Does "Back to Sleep" Delay Babies' Rolling Over?

By Jennifer Goldbronn, RD, MAS

The Back to Sleep Campaign, now known as the Safe to Sleep Campaign, educates parents about ways to decrease SIDS risk, including putting babies on their backs to sleep.

There has been some controversy in the past that this campaign has actually decreased the total time babies spend on their tummies not just during sleep but while they are awake.  There was some concern that less time on the tummy would delay some motor skills such as rolling over, sitting up or crawling. What followed was a campaign to promote “tummy time” during awake time.

Studies then followed looking at whether or not specific developmental milestones were delayed since inception of the Back to Sleep Campaign.

Some studies found slight delays but results were still within developmental norms.  Other studies showed that the age of rolling tummy to back was older and that babies were reversing which milestone they hit first, rolling back to front first instead of front to back. For information on the age at which babies roll over, click here.

Thus, a new study aimed to see if there really was a difference in the developmental milestone (rolling over) before the Back to Sleep Campaign compared to now, 20 years later. Current data were compared to the AIMS (Alberta Infant Motor Skills) data set, a measure of normal infant motor abilities, collected 20 years ago. The current data set used the same assessment guidelines and age ranges as the AIMS data set, and the proportion of infants passing each of four items (immature and mature front to back rolling and immature and mature back to front rolling) by 36 weeks of age was assessed.

What did they find? Infants in both groups achieved the milestone of rolling over at almost the same age. The order with which the infants reached the four milestones (passing each item) was the same in both the pre-campaign and post-campaign groups. The age at which 50% of infants could perform each milestone was also the same in both groups.

The results of this study show no significant effect of the Back to Sleep Campaign messaging on infants’ ability to reach the "rolling over" milestone. The authors of the current study will continue to assess the effects of the Back to Sleep Campaign on other motor skills such as crawling, sitting and walking. Stay tuned for the results!

For more information about making tummy time easier for your baby, click here.

We also clarified some common misconceptions about tummy time in this subsequent post.

Reference

Darrah J, Bartlett DJ. Infant rolling abilities- the same or different 20 years after the back to sleep campaign? Early Hum Dev. (2012) [Epub ahead of print]

Part 2: Tips to Ease the Transition of Baby into Her Own Room

Charlotte, 5 1/2 months

In our last post, we wrote about current practices and recommendations for sleeping locations of infants. It doesn't matter if you are a first time mom or an experienced mom, or how old your baby is, transitioning your baby into her own room will be an adjustment for the whole family Today, we have a few tips that may help make the process easier!

• As with any transition, change takes time. Don’t expect your baby to fall asleep easily in your room one night and just as easily in his own room the next night. Being patient as your baby gets accustomed to his new space is important!
• Take small steps toward a gradual transition into the new location. For example, if your baby sleeps on a sleep surface other than a crib, like in a bassinet, start by moving your baby’s crib into your bedroom and having him sleep there. After your baby gets used to sleeping in his new crib in your room, then move the crib into his room. Another option is to start the transition by having your baby sleep in his new room for daytime naps only. After that is going well for a while, try having him sleep in his room for bedtime too.
• Keep in mind that any change in routine (and transitioning to a new room is a big one!) can affect your baby’s sleep patterns, potentially causing more night awakenings for a short time.
• Be consistent; older babies like routines! It’s important to be consistent with your baby’s bedtime setting as well as his bedtime routine. For more about routines, click here.
• While you are trying to be consistent, it’s also important to be realistic. Things will happen that will be out of your control. Your baby may get sick and be in your room for a few days until she is feeling better. That’s okay! You can get back to your usual routine when she is back to feeling better.
• It’s not unusual for older infants to wake more than usual once in a while. She may have separation anxiety or be conquering a new physical milestone. For a list of reasons why older babies may wake more sometimes, click here.
• It’s not uncommon for some older babies to resist being placed back to sleep in their cribs after awakening during the night. For an explanation of why this happens, click here. For solutions, click here.
• Wait until your baby is in quiet (deep) sleep before transitioning her from one sleeping place to another, such as from your bed or your arms to a crib. Older babies can enter deep sleep more quickly than younger babies, but always look for signs of deep sleep before lying your baby down to sleep.

We hope this information has been helpful! Making a big change, like moving your baby into her own room, is a big milestone and it is important to do what is best for your family. We’d love to hear your stories and tips about how YOU transitioned your babies into their own rooms too!

Repetition in Baby's Daily Life: The Power of Routines

As human beings, we rely on our daily biological rhythms to know when to wake, to work, to eat, and to sleep. These rhythms are controlled by internal things (like hormones) and external things (like light/dark cycles and alarm clocks). Babies are born with somewhat "flexible" rhythms that are influenced by the environment as they grow and develop. This flexibility allows babies to adapt to their parents' world. Most parents don't believe it, but they have enormous influence over their babies' daily rhythms. Routines are an important tool to help parents and babies get in synch.

Right away, I need to clarify that routines are not the same thing as "schedules" that might be forced on babies. Routines refer to patterns of actions, doing the same thing in the same order (as in dance or gymnastic routines). Schedules usually refer to actions that are dictated by the clock rather than the baby's needs.

Predictable daily routines help babies develop rhythms that are just like mom and dad's. As a side effect, they also help babies build trust, social skills, and self-control. Most parents instinctively settle into routines at bedtime, bathtime, and when feeding their babies. Because babies love repetition (see our last post), routines can help babies feel calm and secure. For example, let's pretend that your 3-month-old shows signs of being drowsy. You might take the following steps to lead the baby gently to sleep.

1) Hold the baby close and start using the same words over and over to tell the baby that it's time for nap.

2) Change the baby's diaper and clothes, close to the place where she takes her nap, maybe while singing a special nap time song.

3) Put her down on her back to sleep and gently rub her tummy while still singing or saying the same words over and over.

4) As the repetition lulls her into feeling more and more sleepy, you can step away and let her fall asleep on her own.

To reinforce a routine, you need to repeat these steps before every nap. Routines can be used for most of baby's daily activities. Once babies are older than 2 1/2 to 3 months, they start to develop their own rhythms and even settle into their own loose schedules, sleeping and eating at similar times each day.

I'll be honest, routines won't always make your baby sleepy or happy. But if you keep using them with your baby, your routines eventually will become familiar "dances" and you'll both know all the steps. Routines can be especially helpful for busy toddlers, but that's another post...

Next time: We'll share some fun ways to communicate with older babies.