- The Washington Times - Monday, March 3, 2003

CHICAGO (AP) Stomach sleeping is more common among babies born extremely prematurely, even though they face a much higher risk of sudden infant death syndrome than larger babies, a study suggests.
The American Academy of Pediatrics recommends that infants sleep on their backs to reduce the risk of SIDS and was involved in a 1990s "Back-to-Sleep" campaign that helped reduce the nationwide SIDS rate more than 40 percent.
While stomach sleeping decreased during that time, SIDS still kills nearly 3,000 infants every year and premature babies face a disproportionate risk.
Some parents and doctors may mistakenly believe "that the 'back to sleep' message perhaps doesn't apply to low-birth-weight or pre-term infants," said the lead researcher, Dr. Louis Vernacchio of Boston University.
The study found that stomach-sleeping among very small premature babies has declined. Still, in 1998, 17.5 percent of mothers reported putting such babies to sleep on their stomachs one month after leaving the hospital, compared with 12.8 percent of mothers of the largest babies among those studied.
Rates of stomach sleeping increased at three months, which also is when rates of SIDS peaked.
The study appears today in the March edition of Pediatrics. Doctors from the National Institutes of Health also were involved in the report.
The researchers surveyed mothers of 907 low-birth-weight babies in Massachusetts and Ohio from 1995 to 1998. Dr. Vernacchio said similar results are likely to be found nationwide. The babies' birth weights ranged from less than 3.4 pounds to about 5 pounds.
The overall rate of infant stomach-sleeping reported by mothers dropped from 20 percent to 11.4 percent during the study. Among the smallest babies, it dropped from 34 percent to 17.5 percent.
Parents who placed small premature infants on their stomachs often said their babies and doctors seemed to prefer that position, the study found.
Dr. Vernacchio said the risks of SIDS outweigh any medical problem that might prompt a doctor to recommend stomach-sleeping for premature babies.
University of Virginia pediatrician Dr. John Kattwinkel said many doctors attending to small premature babies prefer stomach sleeping while infants are in the intensive care unit, where they are constantly monitored. Such infants often have lung problems, and doctors said they think the infants can breathe easier on their stomachs.
Doctors should but often don't switch premature babies to back sleeping toward the end of their hospital stays, said Dr. Kattwinkel, who chairs an American Academy of Pediatrics task force on SIDS.
Parents who see their hospitalized babies sleeping on their stomachs may assume that's the correct position at home, he said.

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