What is the best practice?

Always place the infant on his or her back to sleep.

Additional Information to consider:

Some people believe that back sleeping increases the chance of choking if an infant vomits while they are sleeping. This is not true. Infants can clear fluids better when they are on their backs. When an infant is sleeping on their back, the trachea lies on top of the esophagus. Any spit up from the esophagus must work against gravity to get into the trachea. When an infant is sleeping on their stomach, any spit up will pool at the opening of the trachea. This makes it easier for the infant to choke from breathing fluid into their lungs.

If an infant is a tummy or side sleeper at home, the risk for SIDS is much higher. The side position is just as dangerous as placing the infant on the tummy because the infant can accidentally roll to the tummy. If an infant sleeps on their side at home, back sleeping in child care is still the safest choice and does not increase the risk of SIDS.