Co-Sleeping With Your Baby: How To Be Safe

It’s understandable that some parents want to be close to their baby while sleeping at night. It’s convenient to have them nearby for those nighttime feedings and diaper changes. And it can give you peace of mind knowing they’re safe.

But how close is too close? What are the best practices for safe co-sleeping?

We asked pediatrician and breastfeeding specialist Heidi Szugye, DO, about how to sleep soundly (and safely) with your baby.

But before we dive in let’s get some terminology straight, so we know what is safe and what isn’t.

• Bed-sharing is where babies and a parent(s) or caregiver(s) sleep in the same bed.
• Co-sleeping or room-sharing is an arrangement where baby sleeps in the same room as you. But they’re in their own safe sleep place, like a crib or bassinet. Not in your bed.

Some will use the term “co-sleeping” when they really mean “bed-sharing.” But the difference is important.

Safe co-sleeping

Co-sleeping is encouraged by the American Academy of Pediatrics (AAP), which reports that it can reduce the risk of SIDS by as much as 50%.

“It’s a nice alternative to bed-sharing,” Dr. Szugye agrees. “It maintains the closeness that can make life easier for parents, while letting your baby sleep in a safer space that fits their needs.”

Added bonus if you have other kids at home: Being in the room with the baby means you can address their needs quicker — say, before their nocturnal wails alert the troops in the next room.

Dr. Szugye shares advice on safe sleep practices.

1. Consider choosing co-sleeping over bed-sharing

The AAP takes a strong stance against bed-sharing. Their advice? “Never sleep with your baby.”

The reason? Sharing a bed with your baby can increase the risk of sleep-related infant death under certain circumstances. And creating a safer bed-sharing arrangement can be tough to do.

Adults can accidentally roll onto an infant in their sleep. What’s more, pillows, bedding and soft mattresses increase the risk of sudden infant death syndrome (SIDS). Not to mention the risk of falling out of the bed.

Even still, deep feelings and cultural practices that encourage bed-sharing have made warnings against the practice somewhat controversial. And yes, the convenience of keeping your baby with you all night can be tempting.

There also are some (limited) studies that suggest bed sharing can promote breastfeeding or help calm infants.

Guidelines by the Academy of Breastfeeding Medicine suggest a long list of requirements to meet for a safer bed-sharing environment only if an infant is exclusively breastfeeding. They include (among other things):

• Using a firm, flat mattress (and never sleeping on a recliner, couch or other setting)
• Placing baby on their back at the level of your breast (not at your face or on a pillow)
• Removing blankets, sheets, pillows and cords near the bed
• Considering placing your mattress on the floor
• Moving your bed away from walls
• Not bed-sharing with babies who are preterm or have a low birth weight
• Not allowing adults who smoke or who have recently used alcohol or drugs to sleep with baby

“It’s hard to meet all the above criteria for a hazard-free sleep environment, as many infants are breast milk fed via bottle or formula-fed. These criteria only apply to exclusively breastfed infants. Parents would have to be very intentional about following all of these guidelines, which don’t correspond to the typical American sleep environment,” Dr. Sguzye shares.

“However, as many parents accidentally fall asleep with their baby when nursing them or choose to sleep with their infant despite knowing the risks, I think it’s important to raise awareness of what factors in a sleep environment increase or decrease the risk of SIDS."

2. Choose a proper sleep environment

There’s no shortage of innovations in the baby sleep marketplace. But that doesn’t mean all those gadgets are safe.

In 2022, the U.S. Consumer Product Safety Commission (CPSC) created federal safety standards for all products intended for babies to sleep. But products created before that time (like that hand-me-down from your sister) may not meet those standards.

Dr. Szugye warns against putting baby to sleep in things like:

• Inclined sleepers
• Travel or compact bassinets
• In-bed sleepers (bassinets intended to be in your bed)
• Sidecars (a three-walled bassinet that attaches to an adult bed)
• Hammocks
• Swings and bouncers
• Older cribs (think drop sides, wide gaps, decorative cutouts, corner posts, missing parts or lead paint)

Your best bet? A modern crib, bassinet, portable crib or play yard that meets CPSC standards. Check the CPSC website to keep up with recalls, especially on older products.

3. Keep their bed bare

Sure, baby blankets and stuffed animals are cute and cuddly. But they don’t belong in baby’s bed.

Until 1 year of age, babies should sleep alone. As in alone, alone.

Fitted sheets that go around the mattress are OK. Otherwise, keep their beds free from anything soft, like:

• Blankets
• Loose sheets (including flat top sheets)
• Pillows
• Toys
• Crib bumpers

4. Put baby to sleep on their back

Babies should always be put to sleep on their backs. That includes during naptime.

Sleeping on their back helps reduce their risk of SIDS.

What if baby rolls on their own? It’s OK to let them sleep on their belly if they also know how to roll to their back again. If they haven’t yet mastered the belly-to-back roll, readjust them to their back.

When baby starts rolling, it’s also time to stop swaddling, if you haven’t already. Swaddles can keep them from rolling back. Swaddles can also get in the way of their airways if baby rolls to their belly.

5. Keep the temperature comfy

Sure, you may like sleeping in a room that’s on the cool side, but what about when you’re co-sleeping? Especially without blankets to keep them warm, will your baby be comfortable?

Little baby bodies don’t regulate temperature as well as bigger kids and adults. So, they can get too hot or too cold more easily.

Dr. Szugye recommends dressing baby in no more than one layer more than you’d wear. If you’re using a swaddle or sleep sack, consider that their extra layer.

Touch their chest to test if they’re too warm or too cold. And if they’re sweating? Definitely a sign to take off a layer.

You want what’s best for your baby. And, frankly, a better night’s sleep wouldn’t be so bad for you, too. So, keep them close. And keep them safe.