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'My baby won't sleep on their back. Help!'

This is by far one of the most common issues for newborn babies. If you are a new parent you might expect that your baby will sleep anywhere and at any time, and it can be a huge shock to the system when you realise that isn't the case for most babies. A huge majority of babies will only nap in their caregiver's arms in the first few weeks of life, but those babies will often sleep in a cot on their back for at least one long stretch of sleep at night when sleep pressure is high. But for a large minority of babies, they will only sleep if they are being held for 24 hours a day.

Mother sleeping on a sofa with a baby asleep on her chest

In the UK the NHS and The Lullaby Trust provide clear guidance that the safest sleeping position for babies at night is on their back, on a firm and flat surface, within a separate sleep space located in the same room as the parents. But this isn't how babies often like to sleep - they are biologically predisposed to want to sleep close to you and they don't yet know they are a separate entity to you, so they want to be held by you all the time. Just know, what you're experiencing is really normal, and you're not doing anything wrong.

If your baby won't sleep on their back then this can be manageable during the day when you can get help and make use of slings, but at night this can feel like torture. This is really tough time, and although it is very common, it isn't something you should just survive through. This article will hopefully shed some light on the reasons why babies behave this way, and what you can do to help. 

When is this normal? When is it not?

Woman wearing  her baby in a sling

It is very common for babies to want to be in your arms when they sleep, and if you have a very young baby who will only nap in your arms in the day and they resist going into a cot, moses basket or even a pram, this is very normal. Often it is fruitless trying to establish naps in a cot in the very early days of a baby's life as they often sleep best during the day in your arms or close to you.

To make contact naps more sustainable you can use a sling - a stretchy wrap sling* like the one shown here can be perfect. It can allow you to have your hands free while your baby is also able to feel that sense of closeness they are craving. I find these work better than more structured slings for these velcro babies, as it allows them to feel that sense of closeness to you.

Also, if your baby will only sleep on their back for overnight sleep if it's very, very late at night (sometimes as late as midnight-2am) then this is quite normal and could be that your little one is just experiencing some day and night confusion, which can be improved over time.

However, if your little one will not lie on their back ever and they scream if placed on their back for naps, during the night, for nappy changes, when on a play mat and if they are in a pram, this may indicate something isn't quite right.

Why won't your baby sleep on their back?

There are many and varied reasons why your baby may resist sleeping on their back. Sometimes there are physical underlying reasons why your baby will not lie on their back at all.

Below are some reasons:

  1. Skeletal Tension: Sometimes, discomfort on a flat surface may indicate underlying issues with your baby's body posture - there are conditions such as 'torticollis' where your baby may show a preference for holding their head in one particular direction. Consider visiting a cranial osteopath if your baby's posture seems off, especially after an assisted delivery (ventouse or forceps) or if your baby was breach or stuck in the birth canal during labour.

  2. Reflux: Often we think reflux involves a baby projectile vomiting full feeds, so it would be obvious if they had it. But reflux is a symptom rather than a disease itself, and as such it can present differently for all babies. And some babies have what is referred to as 'silent relfux' which is where they actually don't vomit or regurgitate. Reflux can make lying on their back uncomfortable for babies. Getting to the root of your child's reflux is often key - it can be caused by a range of factors which can inclue allergies, intolerances, poor latch, excess air.

  3. Tongue or Lip Tie: Tongue tie can affect feeding and contribute to sleep issues as babies either aren't feeding well or it can be that they are taking in excess air as they feed due to poor latch caused by the tongue tie. If you suspect a tongue tie despite previous reassurances, consider consulting a tongue-tie specialist for evaluation and treatment.

  4. Wind or Gas: Babies can be uncomfortable due to trapped wind or gas. Take the time to burp your baby after each feed to prevent discomfort that may disrupt sleep.

  5. Allergies/Intolerances: I mentioned this a little when I mentioned reflux above, but if you suspect your Little One is showing signs of an allergy, it can be helpful to complete the Cow's Milk related Symptom Score chart here. If your baby has a high score you should discuss this with your GP or Health Visitor.

It may not be that there's anything at all that's underlying there's a couple of

  1. Your expectations are unrealistic: I mentioned this a little earlier, but it may be that you are trying to settle your baby to sleep to early in the evening newborns can have very, very late bedtime. Likewise, if your baby sleeps in a cot at night, but will only sleep with contact in the day, this is normal. It is tough, but I promise it's not forever. Trying to get your little one into a regular pattern of sleep will be most helpful here, regardless of how the naps happen so that your little one comes to expect sleep at certain times in the day.

  2. Your baby is hungry: Babies may resist sleeping on their backs if they aren’t adequately fed. Pay attention to feeding cues and ensure proper latch and milk supply, especially for breastfed infants. Additionally, check if the bottle and teat are suitable for your baby's needs - some babies are sensitive to a flow that's too fast or too slow.

  3. Habit: If your baby used to sleep on their back but they, for example, had a cold and you had to hold them for them to sleep for a period of time, and since then you've been unable to get them back in a cot, then if they are well, this suggests it's less likely to be something physical, and may well just be more habitual.

  4. Your baby wants constant touch: It’s natural for babies to crave closeness and comfort, often preferring to sleep on their parent's chest. Sometimes they will sleep on their back if they are close to you, for example, when bed-sharing, or if you have a sidecar crib that can have the side down and your able to offer comfort at arm's length. My youngest son, Rupert, used to hate sleeping in his cot, but I discovered that I was putting him down to sleep too early (as I mentioned above), and it helped to settle him if I had the side of his Next2Me* crib down and I would literally cuddle him to sleep inside the cot and I held my hand on his chest as he slept overnight if he become unsettled.

Baby sleeping in a Next2Me cosleeping sidecar cot

When it comes to bed-sharing, it's important to stress that the safest place for a baby to sleep is on their back in a separate sleep space, but many do find their cot-refusing baby will sleep on their back in their bed next to them, often after being fed to sleep in a side-lying position. The Lullaby Trust includes important information to mitigate the risk associated with bed-sharing here. and the Baby Sleep Info Source has some helpful information about how to mitigate the risks associated with bed-sharing here.

How to manage things

The Lullaby Trust acknowledges that getting a baby to sleep on their back can be a challenge, particularly if you feed or rock them to sleep in your arms and then transfer them to the cot when they are already asleep, and they suggest it can be more helpful if you have a baby like this to try to settle them to sleep in their cot, rather than in your arms first. But how do you do this? It's easier said than done, right?

If you have a baby aged between 0-3 months then you can download my free 0-3 Month Sleep Survival Guide if you subscribe to my newsletter, it includes multiple methods to help settle your baby to sleep in a cot, and there is tons of other useful nuggets of advice .

Image of the 0-3 Month Sleep Survival Guide

If your baby is over 4 months of age then you can sleep train your baby to sleep in a cot, there are many ways to approach this. I have an online course which teaches step-by-step how you might do this using responsive in-room methods. You can find out more about The Essential Gentle Baby Sleep Course here.

Image of The Essential Gentle Baby Sleep Course

*This article contains some affiliate links.


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