Is It Safe If My Baby Rolls On Side To Sleep?

Here’s another question from one of our readers:

“Dear Sarah,

I love how informative and research-backed your posts are, so I believe you’re the right person I can ask if it’s safe if my baby rolls on side to sleep.

I always place him on his back to sleep, but somehow he manages to roll on his side. Is this OK?

Thanks a lot,


Well, Emily, the straightforward answer is a yes and no. I’ll explain this in a bit. Let me just remind you again that I am no medical expert. But my sources are all reliable ones.


In this article, UK’s National Health Service, American Academy of Pediatrics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, and Ask Dr. Sears.

While all these are reputable institutions, I still advise you to ask your pediatrician regarding this issue.

Let’s start with the no.

When is it not Safe if Baby Rolls on Side to Sleep?


According to the experts mentioned above, side-sleeping is generally discouraged because it is unsafe. The American Academy of Pediatrics (AAP) says, “Side sleeping is not safe and is not advised.”

1. Why is it unsafe?

Side-sleeping, in itself, is safe. However, when your baby is on his side, there’s a high chance that he’ll roll onto his tummy.

Studies conducted in the UK, New Zealand, and the US all conclude that back sleeping is the safest. On the other hand, prone positioning increases the risk of SIDS.

According to the article published by the AAP, sleeping on the tummy increases the risk of choking. This is because our babies’ lung opening in relation to the stomach opening is designed for the supine position. 

2. What does that mean?

Here’s the explanation from the experts at Eunice Kennedy Shriver National Institute of Child Health and Human Development:

“When the baby is in the back sleep position, the trachea (tube to the lungs) lies on top of the esophagus (tube to the stomach). Anything regurgitated or refluxed from the stomach through the esophagus has to work against gravity to enter the trachea and cause choking. When the baby is sleeping on its stomach, such fluids will exit the esophagus and pool at the opening for the trachea, making choking much more likely.”

What if your baby coughs up fluids while lying on his back? Will it cause choking?

The same article above states our babies’ natural reflexes are designed to swallow fluids without harm.

What if your baby’s nose is clogged and has trouble sleeping on his back?

I understand that it’s sometimes tempting to consent to side sleeping in instances like this. But the experts’ advice is still a hard no to the lateral or prone position.

That does not mean that you’ll leave your baby fussy the whole night, though. You may help your baby have a goodnight’s sleep by doing these:

  • Remove what’s blocking his airway using a bulb syringe. This tool does wonder in freeing the nostril from liquid blockage.

  • Incline his bed. This is how you can do it properly:

    • Place a firm pillow or towel under his head. Make sure this is placed under the crib sheet so it won’t suffocate your baby when he makes big movements. 

    • Some bassinets or co-sleepers are adjustable; incline it as necessary.

  • Keep the air moist.

  • Breastfeed more often. If he’s more than six months, give more fluids.

Won’t back sleeping flatten my baby’s head?

Infants have a softer skull compared to adults, so there’s a high chance they’ll have an oddly shaped head when sleeping in the same position.

To prevent this, you can turn his head from time to time while he’s asleep.

When is it Safe if the Baby Rolls on Side to Sleep?

baby sleep with face down

There are only two instances when it’s OK for your baby to roll on his side to sleep that the experts agree on.

When he’s supervised.

If your baby is taking his daytime nap, and you’re just by his side (without falling asleep), you can let him roll on his side to sleep.


If you’re taking those cute photographs for an album, you may, by all means, allow him to side sleep.

It can also be that you’re breastfeeding or just simply cuddling him. What I’m trying to say is, if your attention is fixated on him and you know the first signs of choking, side sleeping is OK. Otherwise, it’s a definite no.

When he can roll over on his own.

At some point in time, your baby may roll over on his own. Baby Center says it starts at four months. However, at this time he can only roll from his back to his tummy and may have a hard time going back. He can master this skill when he’s about six months old. He can even roll on both sides.

A Word of Caution

Despite the instances that allow side sleeping, pediatric experts still deem the supine position to be the best until your baby is about one year old.

But if your baby can roll over on his own, don’t worry. More often than not, he can roll back to the supine position on his own.

We can never be too careful, though. 

So here are what you can do for your peace of mind:

  • Use a baby monitor at all times when your baby is asleep in his own bed. Some baby monitors alert you if your baby’s breathing pattern has fallen below the normal rate.

  • Use a firm mattress. I have always advocated for a firm mattress because I believe that it has less risk of suffocating your baby.

  • Do not swaddle. If your baby moves his arms and legs all the time, it’s best not to swaddle him. A very active baby can roll over to his side or tummy, and the loose cloth may get in the way.

  • Co-sleep until he’s at least six months. Co-sleeping, when done right, has several benefits for you and your baby. This will make you less anxious about him rolling over to his side or tummy, help you breastfeed easier, and monitor your baby’s movements at all times. 

In sum, there are instances when baby rolling on side to sleep is harmless. But we should always err on the safe side. As much as possible, delay side sleeping until he’s about one year old.

Ibeaa Perdon

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