you live in Davenport, as I do, that it's hard to ignore, as influential as the college and the family who founded it have been and still are.

I'm live and let live about chiropractry: if it works for you, it works--there is no one-size-fits all, generally speaking, when it comes to health care, by my lights.

That said, the one thing that does concern me a bit is that since there are so very many chiros around here, and so many patrons, there also seems to be quite a bit more "no vaccines for kids" types. I rarely ran across parents who didn't vaccinate when I lived in the East, but now I do so frequently. Being basically ignorant of epidemiology (am I even referring to the right discipline?), I don't know if there's a critical mass at which there's more of a threat of particular disease outbreak. My kid's now fully vaccinated, but this did bother me when he was a teeny-tiny. And are my and my husband's childhood vaccinations still going strong? What about older people (Iowa's demos trend older than some other states)?

Interestingly, many of the "no vaccine" types that I know are also adamant about back-sleeping, because of the risks. I have a hard time getting my mind wrapped around that one. Does anyone else?

Bennett said...

Reader Iam,

I would add one more issue - co-sleeping - and place them along a continuum. The debate on co-sleeping is whether it is safe for the baby to sleep in the bed with its parent(s). Many people are adamant that this is dangerous and unhealthy on various levels (I'm going to venture a guess that the culture in which men suckle their babies on their nipples does not have a problem with co-sleeping).

The co-sleeping question you can figure out by knowing yourself (how you sleep, how sensitive to your baby's presence you are at night, physically attached you are to your baby) and and knowing the baby (same questions). You have the information (observation) and you have control over the outcome (whether the baby sleeps in a crib or in the bed).

Back-sleeping is also an issue dictated by common sense, not least because you can't do anything about a kid who insists on sleeping face-down. You may have the information (about the SIDS correlation), but not necessarily control (over the baby's sleeping position).

With vaccines, by contrast, you're rolling the dice without much empirical basis for making a decision. We don't have observations or instincts that tell us which way to go, and if a mutant virus blows your baby's way, whether now or in 2050, will his immune system be stronger for having survived lesser viruses without the crutches of immunization, or will another serious illness have claimed the kid before it's even an issue? And of course, will the baby be harmed by the mercury or other components of the vaccine? I know someone whose infant daughter died due to a supposedly safe vaccine, and she knows many other parents whose kids died too.

With vaccines, people typically have little or no good information regarding the dangers of specific vaccine (or lack thereof), but do have the ultimate yes-or-no decision. Because common sense and observation are useless, it's power without knowledge - which makes it one of the scariest choices as the parent of a baby.

Jinnmabe said...

My doctor aunt told me that the conventional wisdom was now that it was ok for babies to sleep on their stomach. Or rather that the SIDS menace had been overstated.

Do most parents take all risks that occur in the 1/1000-0.5/1000 range into account when ordering the lives of their children? Such as having a bucket anywhere on the premises? Or is it just the fashionable, "in-the-news" risks that we guard against?

vbspurs said...

Do most parents take all risks that occur in the 1/1000-0.5/1000 range into account when ordering the lives of their children? Such as having a bucket anywhere on the premises? Or is it just the fashionable, "in-the-news" risks that we guard against?

I was a premie, so I had to be carefully monitored.

I was also one of the very last in my parents' circle, who had a nurse as a matter-of-course. Now, even upper-class families, which might certainly weren't, don't have one.

She apparently had very old-fashioned ideas about sleeping with windows open in the bitter cold, that may well have contributed to a sound constitution, but a propensity for bronchitis.

When I was doing my Peds rotation, we were told to inform mothers of any SIDS concerns, even if they're not at-risk babies.

Like the Avian flu' buzz, it's a question of covering one's butt in the US. Better to hype, than to be accused of not doing so.

Cheers,
Victoria

Tom T. said...

Tying up the two topics in this thread, it seems to me that an enterprising chiropractor could easily put together some sort of device to allow one's newborn to sleep safely in traction.

knox said...

I have a 7-week-old and I am too scared to put him on his stomach... However, I have found that swaddling the baby, laying him on his side and putting him in a swing to sleep works great. He will sleep for hours this way.

I highly recommend the book (and DVD) "Happiest Baby on the Block." It has great information on how to calm a baby and get him to sleep longer without being on his back. A lot of this information is gleaned from other cultures' parenting practices that we don't know about here.

Jennifer said...

The last poster cites a book by Jim Sprott. I won't go into tons of detail but after looking for all the info I could find on his theories and book, I think he is selling a type of mattress cover which purports to block "gases" coming from mattresses which he thinks cause SIDS. I can't find anyone, including a number of SIDS foundations, who gives him any credibility and I think it's a plan to sell books and mattress covers.

On the two other subjects, my daughter kept us in bouts of sleeplessness for almost six weeks. She would fall asleep in our arms or facedown on our chests and less than a minute after being placed on her back, she'd wake up wailing. Finally in desperation I began allowing her to sleep on her stomach. The SIDS phenomenon is a mystery but what is known are some prevailing factors. More boys than girls succumb; more infants who sleep without pacifiers succumb; more children in homes of smokers succumb; more succumb in wintertime; and of course, the most "controllable" factor, more infants who are ruled to have died of SIDS are found on their stomachs.

Since our female child slept in summer with a pacifier in a smoke-free house, we took what they call a calculated risk. She became a perfect little sleeper, literally overnight, once we allowed nature to take its course.

On the point of chiropractic - I have scoliosis. In ninth grade, the medical opinion was that I should have surgery, and I had metal rods inserted in my back, and was told this was to "prevent serious back pain starting around the age of 30." Despite this treatment, I have had chronic back trouble since I was 20 (I'm 34 now), and the ONLY relief I have gotten other than from over-the-counter drugs is from a chiropractor. I can literally feel my joints pop out of place and I can't fix them myself (God knows I've tried). It is worth the out of pocket cost every few weeks or so. None of my medical doctors have recommended anything other than pain pills to help me. I wouldn't go to a chiropractor if I had colon trouble or anything like that but I would not hesitate for bone and joint problems.