Definition

• Sharing the bed with your child
• Bed-sharing should be avoided during the first year of life. Reason: Safe sleep.
• Pros and cons of co-sleeping after 12 months old are discussed.

Health Information

Caution - Risk of Suffocation for Babies

• During the first year of life, it can be harmful to sleep in the same bed with your baby.
• If the adult mattress is soft, your baby can suffocate. In fact, the rate of sudden infant death syndrome (SIDS) for infants is 10 times higher for babies sleeping in an adult bed compared to a crib.
• In addition, there are about 100 deaths per year in the U.S. from parents accidentally laying on and suffocating their children while sleeping. The risk is highest if one of the parents has a deep sleep disorder or sometimes drinks too much.

Co-sleeping: Pros and Cons

• Sleeping in the same bed with your children (co-sleeping) is a parent decision, not a medical decision.
• In general, bed-sharing is not recommended because it results in poor sleep for many parents.
• Also, once begun, it’s a hard habit to break.
• So think carefully before you allow your child to start sharing your bed.
• Here are some facts that will help you make an informed decision.

Benefits of Co-sleeping

• No proven benefit for the child. Your child doesn’t need to share your bed to be secure and happy. Children’s fears and insecurities can be dealt with in other ways. Children turn out fine either way. In some countries, families share beds out of necessity, but most children in our country sleep happily in their own beds.
• No proven benefit for the parents. Bed-sharing is not quality time. If your child is asleep in your bed, it is a neutral time. If your child is crying and keeping you awake, it is an aggravating time.

Harm of Co-sleeping

• Proven harm to the child. Bed sharing can be dangerous for babies. Reason: risk of suffocation. After 12 months, there is no proven risk of harm. There is no evidence that bed-sharing produces children who are more spoiled or dependent.
• Proven harm to parents. Several studies have shown that more than half of the children who sleep with their parents resist going to bed and awaken several times during the night.
• Co-sleeping children always want to stay up as late as their parents do. If you want your child’s bedtime to be earlier, you may need to lie down with your child for 30 to 60 minutes to get them to sleep.
• Since many children are restless sleepers and move around a lot during the night, parents who sleep with them don’t get a good night’s sleep and become sleep deprived. Sleeping with your child is a bad choice if you are a light sleeper and you need your sleep to perform well during the day.
• Co-sleeping potentially can be harmful to the marriage. This mainly occurs if the parents disagree about this arrangement, and one of the parents (usually the father) becomes displaced to another room.
• Bed-sharing is never a long-term solution to sleep problems. Your child will not learn to sleep well in your bed and then decide on his own to start sleeping in his own bed. With every passing month, this habit becomes harder to break. Your child can no longer sleep alone. Most co-sleepers do not become cooperative about sleeping in their own bed until age 6 - 8 years.

Care Advice

1. Sleep in Same Room, but Not Same Bed:
   • Sleeping in the same room, but not the same bed, is a better plan.
   • Let your baby sleep in your bedroom until he doesn’t need a middle of the night feed. Most normal infants can sleep 7 consecutive hours without feeding by 6 months of life.
   • Then move his crib to a separate room, if possible.
   • If you must sleep in the same room with your older infant, don’t allow him to see you during his normal awakenings. If he does, it is an invitation to play. Use a screen or a cover over the side of the crib.
2. Encourage a Security Object at 6 Months of Age:
   • After 6 months of age, encourage a soft toy or stuffed animal as a security object. Otherwise, he may want you as his security object.
3. Use a Safe Sleep Position for Infants (on their backs):
   • The American Academy of Pediatrics strongly recommends that infants sleep on their back in a crib during the first year of life.
   • This has reduced the SIDS rate by 60% in the U.S.

Call Your Doctor If

• Your child is a co-sleeper and you want to end it
• You have other questions or concerns

Author: Barton Schmitt MD, FAAP

Copyright 2000-2020 Schmitt Pediatric Guidelines LLC

Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it. The information contained in this handout should not be used as a substitute for the medical care and advice of your pediatrician. Listing of any resources does not imply an endorsement.

#AAP