What if my baby rolls over while sleeping?

You’ve probably heard how important it is to put your baby on their back to sleep. But what happens if your baby rolls over while sleeping? 

If your baby rolls over while sleeping, you may panic and worry that they are in danger or try to roll them back to a safe sleeping position. And while there is a valid reason to worry and there are steps you can take if your baby happens to roll over onto their stomach while sleeping, it may not be the emergency you first think it is. 

We want both you and your baby to get a restful night’s sleep, so here’s what you need to know about babies rolling over while sleeping. 

Why do babies roll over while asleep?

Babies, like adults, don’t stay completely still during periods of sleeping. And for babies in particular, learning to roll over is an important development milestone that happens around 6 months of age, so it’s a natural part of their growth. 

Once a baby has mastered the art of rolling, chances are they will want to keep on rollin’, because it’s so much fun to be able to move when you haven’t quite figured out many other ways of getting around yet. 

Some babies may also have a preference for sleeping on their stomachs, just like adults, and feel more comfortable in that position. Other things like acid reflux or gas may also lead them to feel more comfortable on their stomach as well. 

Why is it recommended that babies sleep on their back?

The reason that all pediatric experts, including the American Academy of Pediatrics (AAP), recommend that babies sleep on their backs at night and for naps is that back-sleeping significantly reduces the risk of Sudden Infant Death Syndrome, or SIDS.

Being on their back allows better airflow, doesn’t restrict movement, and reduces the risk of something blocking the baby’s mouth while they sleep. There is also some evidence that stomach sleeping triggers some babies with brain abnormalities to stop breathing. 

To help reduce the risks of stomach sleeping, the AAP started the back-to-sleep program to educate parents on the importance of putting babies to sleep on their backs.

When the back-to-sleep program was first introduced in the late 1990s, it helped reduce SIDS rates by over 50%. The numbers showed a huge drop—before 1994 when the program was introduced over 4,000 babies were dying from SIDS every single year. 

Today, there are about 3,400 sudden unexplained infant deaths every year in the United States, a number that includes deaths from SIDS as well as other unexplained infant deaths. According to the Centers for Disease Control and Prevention (CDC), the most recent statistics available show that about 1,389 infants died from SIDS in 2020.

Unfortunately, after declining many years in a row, the rate of SIDS actually increased from 2019-2020, which may have been due to pandemic-related reasons, although the exact cause isn’t clear.  

Is it safe if my baby rolls over?

When your baby starts to roll over onto their stomach, it generally means they have built up enough muscle to lift their heads up more, which can help reduce the risk of SIDS. 

SIDS is the highest risk for very young babies between the ages of 1 and 4 months, as well as for babies who have delays or medical complications, like breathing problems.

But once babies grow and develop enough to be able to roll from back to stomach, it’s a good sign that they are developing appropriately. Most babies are able to push themselves up on their arms when on their stomachs by 4 months and are able to roll over by 6 months, which is when the risk of SIDS drops significantly.  

The bad news is that stomach sleeping is still a risk and if you have been swaddling your baby, you need to immediately stop swaddling them for sleep and naps once they start to roll over.

The AAP explains that if you swaddle a baby who can roll over, it restricts their movement and can increase the risk of suffocation.

In fact, the AAP recommends that parents stop swaddling as soon as they even see their baby attempting to roll over, so be sure to monitor your baby for those first signs of trying to flip over. 

What if baby rolls onto stomach while sleeping but can’t roll back?

Anytime a baby is stuck on their stomach, you should reposition them. Being stuck and unable to roll back to their backs is a safety hazard. Additionally, if it’s your baby’s first time rolling over and they are startled, wake up crying, or are swaddled, you will need to address the situation. 

Always, always make sure you unswaddle a baby if they happen to be swaddled and roll onto their stomachs—and discontinue swaddling immediately. If your baby is up already after rolling and crying, you can pick them up, soothe them, then reposition them to sleep on their backs. 

If your baby is under 4 months old, the risk of SIDS is still high, so you should reposition them on their backs if they roll over as well. 

However, if your baby is over 6 months, rolling regularly from back-to-front and front-to-back even during the day, and there are no other safety concerns, talk to your pediatrician about if it’s safe to let them continue to sleep if they happen to roll over while sleeping. 

What if they roll over, wake up, and start crying?

If your baby rolls over in the middle of the night, it might startle them awake. Rolling over is a skill your baby has to learn and it can take a while to get it right!

If your baby rolls over, wakes up, and starts crying, you can soothe your baby just as you normally would if they wake up during the night. Try to keep your environment calm, with dim lights, and try rocking them or swaying gently while they’re in your arms.

If your baby needs their diaper changed, make sure they have a fresh diaper. If your baby is under six months old, they may also need to be fed a bottle or nursed again. 

Just keep in mind that babies who are rolling should not be swaddled any longer, so even if it’s your baby’s first time rolling over and crying themselves awake, it’s time to discontinue the swaddle. 

What if my baby can’t fall asleep because of rolling over?

If your baby isn’t able to fall asleep because they continually are rolling over and waking themselves up, you may need to give your baby time to re-learn how to sleep. 

As soon as your baby starts rolling, it’s time to move them out of a bassinet if they were in one and into a larger sleeping area, so your baby may just need time to adjust to more room. Imagine going from being swaddled into a tiny bassinet to having the freedom to move in a huge crib—it’s no wonder they turn into roly-polies!

But until your baby adjusts, you should continue to follow the AAP’s safe sleep guidelines. That means don’t add anything to your baby’s crib, like rolled blankets or sleep positioners, to stop them from rolling.

Your baby should always be placed to sleep on their back on their own sleep surface that has a fitted sheet with nothing else in the sleeping area. 

When should you consult your pediatrician?

Every baby is different and if you have a baby who just won’t stay on their backs, you can talk to your pediatrician about strategies that could help.

Some babies may have an increased risk of SIDS, such as babies who were born prematurely or who have certain medical conditions, so it’s also important to know your baby’s own risk. Always talk to your doctor about any concerns you may have.