Study Says Bed-Sharing Risks Overemphasized; AAP Recommendations May Be Dangerous


Bed-sharing risks overemphasized according to a recent studyBedsharing is something that many parents have done for hundreds of years, and only truly questioned in the last few decades with the advent of direct campaigns against bed-sharing and cosleeping. There are so many positive benefits to bed-sharing for both parents and children, though, and we find it is hard to argue against if it is done safely.

What is Bedsharing?

Bedsharing means that you are sharing the same sleeping space, usually a bed (but some new parents will tell you sometimes this means a couch or a reclining chair!). It is different from co-sleeping in that you are literally sharing the same bed with your child whereas co-sleeping could mean that you share the same bed or simply that your child is in the same room with you. Therefore, bedsharing is just one of the ways families can co-sleep. Bedsharing is also sometimes referred to as having a “family bed.” It’s been done really since time began.

How to Make Bedsharing Safe

If you have been a parent long enough you might remember the campaign in which a sleeping baby was seen lying next to a knife in bed in an effort to show how “dangerous” bedsharing and co-sleeping can be. However, many parents, parenting experts, and doctors have found many benefits to bedsharing and there are plenty of recommendations on how to make it safe for you and your baby.

There are certain risk factors that may make bedsharing unsafe but as long as you and your baby are free from these 7 factors, bedsharing could be a safe option for you:

  1. You are non-smoking
  2. You are not user the influence of drugs or medicine
  3. You are breastfeeding
  4. Baby is healthy and full-term
  5. Baby is on his/her back when not nursing
  6. Baby is not swaddled or over-heated
  7. You are both on a safe surface

Although the American Academy of Pediatrics still does not recommend bedsharing, especially for babies under 4 months of age (although co-sleeping is highly recommended without the baby in bed with you), there are some ways you can make it as safe as possible for you and your child:

  • It’s suggested you 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, as research suggests this age is the most at-risk for SIDS if bedsharing.
  • 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 on a soft surface to sleep, such as a soft mattress, sofa, or waterbed.
  • 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.
  • Be cautious if baby is on your chest and you are tempted to fall asleep as well.
  • Be cautious on couches, recliners, or rockers with a baby.

Some experts warn that sometimes this issue isn’t parents sleeping with a baby safely in their beds, especially if all risk factors are avoided and safe sleeping practices are in place, but rather that in an effort not to sleep with their baby in their bed they choose unsafe sleep practices instead.

Any mother will tell you that trying to feed a baby in a rocking chair overnight is utterly exhausting, and probably every single one will tell you that at some point or another they fell asleep doing so. Research has found that this practice, in an effort to avoid bedsharing, can actually be more dangerous than safe practices of bedsharing.

In fact, a study in Breastfeeding Medicine, the official peer-reviewed journal of the Academy of Breastfeeding Medicine, examined the current recommendations by the American Academy of Pediatrics on bedsharing. The study suggested 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.

From the study, Speaking Out on Safe Sleep: Evidence-Based Infant Sleep Recommendations:

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.


Many parents who have practiced bed-sharing for years will tell you that it is not only a wonderful way to bond with your child, but it is also good for the mental health of a newly postpartum mother. There will always be people who disagree with bed-sharing or cosleeping, but each family has to do what is right for them and their children.

Photo: LightField Studios/Shutterstock

2 thoughts on “Study Says Bed-Sharing Risks Overemphasized; AAP Recommendations May Be Dangerous”

  1. The doctor who founded the national SIDS foundation had an article in JAMA Pediatrics where he chastised doctors for not recommending bed sharing (and noted that many doctors themselves privately practice bed sharing). He wrote: “Equal time in counseling should be given to the benefits to bed sharing, such as more sleep for the parent, easier breastfeeding when the infant is nearby, ease of pacifier reinsertion, and the intangible satisfaction of skin-to-skin contact. ” Here’s a link to more about his wonderful editorial.

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