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.
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 within a "sensory" distance of each other, meaning that each can tell that the other is near by their touch, sight, or even smell. (Co-sleeping is sometimes also called sleep-sharing.)
Room-sharing and bed-sharing are types of co-sleeping:
- Room-sharing: This is when parents have a crib in the room with them, a bassinet or portable crib near the bed, a separate crib attached to the bed, or a similar arrangement.
- Bed-sharing: This is when parents share their bed with their children (sometimes called the "family bed"). This is what has raised concerns with pediatricians and others.
Why Some People Bed-Share
Bed-sharing supporters believe — and some studies support their beliefs — that bed-sharing:
- encourages breastfeeding by making nighttime breastfeeding more convenient
- makes it easier for a nursing mother to get her sleep cycle in sync with her baby's
- helps babies fall asleep more easily, especially during their first few months and when they wake up in the middle of the night
- helps babies get more nighttime sleep (because they awaken more often with shorter feeding time, which can add up to a greater amount of sleep throughout the night)
- helps parents regain closeness with their infant after being separated from their babies during the workday
But do the risks of bed-sharing outweigh the benefits?
Is Bed-Sharing Safe?
In some non-Western cultures, bed-sharing is common and the number of infant deaths related to it is lower than in the West. Differences in mattresses, bedding, and other cultural practices may account for the lower risk in these countries.
Despite the possible pros, various U.S. medical groups warn parents not to place their infants to sleep in adult beds due to serious safety risks. Bed-sharing puts babies at risk of suffocation, strangulation, and sudden infant death syndrome (SIDS). Studies have found that bed-sharing is the most common cause of deaths in babies, especially those 3 months and younger.
An adult bed has many safety risks for a baby, including:
- suffocation from lying face-down on a waterbed, a regular mattress, or soft bedding such as pillows, blankets, or a quilt, or due to an infant's head being covered by such items
- suffocation, when an infant gets trapped or wedged between a mattress and headboard, wall, or other object
- strangulation in a bed frame that allows part of an infant's body to pass through an area while trapping the baby's head
Among older infants (4 to12 months old) who died due to bed-sharing, having an additional item (like a pillow or a blanket) on the bed increased the risk of death. Babies should always be placed to sleep on their backs on a firm mattress without any pillows, blankets, toys, stuffed animals, or other items.
Because of the risks involved, both the American Academy of Pediatrics (AAP) and the U.S. Product Safety Commission (CPSC) advise against bed-sharing. The AAP does recommend the practice of room-sharing without bed-sharing. Room-sharing is thought to help lower the risk of SIDS.
Besides the potential safety risks, sharing a bed with a baby sometimes prevent parents from getting a good night's sleep. And infants who co-sleep might learn to associate sleep with being close to a parent in the parent's bed, which can become a problem at naptime or when the baby needs to go to sleep before the parent is ready.
Bed-Sharing & SIDS
Some studies suggest that bed-sharing increases the risk of SIDS, especially in infants younger than 12 weeks old.
Factors that can increase this risk include:
- a baby sleeping on a couch alone or with a parent
- a baby sleeping between two parents
- a mother who smokes
- parents who are extremely tired
- a parent who has recently used alcohol or drugs
- bed-sharing with pillows or bedcovers
It's safer to use room-sharing without bed-sharing. Experts note that parents and babies sleeping in the same room can reduce the risk of SIDS because they tend to wake up more often throughout the night.
How to Room-Share Safely
To avoid the risks of bed sharing while enjoying the benefits of room-sharing, parents have lots of options. To keep your little one close by, but not in your bed, you could:
- 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. The AAP says that having an infant sleep in a separate crib, bassinet, or play yard in the same room as the mother reduces the risk of SIDS.
- Buy a device that looks like a bassinet or play yard with one side that is lower, which attaches to your bed to allow you and baby to be next to each other while eliminating the possibility of rolling over onto your infant.
How to Bed-Share as Safely as Possible
Despite the risks of bed-sharing, some parents decide this sleeping arrangement is best for their family. If you do choose to share your bed with your baby, follow these precautions:
- Don't share a bed with an infant under 4 months of age — a bassinet or crib next to the bed is a better choice.
- Always place your baby on his or her 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 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 that your baby won't become trapped between the frame and the mattress.
- Don't cover your child's head while sleeping.
- Don't use 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 drink alcohol or use medicines or drugs that could keep you from waking or might cause you to roll over onto, and therefore suffocate, your baby.
- 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.
Who Shouldn't Share a Bed With a Baby?
If an infant and a parent are bed-sharing, keep the following people out of the sleep environment:
- other children — particularly toddlers — because they might not be aware of the baby's presence
- parents who are under the influence of alcohol or any drug because that could lower their awareness of the baby
And nobody should smoke in the room, as this increases the risk of SIDS.
Moving Out of the Parent's Bed
Eventually, the bed-sharing routine will be end at some point, either because the child wants to or by the parents' choice.
If you've been bed-sharing with your little one and would like to stop, talk to your doctor about making a plan for when your baby will sleep in a crib. Moving to a crib by 6 months of age is usually easier — for both parents and baby — before the bed-sharing habit is ingrained and other developmental issues (such as separation anxiety) come into play.
Reviewed by: Rupal Christine Gupta, MD
Date reviewed: September 2014