The message from parenting and health experts has been persistent for more than two decades, though most parents are still not following the advice: To lower their risk for sleep-related incidents and deaths, always place babies on their backs to sleep.
Since the start of the Safe to Sleep Campaign by the American Academy of Pediatrics and National Institute of Child Health and Human Development in 1992, the rate of Sudden Infant Death Syndrome (SIDS) has dropped by half. Yet, the latest findings show only 43.7 percent of moms in the U.S. say they plan to place their infants to sleep on their backs, also known as the supine position, and actually do it every time.
Experts are frustrated with the new findings and the misinformation circling, as SIDS is a leading cause of infant mortality. About 4,000 infants nationwide dying unexpectedly every year during sleep time from SIDS, accidental suffocation or unknown causes.
The study, published online on Monday in the Pediatrics journal, found a huge difference between what moms say they will do versus what they actually do, when it comes to their babies' sleep practices. Out of 3,297 moms with babies between the ages of 2 and 6 months who participated in the nationally representative survey, 77.3 percent say the usually place their infants on their backs to sleep, but fewer than half actually did so every time.
Wait, back up. Why do experts think back is best, anyway?
The exact reasoning isn't certain. In some cases, babies who still have underdeveloped regions of the brain may fail to wake up normally to remove themselves from danger if they encounter a harmful situation.
Other findings "suggest that an infant who sleeps on her stomach gets less oxygen or gets rid of carbon dioxide less because she is 'rebreathing' the air from a small pocket of bedding pulled up around the nose," the AAP's Healthy Children website. "Since it is impossible to identify which babies may not arouse normally, and because the relationship between SIDS and sleep position is so strong, the Academy recommends that all infants be placed to sleep on their backs."
But 14 percent of the moms said they usually put babies to sleep on their sides, while 8 percent said they typically put babies down on their stomachs.
Why are parents resistant to exclusively back-sleeping?
Some worry their baby will spit up and choke, though Dr. Michael Goodstein, a neonatologist at York Hospital in Pennsylvania, tells CBS that because of the anatomy of the airways, parents should not worry about choking as a hazard when back-sleeping.
Another reason for resistance? Family words of wisdom such as, "Babies sleep more deeply on their bellies," from people close to the moms are so powerful. After hearing the advice, often from their grandparents, moms are almost 12 times more likely to follow it.
But before you start feeling guilty—or, on the flip side, preaching like a sanctimommy—know that this isn't about shaming moms who don't follow the recommendations. (Note to researchers: Why didn't you include dads also?!) Sometimes babies just don't want to sleep on their backs and sleep-deprived parents feel stuck between a rock and a hard place. What's important here is removing the communication block and learning what information parents are receiving and how medical experts can better educate everyone.
"If we can get parents to explain their decision in their own words, then we can begin to understand what factors are more important in their decision-making than following recommended safe sleeping practices,” Michael Gradisar, a psychology researcher at Flinders University in Adelaide, Australia, who wasn’t involved in the study, tells Reuters.
Talking about it and giving new moms the right information is already making a difference. When doctors explained safe sleep practices, women were 40 to 50 percent less likely put babies to sleep on their stomachs or sides.
It's also important to note that it's not healthy for infants to be perpetually placed on their backs, either. The need for tummy time, also known as prone positioning, is so important for baby's motor skills and development that the AAP modified its original recommendation to include, "supervised, awake tummy time is recommended daily to facilitate development."
Read the AAP's safe sleep recommendations in full.