Parents frequently wonder if it’s good or bad to share a bed with their young infants. Much of the answer to this question is based on intuition and cultural perspectives rather than on solid data pointing to “truth” or to an equivocally correct answer. Thus, in spite of the many studies already performed, co-sleeping remains a controversial topic with its recommendation or discouragement essentially left up to the parents. It should be noted that bed sharing is well-accepted and promoted as the norm in many cultures, but it is not as popular a choice in the United States as it is in many other societies.
The benefits of bed sharing may be substantial. For example, we know that infants who sleep with their mothers are nursed longer, but other possible factors instead of bed sharing could explain this association. Bed sharing is thought to foster bonding between parents and the infant. This would seem to make sense, but unfortunately, there have not been studies to prove this intuitive outcome.
Most of the negatives about bed sharing (and co-sleeping on the same sofa) are related to the risk of the sudden infant death syndrome (SIDS). Studies confirm that bed sharing is a significant risk for SIDS only in mothers who smoke, and that babies under 12 weeks of age are at greatest risk. There are conflicting findings in studies that only look at mothers who do not smoke. If there is an increased risk of SIDS with nonsmoking mothers, it is likely a small one.
The risk of SIDS increases if parents use a soft sleep surface such as pillows, quilts, comforters and blankets because they can cover a baby’s mouth and nose. These should also never be used in cribs for babies who sleep alone.
The risk of SIDS rises if the parent consumes alcohol.
Interestingly, the risk of SIDS is markedly decreased if the infant sleeps in the same room, but not the same bed, as the parents.
Another negative of bed sharing is the loss or rearrangement of sexual intimacy between parents. The potential for this to be a problem increases as the infant gets older. Parents should anticipate this issue and agree on how to most comfortably deal with it before it may cause strife.
One mixed finding is that infants who share a bed with their parents awaken more frequently than infants who sleep alone. However, the awakenings tend to be of shorter periods than for the babies who sleep alone.
Until more research is done to scientifically answer the bed sharing question, it is best of parents to come to a decision jointly and do what they are most comfortable with, taking into account all the cautions stated in this column.
The opinions expressed are solely the writer’s. Robert A. Dershewitz, M.D., Sc.M., FAAP, is a pediatrician at Healthy Kids Care Center in St. John and is affiliated with The Community Hospital in Munster.
