Institutional belief · Pediatrics and public health
Prone infant sleeping
Healthy infants were advised to sleep prone, or on their stomachs, because the position was treated as safe or preferable, including from concern that babies sleeping on their backs might aspirate vomit.
2 episodes
Current understanding
Current understanding
For healthy infants, prone sleep substantially increases the risk of sudden infant death syndrome and other sleep-related infant deaths. Supine sleep is recommended for routine infant sleep; placing healthy infants on their backs does not produce the feared increase in fatal aspiration.
Institutional episode
Australia
During the 1970s and 1980s, prone sleeping became increasingly common among healthy Australian infants as health professionals and infant-care literature repeated advice that had not been scientifically tested. Evidence linking prone sleep to SIDS accumulated, but sleeping position was not initially accepted by the medical community as a causal risk factor. Australian research prompted a national reversal in 1991, when health campaigns and the NHMRC advised that healthy babies generally should not sleep prone.
Institutions
- Pediatric and maternal-child health professionals
- Hospitals and infant-care services
- Health-education advice to parents
Documented consequences
- Widespread prone sleeping among healthy infants
- Increased exposure to SIDS risk
- Delayed reversal of infant-sleep advice
Sources and what they establish
- A safer infant sleeping positionNational Health and Medical Research Council
Describes the rise of prone sleeping from the late 1960s and 1970s because of untested advice, the medical community's delayed acceptance of risk, and Australia's 1991 national recommendation against prone sleep.
Institutional episode
East Germany
Pediatricians in East Germany followed the international recommendation that infants sleep prone, and the practice was used in the state day-care system. After seven infants died while sleeping prone in day care in 1971, the Ministry of Health reviewed the deaths and in June 1972 issued guidelines sharply restricting prone positioning during sleep and limiting it to supervised exercise while awake.
Institutions
- Pediatric services of the German Democratic Republic
- State day-care health system
- Ministry of Health
Documented consequences
- Prone placement of infants in state day care
- Preventable infant deaths
- Rapid reversal of official child-care guidance
Sources and what they establish
- Prevention of sudden infant death syndrome due to an active health monitoring system 20 years prior to the public “Back to Sleep” campaignsArchives of Disease in Childhood
Reconstructs East Germany's prone-sleep recommendation, the seven 1971 day-care deaths, and the Ministry of Health's June 1972 reversal.
Last reviewed: 22/08/2026