A new study in Breastfeeding Medicine, the official peer-reviewed journal of the Academy of Breastfeeding Medicine, examines the current recommendations by the American Academy of Pediatrics on bedsharing. The study suggests that the much touted risks are not only overemphasized but that these recommendations could have unintended, and even dangerous, consequences for parents who end up choosing unsafe sleeping arrangements in an effort to avoid sharing a bed with their infant.
Reducing sleep-related infant deaths is a national priority, but the current recommendations overemphasize the risks of bedsharing and can have serious unintended consequences. The advice never to bedshare may result in deaths on sofas as parents try to avoid feeding their infants in bed. The emphasis on avoiding bedsharing is also diverting valuable resources away from addressing more potent risks for sleep-related infant death. Finally, recommendations to avoid bedsharing may interfere with breastfeeding, which has wide-ranging public health implications.
The American Academy of Pediatrics (AAP) issued recommendations in 2005 and 2011 to prevent sleep-related infant death, which advises that against all bedsharing for sleep. This advice has resulted in a proliferation of high-profile local and national initiatives against bedsharing, including frightening ads with headstones and caskets and costly programs to provide free cribs to poor families.
Annually in the United States, there are about 4,000 infant deaths per year related to sleep, 2,200 (55%) of which are due to sudden infant death syndrome (SIDS), with the rest being due to accidental suffocation or strangulation related to sleep, often when a parent or other adult falls asleep next to an infant. These two types of death are distinct entities, with separate but overlapping risk factors, and the AAP recommendation is intended to address both…
Evidence suggests the AAP’s recommendation about bedsharing may be counterproductive, directly contributing to infant deaths in at least some cases. A 2010 survey of nearly 5,000 U.S. mothers found “in a possible attempt to avoid bed sharing, 55 percent of mothers feed their babies at night on chairs, recliners or sofas. Forty-four percent (25 percent of the sample) admit that they [are] falling asleep with their babies in these locations.” This is cause for alarm and should have triggered immediate re-evaluation of the AAP 2005 recommendation and further study, but instead the recommendation was reiterated in its 2011 statement.
Image: James Benninger