🛏️Bed-Sharing: Safety Guidelines and Considerations
Understanding the risks, benefits, and safe practices for bed-sharing with your child
Understanding Co-Sleeping, Room-Sharing, and Bed-Sharing
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.
Many people use the terms "bed-sharing" and "co-sleeping" to describe the same thing, but there are differences:
🛏️Co-Sleeping
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
When parents have a crib, bassinet, portable crib, or play yard in the room with them near the bed. Or, they attach a bedside sleeper to the side of their bed.
⚠️Bed-Sharing
When parents and infants sleep together in a bed, couch, or chair. This has raised concerns because bed-sharing with an infant increases the risk of sleep-related deaths, including SIDS.
⚠️Why Is Bed-Sharing Unsafe?
In some cultures, bed-sharing is common and the number of infant deaths related to it is low. Differences in mattresses, bedding, and other cultural practices may account for the lower risk in these countries.
But health experts warn parents not to place their infants to sleep in adult beds due to serious safety risks. Bed-sharing increases the chance of suffocation, strangulation, and SIDS.
Adult Bed Safety Risks:
- •Suffocation from soft mattress, memory foam, waterbed, or loose bedding
- •Entrapment between mattress and headboard, wall, or other object
- •Strangulation from bed frame gaps or dangling cords
- •Risk from pillows, blankets, toys, or stuffed animals
AAP & CPSC Recommendations:
- •American Academy of Pediatrics warns against bed-sharing
- •U.S. Consumer Product Safety Commission warns against bed-sharing
- ✓AAP recommends room-sharing without bed-sharing
- ✓Sleeping in parents' room on separate surface lowers SIDS risk
✅Why Do Some Parents Bed-Share?
Bed-sharing supporters believe — and some studies support their beliefs — that bed-sharing:
- •Encourages breastfeeding: Makes nighttime breastfeeding more convenient
- •Increases breastfeeding duration: Helps mothers breastfeed for more months
- •Helps babies fall asleep: Makes it easier for babies to fall asleep
- •More nighttime sleep: Helps babies and mothers get more sleep
- •More closeness: Gives moms more time to be close to their infants
But the risks of bed-sharing can outweigh the benefits.
⚠️Bed-Sharing & SIDS
Bed-sharing increases a baby's risk of dying from SIDS, especially in:
- •Preterm infants (preemies)
- •Babies who had a low birth weight
- •Healthy full-term infants younger than 4 months old
Other Risk Factors:
- •Baby sleeping on a couch alone or with a parent
- •Baby sleeping between two parents
- •Mother who smokes
- •Parents who are very tired
- •Parent who has recently used alcohol or drugs
- •Bed-sharing with pillows or bedcovers
- •Bed-sharing with other children
🛡️How Can We Room-Share Safely?
To keep your little one close, but not in your bed, 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.
🏠Room-Sharing Options
- • Crib, bassinet, or play yard in your bedroom
- • Bedside sleeper that attaches to your bed
- • Separate surfaces but close proximity
- • Recommended until first birthday
- • Wait until at least 6 months to move to another room
✅Safety Standards
Make sure that all sleep surfaces and products you use to help your baby sleep have been approved by the CPSC and meet federal safety standards.
⚠️How to Bed-Share as Safely as Possible
Some parents decide bed-sharing is best for their family despite the risks. If you choose to have your baby in bed with you, follow these precautions:
Essential Safety Measures:
- ✓Always place baby on their back to sleep
- ✓Dress baby in minimal clothing to avoid overheating
- ✓Offer pacifier at sleep time (don't force it)
- ✓Stop swaddling if baby starts trying to roll over
- ✓Use firm mattress that fits snugly in bed frame
- ✓Ensure headboard/footboard have no openings
- ✓Don't cover baby's head while sleeping
- ✓Dress baby in sleeper instead of using blankets
What to Avoid:
- ✗Don't place baby alone in adult bed
- ✗Don't use soft surfaces (sofa, waterbed)
- ✗Don't have pillows, comforters, quilts on bed
- ✗Don't place bed near draperies or blind cords
- ✗Don't fall asleep with baby on your chest
- ✗Don't sleep on couches, recliners, or rockers
- ✗Don't use weighted blankets or sleepers
- ✗Don't smoke, drink alcohol, or use drugs
Additional Important Notes:
- •Don't let baby fall asleep on products not designed for sleeping (car seats, feeding pillows, infant loungers)
- •Don't use products claiming to lower SIDS risk (sleep positioners, monitors) - no products can actually do this
- •Avoid bed-sharing with infants at greatest risk: younger than 4 months, preterm babies, low birth weight
❓Frequently Asked Questions About Bed-Sharing
Is bed-sharing safer in other countries?
In some cultures, bed-sharing is common and the number of infant deaths related to it is low. Differences in mattresses, bedding, and other cultural practices may account for the lower risk in these countries. However, health experts in the U.S. still warn against bed-sharing due to the specific risks in our environment.
What's the difference between bed-sharing and room-sharing?
Bed-sharing means sleeping in the same bed as your baby, which increases SIDS risk.Room-sharing means having your baby sleep in a separate crib, bassinet, or play yard in your bedroom. Room-sharing provides the benefits of closeness while maintaining safety and is recommended by the AAP for at least the first 6 months.
Can I bed-share if I'm breastfeeding?
While breastfeeding may make bed-sharing seem more convenient, the safety risks remain the same. Room-sharing provides the same breastfeeding benefits while keeping your baby safe. You can easily reach your baby for nighttime feedings without the risks associated with bed-sharing.
What if my baby only sleeps well when bed-sharing?
Many babies initially resist sleeping alone, but this is a learned behavior that can be changed with patience and consistency. Try room-sharing first, then gradually transition to independent sleep. The temporary sleep challenges are worth the long-term safety benefits.
Are there any products that make bed-sharing safer?
No products can eliminate the risks of bed-sharing. The AAP and CPSC warn against using products that claim to make bed-sharing safer, such as sleep positioners, bed-sharing pillows, or monitors. These products may actually increase risk and are not recommended.
What if my partner and I disagree about bed-sharing?
It's important for both parents to agree on sleep arrangements. Discuss your concerns openly and consider the safety recommendations together. If you disagree, err on the side of caution and choose the safer option of room-sharing. You can always discuss this with your pediatrician for additional guidance.
How do I transition from bed-sharing to independent sleep?
Start by moving your baby to a crib or bassinet in your room (room-sharing). Once they're comfortable with that, gradually move them to their own room. Maintain consistent bedtime routines and be patient - transitions can take time. Consider working with a pediatric sleep consultant if you need additional support.
What if I accidentally fall asleep while feeding my baby?
If you're concerned about falling asleep while feeding, prepare a safe space ahead of time. Remove pillows and blankets from the area, ensure the surface is firm, and place your baby on their back when you're done feeding. Consider feeding in a chair rather than in bed to reduce the risk of accidentally falling asleep together.
Why do some families choose bed-sharing despite the risks?
Some families choose bed-sharing for cultural reasons, convenience, or because they believe it promotes bonding. However, it's important to understand that these benefits can be achieved through safer alternatives like room-sharing, which provides closeness without the increased SIDS risk.
When is bed-sharing most dangerous?
Bed-sharing is most dangerous for babies under 4 months old, preterm babies, and babies with low birth weight. Additional risk factors include: sleeping on soft surfaces, having pillows/blankets in the bed, parent smoking, parent alcohol/drug use, extreme parent fatigue, and sleeping on couches or chairs.
🤔Making an Informed Decision
The decision to bed-share is personal and should be made after careful consideration of your family's specific circumstances, cultural values, and safety factors. Remember that the American Academy of Pediatrics and U.S. Consumer Product Safety Commission warn against bed-sharing due to safety risks.
Questions to Consider:
- Are all safety conditions met in your sleeping environment?
- Do you and your partner agree on this sleeping arrangement?
- How will this affect your sleep quality and relationship?
- What is your plan for transitioning to independent sleep later?
- Have you discussed this with your pediatrician?
- Are you aware of the increased SIDS risk associated with bed-sharing?
- Have you considered room-sharing as a safer alternative?