Does placing a baby on its back to sleep increase the risk of aspiration?

Placing a baby on its back to sleep does not increase the risk of aspiration and is, in fact, the recommended sleeping position for infants due to its safety benefits related to Sudden Infant Death Syndrome (SIDS). This supine position allows for better airway management and decreases the likelihood of the baby inhaling stomach contents compared to other positions.

In the back position, the anatomical structure of an infant’s airway is less likely to allow for aspiration since the head is in a position that aligns the esophagus away from the trachea. Additionally, healthy infants typically have effective gag reflexes that help protect against aspiration, and the back sleeping position does not hinder this response.

While there might be specific scenarios—such as in cases of severe gastroesophageal reflux where aspiration risk is more pronounced—the general recommendation remains that healthy infants should be placed on their backs during sleep to minimize risks associated with SIDS while maintaining a safe airway. Therefore, the assertion that placing a baby on their back to sleep increases aspiration risk is not supported by current pediatric guidelines.