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Whether you’re a new parent or a seasoned pro, you probably spend a lot of time thinking about your baby’s sleep. You may have even wondered if babies can safely sleep on their sides—especially if they’re having trouble staying asleep. But according to pediatricians, parents should start all naps and bedtime by putting their baby on their back—even if they’ve mastered the art of rolling over.

“Parents should always offer sleep with babies starting on their backs from birth through 12 months old in order to reduce the risk of SIDS (sudden infant death syndrome),” says Sarah Bossio, certified pediatric sleep expert and owner of Your Zen Baby Sleep.1

But what about babies that roll to their side after they’re asleep? Should you move them to their back, or can those babies sleep on their sides? We turned to experts to learn everything you need to know.

Risks of Babies Sleeping on Their Sides

The American Academy of Pediatrics recommends that all babies are put to sleep on their backs.2 Not only is this the safest position for your baby, but it also reduces the risk of SIDS and other potential complications. In fact, some research shows that putting a baby on their side to sleep, even for a nap, increases their risk of SIDS by up to 45 times.3

“The ‘Back to Sleep’ campaign that began in 1994 (and was renamed to Safe to Sleep in 2012) has been one of the single largest contributors to decreasing the risk of sleep-related infant deaths,” says Jenelle Ferry, MD, board-certified neonatologist at Pediatrix Medical Group in Tampa, Florida.

While Side-Sleeping, Babies Can Roll Further

When babies sleep on their side, it is much easier for them to slip onto their stomach, which also can increase their risk of SIDS. Researchers have found that sleeping on the belly lowers your baby’s blood pressure and reduces their ability to get oxygen to their brain. And, for babies between 2 and 4 months old, the reflex to breathe is even more repressed when they are asleep on their belly.4

Side-Sleeping and Positional Torticollis

Babies who sleep on their sides may develop positional torticollis, or wry neck. This condition is caused by your baby’s head being kept in one primary position. It also can occur if your baby has a preference for having their head in a specific position.5

“Torticllis is a condition caused by a tightening of the sternocleidomastoid muscle in the neck, which results in the turning of the head to one side and tilting it to the other, and sometimes limits full rotation of the neck,” says Ferry.6

This condition can be present at birth or develop later, she says. “If an infant sleeps repeatedly on their side, they may develop a preference to turn their head in one direction that could potentially develop into torticollis with tightening of the muscles on one side, although this is not common.” 

When Is It Safe for Babies to Sleep on Their Sides?

Once a baby is developmentally ready to find their comfortable spot and has the skill of rolling from belly to back and vice versa, they may try to sleep on their side, says Bossio. This milestone typically occurs between 4 and 6 months. However, regardless of their abilities, you should still always place your baby to sleep initially on their back.

It’s also imperative to make sure your baby is in a safe sleep environment, adds Kandra Becerra, a pediatric sleep specialist and owner of Rocky Mountain Sleeping Baby. It can be dangerous if your baby rolls to their side while next to a blanket or in a baby swing. “If the baby is in a crib that is flat, and nothing in the crib, they are fine to sleep on their side, as long as they got there on their own.”

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