Developmental Delay Due to Placing Infants on Their Back

Motor development depends upon infant and environmental factors. Varying the positions of the infant during sleep or wakeful time has an impact on their motor development. Since the observation in 1992 that Sudden Infant Death Syndrome (SIDS) may be associated with infants sleeping in the face down position (prone), parents have been urged to put their infants on their back (supine) while sleeping. Some researchers expressed concerns that the supine sleeping position seemed to delay the motor development of the infants.

In a survey of 100 parents, researchers found that among 37% of the parents, the knowledge of SIDS influenced the play positions of their infants and that 26% of parents reported that they never placed their infants in prone (on their tummy) for play, despite the fact that wakeful time in prone is not a risk factor for SIDS. Varying positions for the infants is believed to be important for their motor development and the prone position of particular importance in the development of head control and extension of the body against gravity. This is essential for the development of stability in various weight-bearing positions such as prone-on-hands, on all fours and sitting. Hence, lack of experience in the prone position may have a detrimental effect on the motor development of the infants.

A systematic review of the impact of sleep/play positions on infant motor development has shown that there is a transient delay in attainment of developmental milestones in healthy infants if they have not been exposed to a prone position. In very-low-weight preterm infants with and without neurological impairment, prone sleeping and playing were significantly and positively associated with motor development at all ages as measured by milestone acquisition and motor function.