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New baby safety guidelines stress no co-sleeping, inclined sleepers or crib decorations

The American Academy of Pediatrics issued new rules which also insist on no co-sleeping.
A Black baby dressed in a white onesie sleeps in a crib as a parent looks over.
For the first time since 2016, the American Academy of Pediatrics has updated its guidelines for infant safe sleepBFG Images / Getty Images
/ Source: TODAY

As of Tuesday, there are new guidelines for keeping babies safe while they sleep.

The American Academy of Pediatrics (AAP) has updated its safe sleep guidelines for babies. The new recommendations underline that infants be set up to sleep on flat, non-inclined surfaces with their backs to the bed. The policy statement also emphasized the risks of co-sleeping.

According to the report, almost 3,500 infants in the United States die of sleep-related deaths each year, including sudden infant death syndrome (SIDS) and accidental suffocation or strangulation in bed.

To reduce the risk of suffocation, wedging and entrapment, the guidelines stress that babies be put on firm, flat and non-inclined sleep surfaces. In addition to non-included sleep surfaces, the new recommendations laid out the need to avoid cardboard boxes as short-term emergency sleep locations and bed-sharing.

“The AAP understands and respects that many parents choose to routinely bed share for a variety of reasons, including facilitation of breastfeeding, cultural preferences and belief that it is better and safer for their infant,” the organization noted. “However, based on the evidence, we are unable to recommend bed-sharing under any circumstances. Having the infant close by their bedside in a crib or bassinet will allow parents to feed, comfort and respond to their infant’s needs.”

Related: Is co-sleeping safe for babies?

The organization also shared that it is important for parents to be aware that certain factors — such as exhaustion, pillows and blankets — can increase the risks of bed-sharing.

Additional updates to AAP's recommendations for infant safe sleep included the introduction of tummy time, the use of pacifiers only "once breastfeeding is firmly established," and the avoidance of home cardiorespiratory monitors to reduce the risk of SIDS.

The new guidelines appear to be in line with the U.S. Consumer Product Safety Commission's 2021 announcement of a ban on a range of sleep products, including inclined sleepers.

The change, which goes into effect on June 23, 2022, mandated that all new infant sleep products must be equal to or less than 10 degrees from horizontal.

Related: Everything you need to know about sleep training

In 2020, after a big recall of the Fisher Price Rock ‘n Play inclined sleeper, pediatrician Dr. Nina Ford Johnson told TODAY she recommended parents also make sure their babies are getting 30 minutes daily of tummy time starting around two weeks of age to help prevent serious infant injuries like plagiocephaly (flat head) and torticollis (twisted neck).

“Put them on their stomachs for a couple minutes here, a couple minutes there, so they can build up those arm and neck muscles that they need to strengthen their neck and get better head control,” she said at the time.