Co-Sleeping, Room-Sharing, and Bed-Sharing: What Parents Need to Know
Snuggling up to sleep next to your baby is one of the sweetest feelings in the world. However, co-sleeping has evolved into quite a controversial topic over the years, with heated opinions on both sides. On the one hand, some forms of co-sleeping (like bed-sharing) are associated with an increased risk of harm to the baby, specifically a higher risk of sudden infant death syndrome (SIDS). Conversely, research shows other types of co-sleeping (like sharing a room) can actually offer protection against SIDS and help the entire family get better sleep. So how do you make the healthiest choice for your family? Let’s take a look at some of the pros and cons of co-sleeping and some of the most common questions from parents.
Co-Sleeping, Room-Sharing, and Bed-Sharing: What’s the Difference?
While many people use these terms interchangeably to describe the same thing, there are actually important differences between them.
Room-sharing means parents have a crib, bassinet, bedside sleeper, or play yard in the same room with them near the bed. The American Academy of Pediatrics (AAP) recommends that parents sleep in the same room (but not in the same bed) as their baby, preferably for at least the first six months.
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The Advantages of Co-Sleeping
For many parents, room-sharing makes it easier for them to feed, comfort, and watch their baby. During the early weeks at home with a baby, constant feedings and wakings along with the associated new parent fatigue can make taking the baby back and forth to a separate room a procedural nightmare. Room-sharing makes feedings more convenient, helps babies fall asleep more quickly, and helps increase parental bonding.
One of the biggest benefits of room-sharing is that it can significantly lower the risk of SIDS (by as much as 50 percent). The AAP recommends parents place their baby's crib, bassinet, portable crib, side sleeper, or play yard in their bedroom, close to their bed.
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The Disadvantages of Co-Sleeping
When you are completely exhausted and you’ve finally quieted a fussy infant, the thought of just easing back into bed with your little one can be so enticing. Some nights it may feel like it’s the only option for anyone to get any sleep! However, bed-sharing can be deadly.
Each year approximately 3,500 infants die from sleep-related infant deaths annually in the United States. Research indicates that sleep-related death can occur when an infant with an intrinsic vulnerability to SIDS is placed in an unsafe sleep environment. The risk is especially high in preterm infants (preemies), babies who had a low birth weight, and healthy full-term infants younger than 4 months old. Among Black and American Indian/Alaska Native infants, the rates of sudden unexpected infant deaths (SUIDs) are even higher, more than double and almost triple, respectively, that of white infants (85 per 100 000 live births) in 2010-2013.
Additional factors that increase this risk of death while bed-sharing include:
- a baby sleeping on a couch (instead of a bed) alone or with a parent
- a baby sleeping between two parents
- a parent who smokes
- parents who are overly tired
- a parent who has recently used alcohol or drugs
- bed-sharing with pillows or bedcovers
- bed-sharing with other children
Rebecca Carlin, MD, FAAP, who co-authored the AAP’s 2022 policy statement and technical report says, “We know that many parents choose to share a bed with a child, for instance, perhaps to help with breastfeeding or because of a cultural preference or a belief that it is safe. The evidence is clear that this significantly raises the risk of a baby’s injury or death, however, and for that reason, AAP cannot support bed-sharing under any circumstances.”
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When to Stop Co-Sleeping
By the time your infant is somewhere between the age of six months and one year old, the risk of SIDS decreases significantly. At this point, you can stop room-sharing, according to the AAP's recommendations.
Ultimately, when you stop sharing a room depends on what works best for your family. If the sleeping arrangements work well for everyone, there’s no reason you have to stop. Some studies have shown that older infants (6 to 12 months old) who slept in their own rooms were reported to sleep better than infants who slept in their parents’ rooms.
The Bottom Line
Ultimately, parents have to make the best decision they can with the information they have when it comes to co-sleeping. Remember that while room-sharing is safe and encouraged to reduce the risk of sleep-related deaths, bed-sharing can be risky. If you’re finding it difficult to come up with a safe sleeping arrangement that works well for everyone, consult your pediatrician.
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