Co-sleeping is when parents sleep on the same surface as their babies – for example, when they bring their babies into bed with them to sleep.
Co-sleeping is associated with an increased risk of sudden unexpected death in infancy (SUDI), including sudden infant death syndrome (SIDS) and fatal sleeping accidents in some circumstances. But parents choose to have their babies in bed with them for several reasons.
For example, some parents who co-sleep with their babies believe that it helps them feel safe and secure. These parents like the close body contact, feel that it’s rewarding and satisfying, and believe it’s good for their relationships with their babies.
Also, some parents co-sleep because they find it more practical. Breastfeeding and resettling during the night can be easier. Some parents feel that it helps with establishing breastfeeding.
- For the first 6-12 months of life, it’s safest for babies to sleep in a cot next to a parent’s bed.
- Co-sleeping is when parents sleep on the same surface as their babies.
- Co-sleeping can be dangerous for babies.
- If you choose to co-sleep, there are things you can do to minimise the risk.
The practise 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.
FAQs About Baby Bed
For the first main approach, put her down awake in her crib after the bedtime routine, leave the room, return as often as you would like and give her a consistent verbal response like, “goodnight, I love you.” Do this consistently until she falls asleep.
Sears recommended a "nursing down" method for helping your baby learn to sleep separately from you. In this method, you'd nurse your baby before laying them down, then lay them in the bassinet. The "smooth continuum...from warm breast to warm bed" should help your baby feel as safe and comfortable as possible.
For many parents, co-sleeping means sharing the same bed as their baby. The American Academy of Pediatrics (AAP) and the CDC both advise against sharing a bed with children under a year old because bed-sharing increases the risk of suffocation, strangulation and SIDS in babies younger than 12 months of age.
Several studies have indicated that the associated risk applies only to younger babies and babies whose parents smoke. However, recent studies have shown that even among non‐smokers, bed‐sharing increases the SIDS risk in younger infants, suggesting that all forms of bed‐sharing should be avoided for these infants.
There you have it! If you're loving every minute of co-sleeping (or if you've been forcing yourself to sleep separately), you can relax. Despite the myths and false information, co-sleeping will not make your baby clingy.
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 with 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, 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: This is when parents and infants sleep together in a bed. This has raised concerns because bed-sharing with an infant increases the risk of sleep-related deaths, including sudden infant death syndrome (SIDS).
Advantages of co-sleeping
Co-sleeping is not the best fit for every family, but it can have many advantages:
- Parents often get more sleep.
- Babies often get more sleep. The baby stirs and almost wakes up when she needs to nurse, but since she is right beside mom, mom can breastfeed or soothe her back to sleep before she fully wakes up.
- Breastfeeding during the night is easier when the baby is nearby.
- Breastfeeding at night helps to maintain your milk supply.
- Sleeping in the same room as your baby reduces the risk of SIDS by as much as 50% [AAP].
- Night nursing also tends to prolong the child-spacing effects of breastfeeding.
- No nighttime separation anxiety.
- Fewer bedtime hassles.
- It’s lovely to wake up next to a smiling baby!
Creating a safe sleep area for your baby
Any sleep surface that baby uses (including cribs, nap surfaces, or adult beds) should be made safe for the baby:
- The baby should be placed on his back to sleep.
- The sleep surface should be firm. Do not put a baby on a waterbed mattress, pillow, beanbag, sheepskin or any other soft surface to sleep.
- Bedding should be tight fitting to the mattress.
- The mattress should fit the headboard and footboard (or sides of the crib).
- There should not be any loose pillows, stuffed animals, or soft blankets near the baby’s face.
- There should not be any space between the bed and adjoining wall where the baby could roll and become trapped.
- Babies (with or without an adult) should never sleep on a sofa, couch, futon, recliner, or another surface where the baby can slip into a crevice or become wedged against the back of the chair/sofa/etc.
Bed-sharing is just one of the ways that a family might co-sleep, but it is frequently practised by breastfeeding mothers. One of the biggest issues when it comes to bed-sharing is safety.
Some sources publicise bed-sharing as an unsafe practice, no matter how it’s done, but there are ways to sleep safely while bed-sharing if you follow guidelines for safe sleep surfaces and safe sleep sharing.
If the baby is sharing sleep with another person:
- Very small premature or low birth-weight babies appear to be at greater risk when bed-sharing but benefit greatly from co-sleeping nearby but on a different surface.
- Do not sleep with baby if you are currently a smoker or if you smoked during pregnancy – this greatly increases SIDS risk.
- Do not sleep on the same surface as your baby if you are overtired or have ingested alcohol/sedatives/drugs (or any substance that makes you less aware)
- Baby appears to be safest when sleeping beside their breastfeeding mother.
- Older siblings or other children should not sleep with babies under a year old.
- Do not swaddle your baby when bed-sharing. The baby may overheat (which is a risk factor for SIDS), and a swaddled baby cannot effectively move covers from the face or use arms and legs to alert an adult who is too close.
- Other potential hazards: very long hair should be tied up so that it does not become wrapped around baby’s neck; a parent who is an exceptionally deep sleeper or an extremely obese parent who has a problem feeling exactly how close baby is should consider having a baby sleep nearby, but on a separate sleep surface
Some authorities specifically recommend co-sleeping without bed-sharing since they feel that not bed-sharing is the easiest way to eliminate any risks of bed-sharing.
For example, the American Academy of Pediatrics says, “Room-sharing without bedsharing is recommended— There is evidence that this arrangement decreases the risk of SIDS by as much as 50%.”
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:
- Always place babies on their 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 mattress is firm.
- 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 your baby won't become trapped between the frame and the mattress.
- Don't cover your child's head while they're sleeping.
- Don't have 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 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.
Also, don't smoke, drink alcohol, or use medicines or drugs that can make you less alert or keep you from waking up.
Avoid bed-sharing with infants who are at greatest risk of SIDs. This includes those younger than four months, preterm babies, and those who had a low birth weight.
Safe Sleep Recommendations
A member of the AAP Safe Sleep Task Force, Dr Lori Feldman-Winter, says
“If you are feeding your baby and think that there’s even the slightest possibility that you may fall asleep, feed your baby on your bed, rather than a sofa or cushioned chair.
As soon as you wake up, be sure to move the baby to their bed,” she said. “There should be no pillows, sheets, blankets or other items that could obstruct the infant’s breathing or cause overheating.” Great!
This brings us to the recommendations.
- Place the baby on their back to sleep. Every.Single.Time. No grandma, it’s not 1892 anymore, and we don’t put babies on their bellies or even their sides.
- Use a firm sleep surface. This one does not indent or conform to the baby’s shape. No bean bags, no memory foam, no nothin’ that is too soft.
- Breastfeed if possible.
- Have baby sleep in your room for as long as possible.
- Keep soft objects away from the baby. No loose blankets, sheets, bumpers, toys, etc.
- Offer a pacifier. Yup! Winning!
- No smoking around the baby.
- No drugs, alcohol or anything else that makes you sleepy.
So You want a Bed Share…
Ok, you’ve read all the recommendations, and you feel like you might be interested in bed-sharing. How to do it so that you are reducing as many risks as possible?
Baby On Back
1) First and foremost- place the baby on their back to sleep. Every time. If you are swaddling, stop by when the baby reaches two months or earlier if the baby signs of rolling over.
2) No couch, recliner, overstuffed chair, hammock, chaise lounge sleeping. Ever. Or anything other than a mattress. But you were getting that hint.
Make That FIRM Mattress Only
3) Check out your mattress. Is it super soft? Is it going to indent when you lay baby on it? If so, your mattress and baby may be headed for a breakup.
Check Mattress Location
4) Where is your bed located? If your bed is near a wall or piece of furniture, see if you can pull it away from anything that could pin the baby if s/he ever rolls off the bed. Babies had died when they crawled or rolled to the edge of the bed and became trapped between the mattress and wall (or piece of furniture). Consider putting your mattress on the floor.
Clear Everything But You And The Baby
5) What do you have on your bed? Is your bed filled with pillows, blankets, dogs, a partner, other kids, etc.? It all needs to go. Baby needs to have a sleep space clear of anything that could obstruct their tiny nose and mouth. That includes soft stuff as well as other humans and pets. I hear Target is having a sale on adult footed pyjamas.
6) Are you smoking? Baby goes in a crib or Smitten. Smoking is a big risk factor for SIDS.
No Drugs (Legal Or Illegal) Or Alcohol
7) Did you drink tonight or take meds that might make you tired? That means the baby sleeps separately from you. Remember, a baby can be next to you in a bassinet (like the Smitten). But when you cannot fully rouse, it’s dangerous to sleep with the baby.
Check The Temperature
8) Chances are, it’s not the North Pole in your house. Put the baby in one more layer than what you are comfortable in.
Check Your Baby’s Age
9) Babies 0-4 months of age are at increased risk of SIDS. Be particularly vigilant if your baby is less than four months old.
Use A Pacifier
10) If breastfeeding is well established, offer a pacifier.
Of course, these steps can’t 100% prevent SIDS. But you can certainly reduce the risk by following these guidelines. Happy parenting!
Most parents will tell you that as soon as they announced their pregnancy, the advice started rolling in. Much of it might have been sensible and evidence-based, but it isn’t easy to sort the myths from realities.
Given so much of a new parent’s life is spent settling infants and working out their rapidly evolving sleep patterns, questions soon arise about how to get a baby to sleep, where they should sleep, and for how long.
For many parents, bed-sharing becomes a workable option to settle their infant and gain much-needed sleep. But is it worth the risks?
Sharing a bed with an infant is a risk factor for SIDS, the unexpected and sudden death of an infant during sleep. While a public health campaign has successfully promoted strategies to reduce the risk of SIDS in Australia by 80%, many parents still sleep alongside their infants.
SIDS and Kids brochures state that “sharing a sleep surface with a baby increases the risk of SIDS in some circumstances”. Specifically, “babies who are most at risk of sleeping accidents whilst sharing a sleep surface are babies less than three months of age, and babies born preterm or small for gestational age (low birth weight)”.
In March 2010, a national Galaxy Research survey commissioned by Proctor and Gamble asked 2,000 mothers with babies and toddlers aged up to two years about their sleep patterns. My colleagues and I conducted an analysis of 1,000 responses randomly selected to ensure diversity in age, location and socioeconomic background.
The mothers’ responses highlighted the challenges of getting an infant to sleep, with 92% reporting difficulties at some stage. Of this group, 24% regularly or always struggled to get their infants to sleep. Night waking was a common occurrence, with 51% of the babies waking at least once.
Over half (58%) of the infants slept for six to seven hours per night, while one-third (31%) of the infants slept for four to five hours.
Not surprisingly, many mothers said they felt tired (46%). This sense of sleep deprivation resulted in feelings of exhaustion (75%) and irritability (70%).
The mothers identified they had lower levels of patience (63%) and greater feelings of frustration (27%) than before giving birth. For just over a third (37%), the additional strain was being placed on the relationship with their partner.
The mothers used numerous strategies to encourage their infants to sleep. These included rocking and patting (51%), giving a feed (46%), using a dummy (47%), putting the baby in a cot (57%) and allowing their infant to fall asleep in their arms (48%). Just under half (41%) used bed-sharing as a strategy to get their infants to sleep.
Reducing the risks
The advice from clinicians and public health experts on co-sleeping is based on evidence and policy: have your baby sleep in your bedroom for the first six to 12 months but not in your bed.
But additional advice is needed to minimise the risk when parents decide to bed-share with their infants or see it as a last resort to getting some sleep.
Our research found that many women use bed-sharing as an infant-settling strategy, driven by a desperate need for sleep. These findings are supported by a 2002 study which identified that 80% of the 253 parents studied at some stage shared a bed with their infant.
So how do we best inform parents about the risks of sharing a bed with their infants? Let’s start with the basics:
- Put your baby on his back to sleep (never on his tummy or side)
- Make sure his head is uncovered during sleep
- Keep the sleep environment smoke-free, and
- Provide firm and safe bedding.
In addition to these now well-accepted safe sleeping guidelines, SIDS and Kids recommend you avoid sharing a sleep surface with your baby if:
- You’re a smoker
- You’re under the influence of alcohol or drugs that cause sedation
- You’re excessively tired
- Other children are sharing the bed with a baby
- The baby could slip under bedding (such as pillows or doonas)
- The bed is a waterbed, or if the mattress is too soft
- The sleep surface is a sofa or chair
- Your baby could become trapped between the bed and the wall or the bed rails, or
- Your baby may fall off the bed.
All parents must know not only the risks of bed-sharing but ways to minimise the risk if they choose to share a bed with their infant.