The American Academy of Pediatrics (AAP) has raised concerns about bed sharing. The AAP Task Force on Sudden Infant Death Syndrome suggests newborns and infants sleep in a crib placed alongside the parent’s bed. The biggest threat to safety for bed sharing was for infants under 12 weeks of age who were exposed to secondhand smoke. Some people believe this advisory is too broad and believe steps can be taken to minimize or eliminate any risks that bed sharing poses while supporting potential bed sharing benefits.

Bed sharing benefits include the potential to improve breastfeeding patterns by decreasing disruptions caused by the close proximity of the infant to the mother. Enhanced infant-parent bonding and comforting especially for sensitive or “fussy” babies are often discussed as is the potential to decrease so called SIDS or Life Threatening Events. Mothers and babies who sleep together often sleep in synchrony allowing their arousals to overlap and enhance sleep.

There is no absolute answer to this question. Most pediatricians seek to avoid risk. It is much easier to focus on a safe crib environment than a safe bed environment. Western beds include many forms of soft bedding that can be hazardous and cause suffocation. Most beds are elevated and a pose a risk of injury from a fall off the bed. Some beds have not met safety standards for bed rail positioning to prevent strangulation. Most people sleep with sheets and blankets that can cover an infant’s face and lead to breathing pattern changes that lead to Acute Life Threatening Events (SIDS). Finally there is a risk of a bed sharing parent rolling over and obstructing the breathing of their child. This is especially important for exhausted parents or parents with underlying medical conditions who are more prone to sleep through arousals that a non-sleep deprived parent would not.

What should you do?

If you pursue bed sharing then choose your bed and bed surface carefully. Make sure the mother is the only co-sleeper and neither the mother or baby should wear or use anything that could cover the infants face. There should be no headboard, footboard or railing on the bed and there should be no bed coverings, toys or dangerous bedding including pillows. Make sure there are no draperies, blinds or cords nearby and the mattress should be close to the ground and added protection placed on the ground to soften any fall. Keep the room cool and prevent overheating since most babies sleep in warm clothes.

Due to this long list of precautions most parents prefer to use an approved crib or bassinet that is placed next to the bed. This allows the mother to be within arm’s reach of her infant and provides most of the benefits of bed sharing without the risks. It also allows for the infant to sleep in the same room as the parent and then to be transitioned away from the parent’s bed as age, caretaking and parental preferences allow.

Remember, there are risks to bed sharing and infants sleeping in adult beds. Make your choice wisely.