Bed-Sharing

The practice of bed-sharing — parents sharing a bed with their infant — is a hot topic. Supporters of bed-sharing believe that a parent's bed is just where a baby belongs. But others worry that bed-sharing is unsafe.

What Are Co-Sleeping, Room-Sharing, and Bed-Sharing?

Many people use the terms "bed-sharing" and "co-sleeping" to describe the same thing, but there are differences:

• Co-sleeping: This is when a parent and child sleep in close social or physical contact of each other, meaning that each can tell that the other is nearby.

Room-sharing and bed-sharing are types of co-sleeping:

• Room-sharing: This is when parents have a crib, bassinet, portable crib, or play yard in the room with them near the bed. Or, they attach a bedside sleeper to the side of their bed.
• Bed-sharing: This is when parents and infants sleep together in a bed. This has raised concerns because bed-sharing with an infant increases the risk sleep-related deaths, including sudden infant death syndrome (SIDS).

Why Do Some People Bed-Share?

Bed-sharing supporters believe — and some studies support their beliefs — that bed-sharing:

• encourages breastfeeding by making nighttime feeding more convenient
• increases how many months a mother breastfeeds her baby
• helps babies fall asleep more easily
• helps babies and mothers get more nighttime sleep
• gives moms more time to be close to their infants

But do the risks of bed-sharing outweigh the benefits?

Is Bed-Sharing Safe?

In some cultures, bed-sharing is common and the number of infant deaths related to it is low. Differences in mattresses, bedding, and other cultural practices may account for the lower risk in these countries.

But health experts warn parents not to place their infants to sleep in adult beds due to serious safety risks. Bed-sharing increases the chance of suffocation, strangulation, and SIDS.

An adult bed has many safety risks for a baby, including:

• suffocation from a soft mattress, memory foam, waterbed, or loose or soft bedding such as pillows, blankets, or quilts
• entrapment and suffocation when an infant gets trapped or wedged between a mattress and headboard, wall, or other object
• strangulation in a bed frame that allows part of an infant's body to pass through an area while trapping the baby's head, or from dangling cords

Babies should always be placed to sleep on their backs on a firm mattress without any pillows, blankets, toys, stuffed animals, or other items.

Because of the risks involved, the American Academy of Pediatrics (AAP) and the U.S. Consumer Product Safety Commission (CPSC) warn against bed-sharing. The AAP does recommend the practice of room-sharing without bed-sharing. Sleeping in the parents' room but on a separate surface lowers a baby's risk of SIDS.

Bed-Sharing & SIDS

Bed-sharing increases a baby's risk of dying from SIDS, especially preterm infants (preemies), babies who had a low birth weight, and healthy full-term infants younger than 4 months old.

Other things that increase this risk of death while bed-sharing include:

• a baby sleeping on a couch alone or with a parent
• a baby sleeping between two parents
• a mother who smokes
• parents who are very tired
• a parent who has recently used alcohol or drugs
• bed-sharing with pillows or bedcovers
• bed-sharing with other children

How Can We Room-Share Safely?

To keep your little one close, but not in your bed:

• Put a bassinet, play yard, or crib next to your bed. This lets you keep that desired closeness, which can be especially important if you're breastfeeding. Having an infant sleep in a separate space in the same room as the mother reduces the risk of SIDS.
• Consider using a bedside sleeper, which attaches to your bed, letting you and your baby be next to each other but on separate surfaces. The CPSC has recommended safety standards for bedside sleepers, but no studies have looked at whether these devices prevent SIDS and other sleep-related deaths or injuries.

Experts recommend that infants sleep in their parents' room without bed-sharing until their first birthday. If parents prefer to move the baby to another bedroom, it's best to wait until the child is at least 6 months old.

How to Bed-Share as Safely as Possible

Some parents decide bed-sharing is best for their family despite the risks. If you choose to have your baby in bed with you, follow these precautions:

• Always place babies on their back to sleep to reduce the risk of SIDS.
• Dress your baby in minimal clothing to avoid overheating.
• Don't place a baby to sleep alone in an adult bed.
• Don't place a baby on a soft surface to sleep, such as a soft mattress, sofa, or waterbed. Make sure your bed's mattress is firm.
• Make sure your bed's headboard and footboard don't have openings or cutouts that could trap your baby's head.
• Make sure your mattress fits snugly in the bed frame so that your baby won't become trapped between the frame and the mattress.
• Don't cover your child's head while they're sleeping.
• Don't have pillows, comforters, quilts, and other soft or plush items on the bed. You can dress your baby in a sleeper instead of using blankets.
• Don't place your bed near draperies or blinds where your child could be get caught in and strangled by cords.
• Don't fall asleep with a baby on your chest.
• Don't sleep on couches, recliners, or rockers with a baby.

Also, don't smoke, drink alcohol, or use medicines or drugs that can make you less alert or keep you from waking up.

Avoid bed-sharing with infants who are at greatest risk of SIDs. This includes those younger than 4 months, preterm babies, and those who had a low birth weight.