Are co-sleeping and bed-sharing safe? The topic of co-sleeping is nearly as polarized as vaccinations. I wasn’t planning to write anything about this until an article was published recently on WFLA 8 and a video was created by the Hillsborough County Sheriff’s Office about the “dangers of co-sleeping.”
It starts out sharing about a call received by local deputies. A baby not breathing and in fact had passed away. The cause of death was listed as “co-sleeping”. The Sheriff goes on to share statistics about the number of deaths in Hillsborough County. Then makes a general statement about where moms and dads should put their babies for sleep.
I know the intention of this video comes from a good place. And as the daughter of a police officer, I fully respect what our first responders do and the things they have to see on a daily basis. BUT…
There is no perfectly right way one size fits all option out there. So, I’m going to do my best to include more information on the entire scope of co-sleeping. I’m including my favorite references and resources in hopes that it informs, educates, inspires, and empowers.
Co-sleeping and bed-sharing – they are not always the same
When my kiddos were babies, 5 and 6 years ago, co-sleeping was more synonymous with bed-sharing. Today though, it has evolved to include a few variations of sleeping arrangements. Bed-sharing is one^. When the Sheriff refers to the dangers of co-sleeping in the video, he is referring to bed-sharing specifically.
Some different ways that families may co-sleep today include:
- Bed-sharing: parents and baby share a bed and sleep together
- Baby is in the room with the parents. But the baby is in their own commercial “side-car” or “co-sleeper”. This attaches to the parent’s bed and has the baby in close proximity to them
- Baby is in the room with the parents but in a separate bed. This could include a crib, pack, and play, bassinet, or even a mattress for an older child.
- Baby or child has their own room. But the child goes into bed with the parents when needed and/or after waking in the night.
The American Academy of Pediatrics recommends that babies co-sleep in the form of “room-sharing” i.e. being in the same room with their parents but on a separate sleep surface for a minimum of 6 months and up until 1 year. This is because it has been shown to decrease the incidence of SIDS by 50%.
Bed-sharing benefits and advantages
Let’s talk about bed-sharing specifically. The video specifically focuses on bedsharing and where I think there is room for more information and education. Many mamas who bed-share state the following benefits/reasons for doing so. There is also supporting evidence and research to back it.^^
- Ease of breastfeeding and increased sleep. When the baby is in bed with Mama, they can alert Mama to when they’re hungry. And over time, mama doesn’t have to wake as fully, thus getting better sleep. In addition, in most cases, babies are cradled by mom’s body wrapping around them. In a way that has baby’s feet touch mom’s knees, thus helping them stay put and close. For all my currently breastfeeding mamas or those that did, can I get an Amen? This was a game changer for me with both my babies.
- Attachment and closeness. You don’t have to be an “attachment parenter” to bed-share. But it does have benefits in this regard. Research shows that babies who lack closeness to their parents at night are more likely to exhibit clingy behavior a year later. Also, bed-sharing infants had a lower risk of insecure attachment than their solitary sleeping counterparts.
- It feels “natural” to have baby close. This was personally true for me. My babies both bed-shared and room-shared until they were 1 (and beyond for our son). The first few months of baby’s life outside the womb are often referred to as the 4th Trimester. And there are some physiological benefits to being close to mom as often as possible during that time. Benefits of continued closeness to mom include regulation of their body temperature, stabilized blood glucose levels, better-regulated breathing, and heart rates.
So why if there’s all this evidence and research that points to the benefits, is this such a polarizing topic?
The AAP’s stance is the same as the Sheriff’s stance
The AAP unequivocally states that bed-sharing should just not be done. The organization says the practice puts babies at risk for sleep-related deaths, including sudden infant death syndrome, accidental suffocation, and accidental strangulation. About 3,700 babies die each year in the U.S. from sleep-related causes, with around 25% of those being from accidental suffocation and strangulation.
What we don’t know in the case of the two infant deaths that the Sheriff refers to, is what the risk factors were for baby and/or the environment in which baby was sleeping. This directly affects the possibility of death from SIDS or by accidental suffocation and/or strangulations.
Families who have these risk factors are increasing their chances of deaths from sleep-related causes:
- Sleeping with infants under 4 months
- Premature babies are at a higher risk of SIDS when bed-sharing (though benefit greatly from being nearby)
- If you or your partner are a smoker or if you smoked during pregnancy; it increases the risks of SIDS as well
- If you are over-tired (when is a new mama NOT tired though), have consumed alcohol, taken sedatives or any drugs (or any substance that makes you less coherent)
- Older siblings or other children should not sleep with babies under a year old
- Do not swaddle your baby when bed-sharing. Because they could overheat (also increasing risk of SIDS) nor can they move covers out of the way of their face (as they get older)
- Additional risks include excessively overweight parents (recommended that baby is close by and not in bed), very long hair that can get tangled around baby’s neck and parents who are very deep sleepers
But according to research, not all bed-sharing is the same.
This is one of my favorite articles on bed-sharing, produced by NPR, “Is sleeping with your baby as dangerous as doctor’s say?” published in May of 2018.
In this article, according to one pediatrician who has studied SIDS related deaths for over 30 years, his research states that there is a 1 in 1500 chance of a high-risk baby dying of SIDS in a crib in their parents’ room. While the risk goes up to 1 in 150 if sleeping in bed with parents.
Families who do not have the above-increased risk factors and who practice the following safe bed-sharing techniques reduce their risk for sleep-related tragedies:
- Beds that are firm (no pillow tops, water beds, etc) and that have tight-fitting sheets
- No extra blankets, pillows, stuffed animals, or other things near baby’s face. These items can inhibit breathing for a baby or cause a baby to overheat. (the same is true if they are in their own bed)
- Babies should be placed on the back to sleep
- No gaps between headboard and mattress. Proper bed rails on sides of the bed (with mesh vs slats to avoid baby falling and getting stuck)
- Babies (with or without an adult) should never sleep on a sofa, couch, futon, recliner, or other surfaces where baby can slip into a crevice or become wedged against the back of the chair/sofa/etc.
Citing statistics from the same references as above, the chance of a low-risk baby dying of SIDS while sleeping in a crib in their parents’ room is 1 in 46,000. And the chance of the same low-risk baby dying of SIDS while sleeping in the bed with their parents is 1 in 16,400.
A couple other statistics for comparison here. The likelihood of a child dying from accidental drowning is 1 in 4400 or a child developing a peanut allergy is 1 in 50.
The bottom line and how is a mama to know what to do? Check out my next blog piece to get my take on making a decision.
Additional links and resources: