On the back is best, says new safe-sleep guidelines for babies

The American Academy of Pediatrics has released new safe sleep guidelines for babies, which include a recommendation that babies only sleep on flat surfaces.

The new recommendations are the first update to the AAP’s guidelines since 2016.

Dr. Ari Brown, a pediatrician in Austin, Texas and spokeswoman for the AAP, said babies should avoid sleeping on any incline greater than 10 degrees.

"Babies should not only be sleeping in a naked crib, which is only a flat sheet, but also a flat crib," Brown said. "Anytime your baby is in a position where they might be able to fall asleep, they need to be on a flat surface."

Brown said the guidelines reinforce the "back is best" recommendation, but go a step further in advising against using baby products not intended for sleep. This includes any nests, docks, recliners, and swings for babies that can pose a suffocation hazard.

"These products that are meant for the baby to chill out or relax in, when we know parents are using them as a sleep aid, are really not safe," she said.

The recommendations come as Fisher Price and U.S. product safety regulators sent out a warning less than two weeks ago warning about rockers that were linked to 13 infant deaths between 2009 and 2021. The products include the infant-to-toddler and newborn-to-toddler rockers. The U.S. Consumer Product Safety Commission said the rockers should never be used for sleep and infants should never be left unattended or unrestrained in them.

Parents should also avoid using weighted blankets as they can compress a baby’s chest. In addition, the AAP said other sleep environments like couches, armchairs, and cushions can raise the risk of death by 67 percent.

Infant and toddler sleep consultant Vivian Sonnenberg said she never put a baby in a rocker to sleep. Sonnenberg has worked in the Bay Area for more than 13 as a sleep expert and has helped thousands of families.

"In order to get a baby to sleep well, quickly, I always mention the word calm," Sonnenberg said.

She said the earlier parents can get their baby into good sleep habits, the better off they’ll be.

"Don’t be on your phone," she said. "When you’re with your baby, you’re with your baby."

The AAP said babies are five to ten times at greater risk of sudden infant death syndrome or SIDS when they co-sleep and bed-share with parents. It’s best to have a baby under six months in the same room with the parents, but in their own crib or bassinet.