To sleep or to cosleep: That is the question. And seemingly everyone — from grandma to your mailman — has an answer they swear by.
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The American Academy of Pediatrics (AAP) has repeatedly warned against bed-sharing, a popular type of cosleeping where the baby is in bed with you. Yet lots of parents still do it: Bed-sharing nearly doubled between 1993 and 2010, according to a 2013 Journal of the American Medical Association Pediatrics study. It’s just so much easier than making endless trips to baby’s room for feeding and changing, right?
So what’s an exhausted mom or dad to do? Pediatrician Ei Ye Mon, MD, discusses the risks of bed-sharing — and how to cosleep safely.
What is cosleeping?
Cosleeping is the practice of sharing the same sleeping space as your baby. Most often, people associate it with sharing a bed with a child, but cosleeping can also mean you simply sleep in the same room as your baby.
Bed-sharing and SIDS
SIDS, or sudden infant death syndrome, is the unexplained, sudden death of a healthy baby. While no one knows what causes SIDS, doctors do know that bed-sharing raises a child’s risk of dying from it.
“It’s not a safe sleeping environment for babies,” Dr. Ye Mon explains. “We encourage parents not to do it.”
Pediatricians have made progress encouraging parents to put their kids to sleep on their backs, which reduces the risk of SIDS. But SIDS is still the leading cause of death in babies between 1 month and 1 year old in the U.S.
Room-sharing vs. bed-sharing
Bringing baby into your bedroom can have benefits for both parents and baby: Parents may get more sleep, and it’s easier for moms to breastfeed at night. Plus, the AAP says room-sharing can reduce your baby’s risk for SIDS by as much as 50%.
“Room-sharing decreases the risk of SIDS, and we recommend it for the first 6 months and ideally up to 1 year of age,” Dr. Ye Mon says. “Parents are there and more alert to any breathing issues.”
But turning room-sharing into bed-sharing eliminates that benefit.
“Bed-sharing does the opposite — it increases the risk of SIDS,” Dr. Ye Mon warns. “SIDS is not something we take lightly. It’s a life-altering concern. Even if the child does not die, the suffocation can cause lifelong developmental issues.”
Safe cosleeping 101
So how can you safely cosleep? The first step is honesty. (Wait, what?)
Dr. Ye Mon says she would rather parents tell her they are bed-sharing than try to hide it. That way, they can come up with safe compromises together.
“As a mother myself, I definitely understand the temptation to bed-share,” she says. “The AAP recognized with their most recent guidelines that there are ways to minimize the risks.”
She recommends these safe practices for cosleeping:
- Back sleeping for all naps and at night. Babies who sleep on their backs are much less likely to die of SIDS than babies who sleep on their stomachs or sides.
- Use a firm sleep surface (a bassinet, crib or play yard): Place it right next to the bed so mom can nurse and put the baby back in when she needs to. Or invest in a bassinet that connects to your bed. “It’s the best of both worlds – the baby is still close by but has its own safer, firmer mattress without any pillows and sheets,” Dr. Ye Mon says.
- Don’t sleep with baby on a sofa or chair: Dr. Ye Mon says this practice is more dangerous than bed-sharing: “If you’re so tired that you fall asleep in the chair, you’re too tired to keep your baby from falling or prevent them from suffocating.”
- Use a pacifier: This has been shown to reduce the risk of SIDS, even if it falls out when they are asleep.
- Start sleep training between 4 and 6 months old: “At that point, they are old enough to train to sleep by themselves,” she explains. “It’s a good age because they’re not too set in their current sleeping situation.”
You may have seen products called in-bed cosleepers, which look like portable bassinets that sit in the bed next to the parents. They usually have mesh rails to establish a separate sleeping area for baby. The AAP cannot recommend for or against these products, because there have been no studies looking at their effect on SIDS or if they increase the risk of injury and death from suffocation, Dr. Ye Mon explains. But it is important to have an open and honest discussion with your pediatrician regarding the risks if you are considering using one.
Even if you plan to use the fanciest cosleeper out there, bed-sharing should be taken off the table if:
- Your baby was born premature or has any kind of developmental or health issues.
- You or anyone living in your house smokes or uses drugs or marijuana.
- You’ve been drinking alcohol.
“All of these situations place your baby at a higher risk for SIDS,” Dr. Ye Mon cautions. “And you double that risk by bed-sharing.”
Instead, cosleep the safe way — with baby in your room but in his or her own sleeping space.