New parents LOVE the Rock 'n Play™. How do I know? Because it's included as an "essential," "must-have," "lifesaver" item among nearly all baby registry recommendations.
I also know because so many of the parents I personally know (and love) use the Rock 'n Play as their babies' first sleeping spot - conveniently compact and within arm's reach of new mama.
Unfortunately, I also know that new parents love the Rock 'n Play™ because I'm a pediatric Occupational Therapist. A startling number of the babies referred for therapy services for head flattening, neck tightness and motor development issues have spent LOTS of their time sleeping and playing in this piece of baby gear.
I want to share some real parent experiences as well as important health and safety information about the Rock 'n Play™...not to scare you out of even considering purchasing one or condemn you for using one.
No, I simply want to offer you the full story so that you can make informed decisions about the baby gear you use and how you use it. I want you to be able to assess and balance the risks and benefits/conveniences of a Rock 'n Play™. I want to hear fewer parents tell me they wish they'd known...
What We Wish We'd Known...
Beth had two daughters four years apart, both diagnosed with Torticollis (one-sided neck tightness resulting in a head tilt or turn) around 2 months of age. Both were treated with a home stretching program. Her first daughter's Torticollis resolved with no head shape issues. Her second daughter required Physical Therapy to treat the Torticollis and now has severe Brachycephaly and mild Plagiocephaly (head flattening). "The ONLY difference between my two daughters is that daughter #1 slept in a traditional flat bassinet and daughter #2 slept in a Rock 'n Play™. I honestly feel that daughter # 2's issues were at least exacerbated by the use of the Rock 'n Play™. -Beth
"I blame it [the Rock 'n Play™] for my little one's Brachycephaly (head flattening). But we are helmeting and fixing the issue. I've been trying to get the message out to other mommies! Our second baby won't lay in a Rock 'n Play™ for one single second." -Lauren
"I remember reading one person's horrible review of the Rock 'n Play™, saying it caused a severe deformity of her son's head. And then I saw the thousands of good reviews and I bought it. I should have known. My daughter got her flat head from that [the Rock 'n Play™]. My mommy friends don't understand why I keep advising against using it." - Erika
"Dear Fisher-Price...as a pediatrician and parent consumer, I believe it irresponsible to promote the Rock n’ Play™ Sleeper as an safe, overnight sleeping option for infants. By continuing to do so, you are putting babies at risk." -Dr. Natasha Burgert Read the full letter to Fisher-Price.
The Truth About Rock 'n Plays™
Sleeping In A Rock 'n Play™ Goes Against SIDS Prevention Guidelines
Many parents have NO IDEA that letting babies sleep semi-reclined in baby gear like the Rock 'n Play isn't the safest choice for their babes.
To reduce the risk of Sudden Infant Death Syndrome, the American Academy of Pediatrics advises parents place babies on their backs on a firm, flat sleep surface for EVERY sleep. It also encourages parents not to let babies sleep in "sitting devices" (strollers, car seats, swings, slings, etc.) and advises sleeping babies be moved from these devices to a flat surface as soon as possible.
The concern? The semi-reclined sleep positions, as seen in the Rock 'n Play™, can compromise baby's airway and restrict breathing. Many of these infant positioners also include fluffy pillows and headrests, which increase the risk of SIDS. Read the full SIDS prevention guidelines here.
The Semi-reclined Position Contributes To Flat Head Syndrome & Torticollis
A common misperception among parents is that a soft surface can't deform a baby's skull. This is simply not true. Pressure is pressure and the softer the surface, the less able your baby is to move his own head to vary the pressures on the back of his skull. Over-use of even soft infant positioners is a huge contributing factor to Flat Head Syndrome (Positional Plagiocephaly).
Many babies are born with minor muscle asymmetries due to their squished womb positions. Active playtimes and laying flat to sleep allow baby to find a variety of body positions and, usually, to stretch and strengthen out of minor asymmetries. The semi-reclined position (like a Rock 'n Play™ supports) allows gravity to pull baby into his position of preference and get nice and comfy there with limited movement. This can cause Positional Torticollis (baby gets after he's born) and exacerbate Congenital Torticollis (baby is born with). Torticollis, or one-sided neck tightness, not only has developmental implications and usually requires treatment but is also another contributing factor to Flat Head Syndrome.
The Semi-reclined Position Is Not Shown To Reduce Reflux
A very common reason for overuse of the Rock 'n Play™ is for management of reflux.
Science shows that the semi-reclined position of the Rock 'n Play™ and other Baby Holding Devices does NOT decrease reflux. In fact, "The amount of reflux in supine infants with head elevated is equal to or greater than in infants supine and flat" and "the semisupine positioning as attained in an infant car seat exacerbates GER" (supine means laying on the back; semisupine means reclined back, as in a Rock 'n Play™ and other baby positioners; GER means gastroesophageal reflux). *From the Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN)
The American Academy of Pediatrics' reflux management guidelines for physicians states, "Semisupine positioning, particularly in an infant carrier or car seat, may exacerbate GER and should be avoided when possible, especially after feeding." (again, GER means gastroesophageal reflux; supine means laying on the back; semisupine means reclined back, as in a Rock 'n Play™) Read the full GER treatment guidelines here.
There's no denying that many (many) parents of fussy, colicky or reflux-y babies report that the Rock 'n Play™ helps their baby be calm and sleep. So I don't argue one bit that it can affect the behavior of a child with reflux. But the science suggests that what's actually going on with the acid levels inside baby's esophagus are no better and can be worse when semi-reclined after eating. Keep reading to learn what research says could help!
Restriction of Natural, Healthy Baby Development Through Movement
Babies who spend lots of time in baby gear and equipment like Rock 'n Plays™ score lower on tests of motor development. What babies need for healthy motor, cognitive and sensory development is active awake time - time to look around, turn towards sounds they hear, kick their legs, reach their arms, stretch and strengthen out of their womb positions and feel their weight shifting on a firm surface beneath them as they move.
Awake time spent in a Rock 'n Play™ is what I like to call "lump on a log" time. Your baby is sitting in a comfy seat watching the world go by instead of actively participating and learning. Learn more about how Rock 'n Plays and other Baby Holding Devices affect development.
Why Target The Fisher-Price Rock 'n Play?
To be fair, the Fisher-Price Rock 'n Play™ is not the only Baby Holding Device that carries these risks. Learn more about how all baby seats and positioners that support your baby in a semi-reclined position carry these risks.
The Rock 'n Play™ is unique in that it specifically markets itself for overnight sleep and naps. It also tops the list of baby-must-haves so common on the internet and in parenting magazines and seems to be a staple on every baby registry. Many, many (many) parents don't think twice about letting their newborns sleep primarily in a Rock 'n Play™.
The Rock 'n Play™ informational insert has a page about preventing head flattening, which states, "Try to minimize the amount of time your baby spends in car seats, carriers and bouncy seats while awake."
A baby's soft skull bones and developing neck and trunk muscles don't know or care if baby is awake or asleep. They respond only to the force loading of a particular position. Encouraging parents to allow their babies to sleep all night in a piece of equipment like a Rock 'n Play in big letters on the box and then encouraging them to limit time in devices in fine print inside the box feels misleading to me.
Alternatives To The Rock 'n Play™
This portion of the post includes affiliate links. I only link to products I use or love. See my disclosure page for more information.
Look for flat, firm sleep surfaces for your baby - those specifically described as "cribs," "bassinets" or "play yards / playards" are approved for safe sleep by U.S. standards. Nappers, sleepers, loungers, etc. are NOT.
Fisher-Price actually makes a Rock 'n Play Portable Bassinet (1) that is flat and this would be a great alternative for the baby who needs gentle movement to fall asleep. We used and loved the Graco Pack 'n Play (2) which adjusted to a bassinet height (note: do not use the "napper" attachment that comes with some models, which puts baby right back into that semi-reclined position enveloped in soft, padding and isn't approved for safe sleep.
The Halo Bassinest (3) is a newer safe sleep item that many parents love, especially moms recovering from a C-section, due to the ability to swivel it over the side of the bed to get baby in and out.
For Awake Times
I want a bumper sticker that says "FREE THE BABIES!" (Yes, I'm a child development nerd!) During awake times, your baby needs the freedom to move and interact with the world around him unrestricted by Baby Holding Devices like the Rock 'n Play™.
Put baby on a blanket on the floor for Tummy Time, sidelying play, or belly-up play with toys placed to either side to encourage head turning, rolling and reaching. Hold baby upright or wear him in a carrier if he's fussy or if you need to get things done.
If the floor isn't a safe spot due to pets or siblings, try a portable play yard like the Graco Pack 'n Play. And if you really feel like you need a baby seat, the Tiny Love 3 in 1 Rocker Napper is my #1 choice for awake times (not approved for safe sleep). Read and watch my full review of the Tiny Love 3 in 1 here.
We need to take every opportunity to allow our little ones to learn, grow strong and develop their sensory processing abilities through movement and play.
I'm not a physician so I can't give you specific medical advice about treating your individual baby's reflux. But I will say that as a mom, one of my screening questions when shopping for a pediatrician was, "What would you advise if my baby had reflux." Why? I was looking for a doctor whose answer demonstrated understanding of current evidence/research/recommendations for reflux management & SIDS prevention.
If a doc advises you to use a Rock 'n Play™ (or car seat) to manage reflux, you might consider discussing the American Academy of Pediatrics guidelines for safe sleep and reflux management. You might ask your child's physician to help you understand the relative risks and benefits of the semi-reclined position. Each parent and health team has to make the best decision for baby on a case by case basis. But an informed discussion is ALWAYS a wise idea.
Alternative reflux management topics to discuss with your doctor include: completely upright positioning after eating, sidelying awake times after eating, flat on belly during awake times, and thickened feedings.
All Things In Moderation
I try to be as realistic and positive as possible here at CanDo Kiddo. I'm a fellow mom on the front-lines with an infant. Sometimes we're just surviving! There is nothing inherently terrible about the Rock 'n Play™ or any other Baby Holding Device. The problem lies in over-use AND in irresponsible marketing/labelling by manufacturers.
If you have a Rock 'n Play™ and it is the key to your sanity, don't collapse in a heap of tears that you'll have to go cold turkey and will never sleep again. Try to gradually reduce your baby's dependence on the Rock 'n Play™ for sleeping and for staying content during awake times. Here are some tips to make baby's transition from sleeping in the Rock 'n Play to sleeping flat on the back a bit easier. Move toward following my Rule of 2 and 15 for Baby Holding Device use. If your baby has a rough day and spends more time in Baby Holding Devices, aim to use them less in the coming days.
Be well-informed. Be intentional in your use of baby gear. Be gentle on yourself and the parents you meet everyday.
I created a free email course just for you!
Given the sky-high rates of head flattening in infants (as high as 48%!!!), I believe every new parent deserves clear information about how to prevent AND treat flat spots. So I created a free email course that will help you:
- understand the biggest way you can impact your baby's head shape (and development)
- learn simple strategies for reducing your baby's risk of needing a helmet
CLICK HERE to sign up for the free course or click the image below: