Bedsharing and co-sleeping are huge topics in the early days of a baby’s life. There is a consistent expectation that parents sleep babies on a separate sleep surface, sometimes in an entirely separate room. Despite this, the vast majority of parents do end up sharing a bed at some point with their child. So let’s talk about the logistics of bedsharing and how to do it safely!
Bedsharing vs. co-sleeping – what is it?
There seems to be a bit of confusion around the terms co-sleeping and bedsharing! So before we get started, I thought I’d define these terms for the remainder of this discussion!
Co-sleeping – sharing a bedroom with your baby, not the same sleep surface necessarily
Bedsharing – sharing the same sleep surface (i.e. a bed) with your baby
How many parents bedshare?
Around the world, bedsharing is perceived in different ways based on different cultural norms and expectations (Shimizu and Teti, 2018). It is the biological norm for parents to want to share a sleep space with their children (Ball et al. 2019), and historically has been a way of keeping babies warm, safe from predators and well fed. Recent Australian research (Cole et al., 2020) reported that of 3341 survey respondents, 76.9% of parents had shared a sleep surface with their baby at some point. The majority had done this in the fortnight prior to survey. Of those parents who had bedshared, 57.3% said it wasn’t actually their intention. Given these rates it is important that all parents are aware of the potential to bedshare with their child. It is also important that all parents are aware of the ways to bedshare safely.
Why do parents bedshare or co-sleep?
So why DO parents end up sharing a bed? There are a HUGE number of reasons, but here are just a few! In the United States it has been reported that the key reasons for sharing a bed are to facilitate sleep (Tully et al., 2015), due to housing/financial circumstances (i.e. limited space or not able to purchase a basinette/cot) and for infant care and breastfeeding maintenance (Ball, 2002). Different societies and cultures differ in the way they perceive bed-sharing and its impact on child autonomy and independence (McKenna & McDade, 2005). Some studies report that children who bedshare in infancy were more independent and exhibited greater confidence and self esteem (Keller and Goldberg, 2004 and Crawford 1994).
Bedsharing with breastfed infants has been reported as a way of reducing Sudden Infant Death Syndrome (SIDS; Bartick et al., 2022). ‘Breastsleeping’ (James McKenna) has also been reported to improve breastfeeding initiation (Ball, 2006), duration and exclusivity (Blaire et al., 2010 and Moon 2016). However, there are several campaigns which link bedsharing with increased risks of SIDS (Red nose, 2019). Some of the contention around safety with bedsharing arises due to situations where babies ‘bedshare’ in a space not intended for bedsharing (i.e. a couch or a bed not set up for safe bedsharing). These situations absolutely increase the risk of SIDS and suffocation. So let’s talk about safe infant sleep and how we can promote this in a bedsharing situation.
So how do we bedshare safely?
In order for a baby to be safest in a bedsharing situation, there are 7 recommendations, they are known as ‘The Safe Sleep Seven‘:
1) A smoke free bed – The greatest risk factor for SIDS is exposure to smoke. This is the case either during pregnancy or via second/third hand smoke after birth (Bednarczuk et al. 2020). Smoke in the room, on parent’s clothing or even on their breath increases the risks of SIDS. Stopping smoking will reduce your baby’s SIDS risk drastically.
2) No drugs or alcohol – Medications, prescription or not, that impact sobriety or drowsiness can increase the risk of SIDS for bedsharing babies. Maternal alcohol consumption during pregnancy also increases the risk of SIDS (Fleming et al. 2023).
3) Breastfeeding – Breastfed babies are at significantly lower risk of SIDS than their formula fed peers (Vennemann et al., 2009). This is not only due to the protective factors of breastmilk, breastfeeding, and lighter sleep cycles (Baddock et al. 2019 and Mosko et al. 1997), but also the positioning that a breastfed baby holds when bedsharing (typically on their side or back; Ball 2006 and Baddock et al. 2019). The mother often lays in a ‘cuddle curl’ which prevents her rolling on baby, and facilitates breastfeeding. The bedsharing mother-infant dyad also have improved sleep synchronicity (Baddock et al. 2019). This means they wake alongside one another rather than at differing times leading to better sleep overall.
4) Healthy, full-term baby – Preterm or ill babies and those with chronic health issues are at a higher risk of SIDS and possibly suffocation (Hakeem et al., 2015).
5) Baby remains on their back – Sleeping on their back and not in the ‘prone’ position (i.e. on their tummy) significantly reduces SIDS and suffocation (Vincent et al., 2023).
6) No overheating – Providing a cool room and not overdressing baby helps to reduce the risk of SIDS. An overheated baby will be more difficult to rouse. Additionally, overheated babies experience differences in heart rate and breathing patterns which predispose them to SIDS (Vincent et al., 2023).
7) Safe Sleep Surface – A sleep surface should be free of gaps, corners, extra blankets etc.
What is a safe sleep surface for bedsharing?
Firm mattress – Baby shouldn’t be able to roll into the parent’s body or into a prone position.
No gaps – Check around the bed and do not use bed rails to avoid gaps and corners. If there are gaps then you can stuff this space tightly with a rolled towel or a small rolled blanket.
No cords or corners – Anything baby could possibly get tangled in/around must be removed from the bed and the space around the bed.
No fluffy doonas, blankets or pillows – Avoid heavy quilts and comforters, teddies, bolsters and sleep positioners or extra pillows as these pose a suffocation risk. You can consider sleeping your baby in a sleeping bag for baby and keep the blanket on your (and your partner’s, if applicable) side of the bed. Baby shouldn’t have blankets or pillows on their side of the bed.
Keep baby to one side of the bed – Baby should sleep next to the mother unless there are concerns of doing so, and not between mum and another adult or child. Other children or partners are less likely to be as responsive and rouse to the infant if required.
For further guidelines see Red Nose Australia guide on Cosleeping with your baby.
An absolutely excellent book all about safe infant sleep is by Dr James McKenna! It is well worth the read and explores the research and the idea of ‘breastsleeping’ with your baby.
That’s it!
You can go very deep into this topic! Hopefully this gives you a starting point from which you can investigate and explore a little further. It is OK to trust your intuition and listen to your gut – parenting is hard enough, don’t doubt yourself! As always, please don’t hesitate to reach out if you have any questions! ????