Precautions for sharing a bed with an infant

Bed sharing (also called co-sleeping or the family bed) is common in many cultures and is becoming more frequent in the United States. This arrangement can make breast-feeding easier and help the mother rest. But there is controversy about whether bed sharing decreases or increases the risk of sudden infant death syndrome (SIDS). Other safety issues, such as accidental entrapment or suffocation, may be more likely to occur in an adult bed.

The American Academy of Pediatrics (AAP) advises parents not to share their bed with babies.¹ The AAP states that the best place for a baby to sleep until at least 6 months of age is in a crib (or bassinet or cradle) that is placed in the parents' room, close to their bed. (Baby beds that attach to the side of the parents' bed have not yet been tested enough to have set safety standards.)

If you decide to share a bed with your baby, the following suggestions may help make it safer:

• Do not sleep with your baby if you smoke. Smoke clings to skin and clothing, exposing your baby to even more potentially harmful substances.
• Make sure the mattress is firm. Unlike cribs, adult mattresses are not designed with a baby's safety in mind. Never use a water bed or any other sleeping surface that is not firm and smooth. Do not sleep with a baby on a sofa or chair.
• Keep the baby on his or her back.
• Do not drink alcohol, use medicines that make you sleep very soundly (sedatives), or use illegal drugs before sharing a bed with a baby.
• Do not allow comforters, pillows, or other soft bedding under the baby or near the baby's face.
• Do not place the bed next to a wall or other furniture, where a baby could slip between the mattress and the wall (or furniture) and become trapped. Make sure the mattress fits snugly against the headboard or the wall at the head of the bed, with no room for the baby to become trapped between the mattress and anything else.
• Prevent the baby from falling from the bed by placing the baby between two adults or by using some firm barrier that fits snugly to the bedside (such as a bed rail approved for this purpose). Avoid any barrier that could allow the baby's face to become wedged in a corner without air circulating around it. Do not use pillows as barriers to prevent the baby from falling from the bed.
• Do not allow anyone other than parents (no other adults or children, including siblings) to sleep with the baby.

Do not ever sleep with your baby on a couch or armchair. These areas are particularly dangerous for babies.

Citations

1. American Academy of Pediatrics (2005). Policy statement: The changing concept of sudden infant death syndrome: Diagnostic coding shifts, controversies regarding the sleeping environment, and new variables to consider in reducing risk. Pediatrics, 116(5): 1245-1255.