An article published in USA Today has added fuel to an already-raging fire — the debate over co-sleeping. The article references a study which found that while the number of SIDS-related deaths has dropped by over 50% in the past two decades (since the introduction of the “Back to Sleep” campaign in 1994 began discouraging tummy sleeping), the drop has plateaued recently. What’s more, the number of SIDS-related deaths as a result of co-sleeping is actually on the rise.
There’s no doubt that co-sleeping is a controversial topic, with parents offering strong and emotional opinions on both sides. Reports like the one in USA Today seem to indicate that co-sleeping is dangerous, but co-sleeping advocates point to research showing that it’s safe. So what do we make of this? Is co-sleeping actually dangerous? Should you and your baby co-sleep?
Defining Our Terms: Co-Sleeping vs. Room Sharing vs. Bed-Sharing
First, let’s get our terms straight. Co-sleeping simply means that a child shares a sleeping space with a parent. With that in mind, co-sleeping can mean a baby sleeping in the same bed as his parents; however, it can also mean a baby in a bassinet next to the bed. The American Academy of Pediatrics (AAP) calls that kind of sleeping arrangement “room-sharing”. Room-sharing is considered completely safe, as long as baby’s sleeping area follows safety guidelines (no loose bedding, firm mattress that’s flush with the sides of the bassinet, tight-fitting bottom sheet, etc.) Bed-sharing refers to the practice of parents and children sharing the same bed. Bed-sharing (specifically when infants are involved) carries far more risks than other forms of co-sleeping.
Can Co-Sleeping Be Dangerous?
Room-sharing is safe; bed-sharing, however, is inherently risky, specifically when it involves young infants. As rates of bed-sharing continue to rise in the United States, so do the rates of infant deaths related to bed-sharing. The most obvious danger related to bed-sharing is suffocation. An adult (or an older child) can roll on top of a baby, or the baby can be smothered by the large pillows and heavy blankets that most adults use in bed. Some less obvious dangers include a baby falling from the mattress to the floor, or a baby becoming wedged between the mattress and the headboard/footboard or wall. The mattress itself can also be a threat; if it’s overly soft, a baby can sink too low and suffocate.
As a growing number of babies die due to bed-sharing, health organizations are stepping up their efforts to warn parents. The AAP, along with the Consumer Product Safety Commission (CPSC), has issued precautions against bed-sharing, warning parents that it puts babies at a much higher risk of suffocation. And warnings like these aren’t just happening on a national scale; they’re happening at the local level, too. Bed-sharing was blamed for causing increasing rates of infant death in Milwaukee, WI, so the city’s health department responded by releasing a highly controversial ad depicting a baby curled up (in an adult bed) next to a large butcher knife. When critics attacked the ad as extreme (and it is), Milwaukee’s Commissioner of Health replied, “…what is even more shocking and provocative is that 30 developed and underdeveloped countries have better [infant death] rates than Milwaukee.”
Can Co-Sleeping Be Safe?
Again, room-sharing arrangements are considered very safe. In fact, the AAP recommends room-sharing as the best sleeping arrangement for infants, since it’s been shown to produce lower rates of SIDS than a solitary sleeping arrangement (which places baby in a room by herself.) And while bed-sharing is statistically less safe, advocates of bed-sharing point out that research studies (like the one cited in the USA Today article) fail to account for a variety of factors and ultimately make bed-sharing seem more dangerous than it actually is.
For example, researchers refer to bed-sharing as a baby and an adult sharing an “adult bed.” But an adult bed doesn’t necessarily mean an actual bed — in these studies, it can also mean a couch, or a recliner, or a waterbed (all surfaces that bed-sharing advocates would never recommend using). Research studies also fail to account for safety factors like smoking, or drug and alcohol abuse (parents who smoke or use drugs or alcohol should never bed-share.) Even factors like obesity, which advocates say should be considered (since obese parents are advised not to bed-share), aren’t considered in research studies.
Supporters of bed-sharing claim that when these factors are considered, research shows that safe bed-sharing practices make putting a baby to sleep in an adult bed just as harmless as putting a baby to sleep in a crib. In fact, a 2006 study indicates that when researchers controlled for these kinds of safety factors, rates of infant death related to safe bed-sharing proved to be very low.
A study published in 2013 reveals that any kind of bed-sharing, even safe bed-sharing, increases an infant’s risk of SIDS five-fold. The study’s researchers found that even in the safest of settings, bed-sharing presents a dramatic increase in the risk of SIDS. This stands in direct opposition to the earlier study which found that safe bed-sharing produces low rates of infant death.
Supporters of co-sleeping also point to the fact that co-sleeping in all its forms (including bed-sharing) has been the norm for human infants since the dawn of time, while putting babies in cribs, in their own rooms, alone, is a practice that’s less than 200 years old. Anthropologist Dr. James McKenna, an outspoken advocate of co-sleeping, points to these facts as proof that mothers and babies are biologically designed to sleep together, and he asserts that co-sleeping is the best sleeping arrangement for families.
Finally, bed-sharing advocates emphasize that while co-sleeping is no longer standard practice in most Western cultures, it remains the norm in many, many countries around the world. These advocates are quick to point out that if it works for families around the globe, it can work for families in the West.
An important note, though, about comparing bed-sharing in Western countries to bed-sharing around the world: the comparison isn’t always a fair one. Western-style beds (with their soft, elevated mattresses as shown above, and their abundance of pillows and blankets) make bed-sharing more dangerous than do other types of beds found around the world. What’s more, health-habits vary worldwide, making the bed-sharing comparison a tricky one. Western mothers are more likely to smoke than are Japanese mothers, for example; this may partly explain why Japan has an extremely low rate of deaths related to bed-sharing. It’s best to take cultural differences like this into account when looking at bed-sharing from an international perspective.
Should You Co-Sleep Or Not?
Putting a baby to bed is a bit like stepping into a car. There are risks associated with driving, and traveling in a car can certainly kill you. But there are many steps you can take to make driving safe, like wearing a seat belt, obeying traffic signs, and taking proper care of your vehicle. Baby sleep can work the same way. There are risks associated with any sleeping arrangement, but parents can take steps to make their baby’s sleep environment as safe as possible. Parents who educate themselves and practice safe co-sleeping shouldn’t be made to feel guilty about their decision. And of course, neither should parents who choose not to co-sleep; after all, it won’t work for everyone! That was certainly the case with Nicole — during the short time she co-slept, she found herself so worried about harming her son that she hardly slept at all.
A final word: while many forms of co-sleeping are safe, bed-sharing is inherently risky. There are ways to bed-share safely, but the list of precautions is long, and some of the precautions themselves border on extreme. For example, it’s recommended that you remove pillows and blankets from the bed, and even that you put your mattress directly on the floor. It’s also safest if the only people in bed are mom and baby, meaning that if dad is around, he needs to find somewhere else to sleep! What’s more, safety guidelines specify that some people shouldn’t bed-share, including those who smoke and use drugs/alcohol, those who are obese, and those who are “overly exhausted.” That last one is bound to exclude many readers of this blog! If you’re considering bed-sharing, remember to review the list of precautions carefully, and then commit to following them. Otherwise, we recommend that you consider a different method of co-sleeping.
What do you think? Room-sharing? Bed-sharing? No-sharing? Tell us your thoughts on co-sleeping!
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Katia says
The USA Today article is a little confused on the science. As mentioned in the article, most deaths related to co-sleeping were attributed to suffocation, but this is not SIDS. Research demonstrated the significant risk factors are mostly parental: drinking, drugs, obesity. If you aren’t in one of these risk categories and take common sense precautions like those mentioned in the article, the risk is minimal. There are still reasons to co-sleep and not to co-sleep and you should do what works for your family.
Alix says
Oh, just to clarify — we co-slept with our kids til they were 3 or 4 months old. I just mean, after infancy, is there any kid or parent who gets a solid night of sleep while sleeping in the same bed?
Nadina says
I co-slept with my son when he wouldn’t sleep in his own bed and that was the only way we could get some rest. Our co-sleeping arrangement continued for about three months. Then whenever my husband or I would turn over, we would disturb the sleep of the little man and he would wake up several times per night. This is when we decided to teach him to sleep in his own cot, which was in our bedroom. That also worked for a while, until his sleep was disturbed if either his father or I would get up in the middle of the night to go to the bathroom. We then moved him to his own room and he started sleeping much better. I was terribly reluctant to put my baby in a room on his own, but it appears to have improved his sleep and he gets more sleep these days.
I would say that one should go with the flow. You know your baby and you know what they need. If co-sleeping is what works best, then take the necessary precautions and go for it. If you feel that it’s best for the baby to be in her/his own room, then do it. Don’t let other people make you feel guilty about your choices, because you have your little one’s interest and well being at heart.
Alix says
I love Meagan’s response! I’m not a fan of co-sleeping myself, and I’ve never met a co-sleeper who gets a solid night of sleep (either the baby or the kid — please prove me wrong if there’s someone out there who is sleeping soundly with kid next to them!), but of course we can all do what we like as long as it’s safe. I just wanted to add to Meagan’s — folks are always saying, “Well, families co-sleep and wear their babies and breastfeed until age 4 all over the world.” That’s totally fine with me, but you know what — there’s also rampant disease, illiteracy, genital mutilation, infant mortality, and ecosystem destruction for farmland in other places in the world. My point is this: don’t use other people, whether our ancestors or “people who are closer to the earth” than us Westerners, to justify your practice. Just do it.
Shari says
I co-slept with both my babies and loved it, honestly I couldn’t imagine doing it any other way, I would not have gotten much sleep. I wanted to mention that I thought I read somewhere that the co-sleeping deaths in Milwaukee were apparently alcohol and drug related in many instances. I think most of them were from “poor” families also?
Emily DeJeu says
@ venessa — sounds like you’re taking proper precautions and co-sleeping safely; good for you! Glad to hear that co-sleeping has been a positive experience for you and for your daughter 🙂
@ Tricia — Thanks for sharing your experience! Yours is a good one for people who are considering co-sleeping to consider, I think, because it offers proof that you can co-sleep for a time and then transition to independent sleeping later. I think some people avoid co-sleeping out of fear that their child will sleep with them until age 18 😉 Good reminder that co-sleeping can happen for a period of time and then stop happening when it’s no longer working/necessary.
@ Lester — you’re right about there being risks no matter what sleeping arrangement we use for our babies. Everything carries some level of risk, doesn’t it? The important think it to take reasonable precautions to make sleeping as safe as possible.
@ Meagan — I completely agree with you! That argument doesn’t make tons of sense to me either. Human beings have been walking around on foot since the dawn of time; cars have only been around for the last 100 years or so. And yet we don’t hold that up as evidence that human beings were biologically designed NOT to ride in cars, do we? Of course, the comparison between cars and co-sleeping isn’t a perfect one, but I think the general principle is the same in both cases — just because something is relatively new in human history doesn’t mean it’s bad or wrong.
Meagan says
I think cosleeping, done carefully, is more or less safe, but the “we’ve been doing it since the dawn of time so it must be safe” argument drives me nuts. In order for human beings as a species to survive, we only need two of our (then) many children to survive. We weren’t “designed” to do anything, our traits (or in this case habits) survived or not, based on the best offspring survival rates, and OF COURSE babies had a better chance of survival if their parents kept them close. Since most of us aren’t being stalked by leopards these days, it’s not a terribly compelling argument.
But as I said, it seems fairly safe done correctly, so I see no problem with it. I just wish proponents would stop trying to prove that it’s BETTER because that’s how our human ancestors did it,
Lester says
I been co-sleeping with my daughters (twin louise and venice) together with my wife since in their first month until they are now 7 months and we found out that indeed sometimes there is a risk when you are co-sleeping with your babies for the potential suffocation and other possible injuries of an infant. However, there is always risk whether we are on sleep or while we are taking care with them during day time or night time, all we have to do is to take an extra precaution in taking care with them for they do need it. Further, the effect of being with my children during sleep time make them more secure and closer to us. That’s something that a parent cannot be denied the happiness it brings nor can be exchange for something.
Tricia says
I coslept with my daughter for about 6 months and I really enjoyed it for a while. I felt like we had no choice when we brought her home from the hospital and she screamed like crazy until I was holding her. When it stopped working for us, we taught her to sleep in her own bed. It was a painful few days, but it was worth it. Now she can ONLY sleep by herself. I’ve tried when she or I have been sick to get her to lay down with me but she just squirms and plays–part of the reason it was time for her to sleep in her own bed. I can look back with fondness at our cosleeping days…but with a new baby arriving in a few weeks I hope to only room share and not bed share.
venessa says
I’ve co slept with my daughter from day one, and shes two and 4mths now… I get lots of so called ‘advice’ from ppl, most of it negative, but you know what? My daughter and I are very bonded and content with our arrangement.. Its not for everyone, it works for us and I wouldn’t change a thing… As long as you take the correct precautions, it comes down to common sense.. If you are a heavy sleeper, dont co-sleep, if you are under the influence of drugs or alcohol, dont co-sleep… Get one of those safety co-sleeping beds that attach and they help as well… My daughter has never been a good sleeper, so for my own state of mind I chose to co-sleep because that was the only way to get rest… As I said, its not for everyone, but it worked wonderfully for us, and I believe im closer to my daughter because of it….