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.
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 in the room with them; a bassinet, portable crib, or play yard near the bed; or a bedside sleeper attached to the side of the parental 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 Some People Bed-Share
Bed-sharing supporters believe — and some studies support their beliefs — that bed-sharing:
encourages breastfeeding by making nighttime breastfeeding more convenient
makes it easier for a nursing mother to get her sleep cycle in sync with her baby's
helps babies fall asleep more easily, especially during their first few months and when they wake up in the middle of the night
helps babies get more nighttime sleep (because they awaken more often with shorter feeding time, which can add up to a greater amount of sleep throughout the night)
helps parents regain closeness with their infant after being separated from their babies during the workday
But do the risks of bed-sharing outweigh the benefits?
Is Bed-Sharing Safe?
In some non-Western cultures, bed-sharing is common and the number of infant deaths related to it is lower than in the West. Differences in mattresses, bedding, and other cultural practices may account for the lower risk in these countries.
Despite the possible pros, various U.S. medical groups warn parents not to place their infants to sleep in adult beds due to serious safety risks. Bed-sharing puts babies at risk of suffocation, strangulation, and SIDS. Studies have found that bed-sharing is the most common cause of deaths in babies, especially those 3 months and younger.
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
Among older infants (4 to 12 months old) who died due to bed-sharing, having an additional item (like a pillow or a blanket) on the bed increased the risk of death. 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, both the American Academy of Pediatrics (AAP) and the U.S. Consumer Product Safety Commission (CPSC) advise 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.
Besides the potential safety risks, sharing a bed with a baby sometimes prevent parents from getting a good night's sleep. And infants who sleep with their parents learn to associate sleep with being close to a parent in the parent's bed, which can become a problem at naptime or when the baby needs to go to sleep before the parent is ready.
Bed-sharing increases the risk of SIDS, especially in preterm infants (preemies), babies with low birth weight, and healthy full-term infants younger than 4 months old.
Other things that further 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 extremely tired
a parent who has recently used alcohol or drugs
bed-sharing with pillows or bedcovers
bed-sharing with other children
How to Room-Share Safely
To avoid the risks of bed sharing while enjoying the benefits of room-sharing, parents have lots of options. To keep your little one close by, but not in your bed, you could:
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 to allow you and your baby to be next to each other but on a separate surface. 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.
How to Bed-Share as Safely as Possible
Despite the risks of bed-sharing, some parents decide this sleeping arrangement is best for their family. If you do choose to share your bed with your baby, follow these precautions:
Don't share a bed with an infant under 4 months of age — a bassinet or crib next to the bed is a better choice.
Always place your baby on his or her 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 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 sleeping.
Don't use 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 drink alcohol or use medicines or drugs that could keep you from waking or might cause you to roll over onto, and therefore suffocate, your baby.
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.
Moving Out of the Parents' Room
Experts recommend that infants sleep in their parents' room until their first birthday. If parents prefer to move the baby to another bedroom, it's best to wait until their child is at least 6 months of age.