The practice of bed-sharing, where parents share a bed with their infant, is a topic of ongoing debate. Advocates believe that a parent’s bed is the natural place for a baby, while others raise concerns about the potential dangers associated with bed-sharing.
Co-Sleeping, Room-Sharing, and Bed-Sharing: Understanding the Differences
Many people use the terms «bed-sharing» and «co-sleeping» interchangeably, but there are distinct differences:
- Co-sleeping: This refers to a parent and child sleeping in close proximity, allowing both to be aware of each other’s presence.
- Room-sharing: A type of co-sleeping where parents have the baby sleep in a crib, bassinet, or portable crib in the same room, often near the bed. Some parents may use a bedside sleeper attached to their bed.
- Bed-sharing: This involves parents and infants sleeping together in the same bed, couch, or chair. Bed-sharing raises safety concerns due to the increased risk of sleep-related deaths, including sudden infant death syndrome (SIDS).
Why Do Some Parents Choose Bed-Sharing?
Supporters of bed-sharing argue—and some studies support—that this practice:
- Facilitates breastfeeding by making nighttime feedings more convenient.
- Prolongs the duration of breastfeeding.
- Helps babies fall asleep more easily.
- Improves sleep for both babies and mothers.
- Increases the amount of close, bonding time between mother and baby.
However, despite these potential benefits, the risks associated with bed-sharing can outweigh the positives.
Why Is Bed-Sharing Considered Unsafe?
In some cultures, bed-sharing is common, and the incidence of infant deaths related to it is low. These differences might be due to variations in mattresses, bedding, and other cultural practices.
Nevertheless, health experts in many countries advise against placing infants in adult beds due to significant safety risks, including:
- Suffocation: This can occur on soft mattresses, memory foam, waterbeds, or with loose bedding such as pillows, blankets, or quilts.
- Entrapment: Infants can get trapped between the mattress and a headboard, wall, or other objects, leading to suffocation.
- Strangulation: This can happen if an infant becomes trapped in a bed frame or if there are dangling cords nearby.
To reduce these risks, infants should always be placed on their backs to sleep on a firm mattress or another firm sleep surface, such as a crib, without any loose bedding or toys.
Given the risks, the American Academy of Pediatrics (AAP) and the U.S. Consumer Product Safety Commission (CPSC) strongly recommend against bed-sharing. Instead, they advocate for room-sharing without bed-sharing, where the baby sleeps in the parents’ room but on a separate surface. This setup has been shown to lower the risk of SIDS.
Bed-Sharing and SIDS
Bed-sharing significantly increases the risk of SIDS, particularly in certain groups of infants, such as preterm babies, those with low birth weight, and healthy full-term infants under four months of age.
Additional factors that increase the risk during bed-sharing include:
- Sleeping with a baby on a couch, either alone or with a parent.
- Having a baby sleep between two parents.
- Bed-sharing when the mother smokes.
- Parents who are extremely tired.
- Parents who have recently used alcohol or drugs.
- Bed-sharing with pillows or bedcovers.
- Bed-sharing with other children in the bed.
How to Practice Room-Sharing Safely
To keep your baby close without sharing a bed, place a bassinet, play yard, or crib next to your bed. This allows for the closeness that is particularly beneficial if you’re breastfeeding, while also reducing the risk of SIDS. Bedside sleepers, which attach to the bed, are another option, letting you keep your baby nearby but on a separate surface.
Ensure that any sleep products you use are approved by the CPSC and meet federal safety standards.
Experts recommend room-sharing without bed-sharing for at least the first year of life. If you prefer to move your baby to another room, it’s best to wait until they are at least six months old.
How to Bed-Share as Safely as Possible
Some parents choose to bed-share despite the risks. If you decide that this is the best option for your family, follow these precautions:
- Always place your baby on their back to sleep to reduce the risk of SIDS.
- Dress your baby in minimal clothing to avoid overheating.
- Offer a pacifier at sleep time, but don’t worry if it falls out during sleep.
- If your baby is swaddled and begins to roll over, stop swaddling immediately.
- Never leave your baby to sleep alone in an adult bed.
- Avoid placing your baby on a soft surface like a mattress, sofa, or waterbed. Ensure the mattress is firm.
- Ensure that the bed’s headboard and footboard have no openings that could trap your baby’s head.
- Make sure the mattress fits snugly in the bed frame to prevent entrapment.
- Never cover your baby’s head while they’re sleeping.
- Keep pillows, comforters, quilts, and other soft items out of the bed.
- Avoid placing your bed near draperies or blinds that could pose a strangulation risk.
- Never fall asleep with your baby on your chest.
- Avoid sleeping on couches, recliners, or rockers with your baby.
- Don’t use weighted blankets, sleepers, or swaddles on or around your baby.
Also:
- Never let your baby fall asleep on products not designed for sleeping, like car seats, feeding pillows, or infant loungers.
- Avoid using products that claim to reduce the risk of SIDS, such as sleep positioners or monitors that detect heart rate and breathing patterns. These products have not been proven effective.
- Avoid smoking, drinking alcohol, or using drugs or medications that might make you less alert.
It’s crucial to avoid bed-sharing with infants at higher risk of SIDS, including those younger than four months, preterm babies, and those with low birth weight.