Thirty years ago, the Back to Sleep campaign, now known as the Safe to Sleep campaign, reduced the incidence of Sudden Infant Death Syndrome by more than 50% by changing the way parents put their infants to bed.
Pediatricians like Katie Edwards, medical director with Annapolis Pediatrics, are working with parents to further reduce the number of sleep-related infant deaths.
“A lot of the cases that we see now are accidental suffocation,” Edwards says.
Some of these cases are attributed to bedsharing—the practice of sleeping in the same bed as your baby or sharing the same sleeping surface.
In recent years, the American Academy of Pediatrics, of which Edwards is a fellow, noted growing concern among public health officials over bedsharing. The AAP, which is the largest professional association of pediatricians in the United States, does not condone this practice in any way, citing major safety concerns.
“Everybody sleeps better in their own sleep space,” Edwards says. “Parents should take care of themselves and be as healthy as they can to be the best parents they can be,
and that involves getting a good sleep.”
The AAP does, however, recommend room sharing, which decreases the risk of SIDS by as much as 50%, according to its most recent technical report.
Why It Happens
Some parents bedshare to be close to their babies, or because they believe it makes it easier to breastfeed, or because they can’t afford a separate sleeping space or accidentally when they fall asleep during a feeding. Some parents may also bedshare for cultural reasons.
Edwards, a mother of four, advises parents to establish a safe, flat sleep space for their infant near the parents but not in the bed.
“I try to keep it very simple and encourage parents to think about a sleep-feed-wake cycle, so letting your child sleep until they wake up hungry, and that is OK,” Edwards says.
To prepare for a new baby, parents should make sure they have their safe sleep space set up before the baby comes home and ask for help from family and friends when they know they’re exhausted.
While the reason bedsharing contributes to an increased risk of SIDS is not perfectly understood, experts are aware of other factors that increase the risks associated with bedsharing.
According to the AAP, these risks include factors like parental fatigue, sedating medications, a soft bed surface or accessories, an infant being younger than 4 months, bedsharing with someone who is not the infant’s parent, preterm or low birth weight and bedsharing with a current smoker.
“It’s really important for the parents also to get sleep, so I recommend not co-sleeping and really [form] as soon as possible good sleep hygiene for the child,” Edwards says.
Having good sleep hygiene means having a regular sleep routine with approximately the same bedtime every night and a similar sleep routine—for example, having bathtime, then brushing teeth and finally reading a book for 10 minutes before bedtime.
According to Edwards, good sleep hygiene isn’t just for infants. Having a regular nighttime routine free of electronic distractions will help adults sleep soundly, too.
Safer Alternatives
One way for parents to be close to their babies without bedsharing is to have frequent skin-to-skin contact, particularly during the first week of life.
Another way to maintain closeness to your infant and monitor them is to have their crib in your room, but still separate from the bed.
Parents who might be struggling with the affordability aspect of having a separate sleep space should consult their pediatrician to see if they offer cribs, pack-n-plays or other safe sleep spaces. A national option for parents struggling with affordability is to request a crib online through Cribs for Kids, a nonprofit that provides safe sleep equipment to families in need.
According to the AAP, infants should be placed on their backs for sleep in a crib, bassinet or portable play yard. They should have a firm, flat mattress and a fitted sheet with no loose blankets, pillows, stuffed toys, bumpers or other soft items.
Parents can check saferproducts.gov to view safety complaints about a product before buying it.
Academic Discourse on Bedsharing
A 2018 study published in the Journal of Midwifery & Women’s Health found that women who bedshare more frequently at 14 weeks postpartum reported longer durations of breastfeeding. Other studies published in 2013 and 2016 have found that bedsharing is associated with a strong motivation to breastfeed and longer duration of breastfeeding.
However, according to the AAP’s 2022 technical report, there is no definitive data to support the idea that bedsharing in the youngest age group is safe. Because of this, the AAP continues to recommend that infants sleep in the parents’ room, close to the parents’ bed but on a separate surface designed for infants, at least for the first six months.
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