Bed-sharing is a type of co-sleeping that occurs when a mother and baby share the same sleep surface. This practice is often met with criticism and concern for the baby’s safety.
Some health care providers and parents believe that bed-sharing increases a baby’s risk of suffocation. Other health experts and parents who practice bed-sharing maintain that it enables the parent to assess and respond to their baby’s needs more quickly, protecting the baby against sudden infant death syndrome (SIDS) and conferring a host of health benefits.
James McKenna, PhD, head of the Mother-Baby Behavioral Sleep Laboratory at Notre Dame University, contends that mother-infant bed-sharing, when done properly, can improve nighttime feedings, extend the duration of breastfeeding, boost infant and maternal health and well-being, and perhaps save infants’ lives.
While the American Academy of Pediatrics (AAP) acknowledges the need for infants to sleep in close proximity to their parents (room-sharing), it opposes bed-sharing. In its latest policy statement on SIDS and safe sleep, released October 2016, the AAP urges parents to place their baby’s crib or bassinet in the parents’ room, ideally for the first year, but for at least the first six months. Room-sharing not only facilitates infant feeding and enhances parental awareness of infant well-being, but it also reduces the risk of SIDS by 50 percent.
Bed-sharing safety tips
Parents, particularly those who breastfeed, may not intend to bed-share, but studies show that many (some studies indicate an estimated 60 percent of families with young children) do so as a means of “making it through the night.”
When it comes to bed-sharing, parents must weigh the risks and benefits. If they are going to share a sleep surface with their baby, they should do so only when following safe sleep guidelines, including these tips:
- Use only a firm mattress.
- Do not sleep with your baby on a waterbed, armchair, sofa, or couch. Babies can fall into cracks between cushions or sink into soft surfaces, which can make it difficult for them to breathe.
- Keep your sleep space free of extra pillows and blankets. If your baby is sleeping with you, or comes into your bed for a feeding during the night, remove items that increase the risk for suffocation. Remember, "bare is best" when it comes to your baby's sleep surface.
- Place your baby to sleep on her back. (For more on “back to sleep,” read this.)
- Avoid sleep positioners. Studies have not shown these devices to be beneficial to infant sleep, and some are inconsistent with safe sleep recommendations. The CPSC and Food and Drug Administration issued a warning in 2010 against the use of certain infant sleep positioners because of the risk of suffocation and entrapment.
- Do not bed-share if you or your partner is intoxicated or have been using drugs or medications, or if you are overtired and would be difficult to awaken. Alcohol, medications, and excessive sleepiness may make you less aware of your baby and her movements.
- Do not bed-share if you or your partner is a smoker. Secondhand and thirdhand smoke has been associated with a higher incidence of SIDS.
- Never leave your baby unattended on an adult bed.
- Do not allow a sibling or pet to sleep with your baby.
- Do not place your bed against a wall or other furniture. This increases your baby’s risk of slipping between the wall and mattress, or mattress and furniture, and suffocating.
- Make sure the bed is placed away from strangulation hazards. Avoid having the bed near long curtains, window blinds, or cords of any kind.
- Avoid overdressing your baby. Dress your baby in one layer of clothing. If you are concerned about warmth, place your baby in a wearable blanket or sleep sack.
- Keep the room temperature between 68°–72°F (20–22.2° C).
- Consider using a fan. Fans may reduce the risk of SIDS by circulating the air and lowering the baby’s risk of “re-breathing.”
- If you have long hair, tie it back. A parent’s long hair can cause strangulation.
Talk with your health care providers about sleeping arrangements and discuss specific strategies for keeping your baby safe while sleeping.
In addition to room-sharing for the first year, there are a number of other ways in which parents can ensure their baby’s safety while sleeping. Learn more safe sleep tips here.