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My son has apnea and reflux. Should he sleep on his back or side?
Q: My 7-month-old son has been on an apnea monitor since he was 2 weeks old. He also has severe reflux and must take Zantac in addition to a stomach relaxer. Our pediatrician told us to still have him sleep on his back or side regardless of the reflux, but when sleeping on his back or side, he still chokes on his vomit. However, his apnea doctor says that because of his reflux and the fact that he is on a monitor, it won't hurt to put him to sleep on his stomach. I have put him on his stomach since we noticed the reflux but haven't told his pediatrician because he thinks it is a heath risk. What is your opinion?
Angelisa Branson
A: Angelisa, it sounds like you feel caught between the different recommendations of your doctors. In fact, this is an area that has been hotly debated by the experts.

For the past 10 years, it’s been recommended that healthy babies under 12 months of age be put to sleep on their backs to reduce the chance of SIDS, Sudden Infant Death Syndrome. Studies have found that when healthy babies are put to sleep on their backs, they breathe better and are less likely to suffocate. This recommendation has cut the rate of SIDS in the U.S. in half.

The recommendation is different, however, for babies such as yours with medical problems like petroltroesophageal reflux. Although some doctors still recommend that babies with reflux sleep on their backs, others recommend that they sleep on their stomachs. Since there is a small risk with either position—your baby could vomit and choke on his back, or smother on his tummy—you need your doctors to help you weigh the risks and decide which is safest for your baby. Your own observations that your baby vomits and chokes on his back but sleeps well on his tummy probably indicate that your baby does best on his tummy. And since he’s still on the apnea monitor, the alarm will sound if he has problems breathing.

Be sure to also follow all the other recommendations to prevent SIDS: put your baby to sleep on a firm cot mattress, not a down comforter, sheepskin or waterbed; remove blankets, pillows, and stuffed animals that could smother your baby; don’t overheat the room; and don’t smoke in the house.

You shouldn’t feel ashamed about your dilemma. Talk with your pediatrician about it and explain your observations of your baby and the specialist’s recommendations. Everyone wants what’s best for your baby. Encourage the two doctors to talk with each other if there are any questions.