Bedsharing

Trigger Warning: Sudden infant death syndrome

Please jump to the end if you would like to go right to the evidence-based sleep resources.

Have you ever brought your baby to bed with you? Were you planning to or did it happen out of convenience? Or perhaps because of a bit of sleep deprivation (ahem, utter exhaustion)?

Whatever the reason, most families do it. When we try to avoid bedsharing, we often create more dangerous sleep situations (ie couch sharing), and unintentionally increase the risk of infant death due to unsafe sleep conditions.

Here in the US, hospital staff must follow the American Academy of Pediatrics guidelines on safe sleep. They must teach all parents to only put their baby to sleep in their own sleeping space. But they don’t teach what to do if this is not desired or possible. They’re not allowed to.

“Lactation specialists and nurses employed by many American and European hospitals are threatened with losing their jobs should they even mention the words cosleeping.”
— James McKenna, PhD

The Lullaby Trust, a UK based organization, understands (with the help of anthropologist Helen Ball) that bedsharing does happen. They help parents create safer sleep environments via education rather than dismissing normal human behavior.

We know that certain sleep environments are more dangerous than others, but does this mean all bedsharing is dangerous? No.

For millions of years humans have shared a sleeping surface with their babies. Countries with the highest bedsharing rates, such as Japan, also have the lowest SIDS rates. Bedsharing does not cause infant death. To bedshare or not is a cultural norm, not a human norm.

The close proximity between the birth parent and baby allow for frequent latching during the night which helps maintain milk supply, infant growth, and allows breastfeeding to continue longer. Longer duration of breastfeeding has so many health implications for parent and baby but that’s for another post!

As James McKenna, infant sleep anthropologist and director of the Mother-Baby Behavioral Sleep Lab at University of Notre Dame argues, bedsharing (in the absence of known risk factors) is protective against SIDS. He has seen in lab studies that “more maternal inspections, more infant arousals, and less deep sleep among infants occurs” when bedsharing.

 
Cecilia Tomori; cosleeping
 

As of now, the leading theory in regards to what causes SIDS is a baby’s inability to rouse from a deep sleep.

Sleeping next to your baby enables a reciprocal relationship of waking, thus preventing long periods of deep sleep before a baby is biologically ready. Parent twitches, baby adjusts position. Baby makes a peep, parent touches baby. Per McKenna in his book Safe Infant Sleep: “The Sensory experiences, sleep architecture, [parental] vigilance, and mutual arousals experienced by breastfeeding [parent]-baby pairs converge to potentially reduce SIDS.”

This is why sleep training may not be good for your baby’s health, particularly if baby is in a separate room. More deep sleep before a baby is ready, possibly before their arousal mechanisms are fully functioning, may increase the risk of SIDS.

 
““You and your baby may be waking up more often, but these awakenings are briefer and calmer than the disruptions that occur when the baby is placed in another room.” ”
— James McKenna, PhD
 

What if bedsharing (in the absence of known risk factors—see graphic) is a protective behavior for you and your breastfed baby? McKenna and Lee Gettler, PhD (parenthood anthropologist at Notre Dame) coined the term “breastsleeping” to encompass the “highly integrated system of healthy infant sleep combined with healthy breastfeeding behavior.”

McKenna’s list of “don’ts” in regards to breastsleeping assume a parent and baby are breastfeeding which provides a biological synchronicity in feeding and sleeping cycles and a hormonal level of being “in tune” with your baby.

Because formula fed babies and parents have sleep cycles that may not be in sync, it is recommended that formula fed babies share a room (co-sleep) with parents but not a bed. Formula fed babies also tend to sleep in different positions and places in relation to parents, compared to breastfed babies, which tend to be more dangerous.

 
Breastsleeping Don'ts
 

I am not telling you that you should (or should not) sleep with your baby. I believe you should have information on how bedsharing can be beneficial for your family.

There is plenty of information thrown at you as to why you should not share a bed with your baby. I don’t need to tell you that side of the story. But the information is one-sided and does not allow families to make an informed decision. Rather, it tells you what (not) to do.

I highly encourage you to do more research on bedsharing.

I guarantee you that one night in the first 3 months postpartum you will want to bedshare with your baby for some reason. Do your research before that night so you feel confident the choice is right (and safe) for your family.

UPDATE 4/23: In early 2023, The Academy of Breastfeeding Medicine created an easy to read PDF for parents regarding bedsharing and breastfeeding. This is a fabulous resource to share with friends, family, and pediatricians (or other healthcare professionals) who are not supportive of any bedsharing. The ABM also created a handout about physiologic infant care, which highlights the importance of night feeds.

Resources:

If you have another great resource to add, contact me or leave a comment!

Books

Podcasts

Websites

Videos

Resources added 4/14/23

Babies, Feeding, ParentingLisa GonzalesBedsharing, Breastsleeping, SIDSComment