Baby Sleep 101: The Truth About Co-Sleeping & Bed-Sharing
When it comes to safe infant sleep and co-sleeping, there’s a lot of conflicting information in terms of what’s really better: having your newborn baby sleep on a separate sleep surface (like a crib or bassinette) or sharing your sleep space by following a bed-sharing approach.
As we become new parents and live through the first few weeks and months with a new baby, we tend to remember our pediatrician’s advice to always follow the ABC’s of safe sleep. This means that ideally, babies should be sleeping alone, on their back and in a crib. And if we don’t follow this advice, we increase the risks of sudden infant death syndrome (SIDS) considerably.
In reality though, many new families are faced with an impossible dilemma...
They desperately want their baby to sleep on their designated, separate sleep surface, but just can’t seem to make it work. Their baby may wake frequently during the night, may hate sleeping in the crib or simply prefers sleeping in close proximity to their caregivers. And who would blame them?
Unfortunately, what often happens is that new parents actually end up falling asleep with their baby, but constantly worry about whether or not they’re doing it safely.
That being said, can co-sleeping with your newborn baby really be done safely? If so, how can parents make sure that their baby is sleeping in a safe space, all while getting some much-deserved sleep themselves?
In today’s article, I'm sharing seven (7) recommendations about bed-sharing and co-sleeping safely:
No smoking
No alcohol or substance abuse
A breastfeeding parent
A healthy & full-term baby
Baby on the back
Baby lightly dressed
Baby on a safe sleep surface
Disclaimer: This article does not explicitly advocate for or against co-sleeping or bed-sharing. Instead, it outlines how to co-sleep or bed-share safely, should your family decide to do so. Whatever feels right for you as a family will guide your decision-making process around infant sleep, regardless of whether it’s sleeping separately or sharing your sleep space. You do you!
What is co-sleeping?
Co-sleeping refers to a sleeping arrangement in which the parent sleeps in close proximity to the baby. Co-sleeping can be done either in the same bed (bed-sharing) or in the same room (room-sharing). In that sense, bed-sharing is one way of how to co-sleep.
Although co-sleeping and bed-sharing are not exactly the same thing, both terms will be used interchangeably and relate to sharing the same bed.
Important: When you google the term “co-sleeping”, you will likely come across a variety of conflicting information... Some sources will discredit co-sleeping as dangerous, risky or a bad habit, and other sources will celebrate co-sleeping for its many benefits and advantages.
To find out which side is right and which approach will work best for your family, we’ll have to look at normal infant sleep patterns and unsafe co-sleeping practices first.
About normal infant sleep
Before we dive in to whether and how co-sleeping can be done safely, we need to learn about normal patterns in terms of infant sleep.
Newborn babies tend to sleep a lot and often, meaning that they take many naps over a 24-hour period and pretty much spend most of their time asleep.
Before newborn babies fully develop their circadian rhythms and can understand the difference between night and day, they tend to wake frequently and be awake for extended periods of time – even during the night.
Sleep Duration Recommendations (The National Sleep Foundation, 2015)
A lot of new parents know this. But what they don’t realize as much is that most babies do not like sleeping alone, at least not from the get-go...
Babies crave physical connection, even when asleep
After spending about 9 months in the wombs, newborn babies typically crave physical connection to their parents. They love being held close, snuggling up in comfy baby carriers and, guess what, sleeping very close to their parents.
For babies, sleep usually equates to extended periods of separation, especially when being placed on a separate sleep surface.
In other words, you may have prepared your baby’s nursery with loving attention to detail and chose a beautiful crib for your little one, but whether they will actually like sleeping in it will depend on many factors: their tolerance of separation, their temperament, their age etc.
A little side note about sleeping separately
Of course, that’s not to say that your baby will never sleep separately, but please keep in mind that it may take a little while to get them accustomed to their sleep space.
Important: Even if you are not comfortable with co-sleeping, I highly recommend educating yourself on how to do so safely should the need arise. In the end, you never know when you may be too tired in the middle of the night to place your baby back in the crib for the umpteenth time.
Is co-sleeping with your baby safe?
This is going to be a very ‘lawyer-like’ answer, but it really depends.
Yes, it can be safe to co-sleep with your baby if you follow a set of health and safety guidelines.
No, it can be risky to co-sleep with your baby if you are not aware of how to do so safely.
And no, it’s not exactly safe how the family in the above picture co-sleeps (more on that below).
Before making a decision for your family, I’d first like to explain why co-sleeping tends to get such a bad reputation by pediatricians or pediatric associations . Opposition or reluctancy to co-sleeping usually stems from two main concerns: suffocation and Sudden Infant Death Syndrome (SIDS).
Suffocation
Suffocation is death by a blocked nose or mouth that prevents breathing, a lack of oxygen or choking.
If a baby’s body is tangled up in layers of blankets, toys or pillows, there is a very real risk of suffocation that needs to be taken seriously. An example can be a co-sleeping situation where the sleep environment hasn’t been properly prepared ahead of time.
Similarly, the bassinette/ crib can also become dangerous if it isn’t prepared properly. Cribs with a mattress that’s too soft or that are decorated with pillows, blankets or stuffed animals are not considered safe for infant sleep either.
Sudden Infant Death Syndrome (SIDS)
SIDS relates to sudden and unexplained infant death, usually during the first 12 months of a baby’s life, without any proper explanation.
Although unexplained, there are a variety of risk factors at play that can put infants at greater risk of SIDS, including stomach sleeping, age, overheating, an unsafe sleep environment or tobacco/ alcohol use.
As you can tell, these risk factors can be present in co-sleeping arrangement as well as in arrangements where the baby is sleeping separately. What’s important then is to create a safe sleep environment above all else, rather than pick a side.
The risks of falling asleep with your baby
According to the American Academy of Pediatrics (AAP), “infants may be brought into the bed for feeding or comforting but should be returned to their own crib or bassinet when the parent is ready to return to sleep”.
In reality, this can be really hard to do for new parents, who are usually overtired, sleep-deprived, exhausted and steeped in sleepy hormones. Instead, they tend to fall asleep on very unsafe sleep surfaces like couches, recliners or propped up by breastfeeding pillows – and that’s where the real danger lies.
In fact, up to 44% of mothers who nurse on sofas, recliners or upholstered chairs have fallen asleep at least once – and I am very certain that the real number is much, much higher than what’s reported/ admitted.
And even if most breastfeeding mothers don’t intend to bedshare, recent studies have proven that at least 60-75% will actually end up sharing their bed with their baby, at least sometimes.
How to safely co-sleep with your baby
Once you are aware of the risk factors around infant sleep, you can absolutely make an informed decision about co-sleeping if it feels right the right choice for your family. After all, most families around the world co-sleep with their babies – it's a natural and normal sleeping arrangement that was physiologically intended.
James J. McKenna, Ph.D. Professor of Biological Anthropology, Director, Mother-Baby Sleep Laboratory, University of Notre Dame, has published numerous works about safe co-sleeping guidelines over the years.
The Safe Sleep Seven
La Leche League International published the so-called Safe Sleep Seven, a set of 7 clear guidelines and rules about making co-sleeping arrangements as safe as possible.
The Safe Sleep Seven can be summarized like this:
“Stay smoke-free. Stay sober. Stay off sofas, upholstered chairs, and recliners for sleep. Keep your healthy baby lightly dressed, on his back, and near you for sleep. And, of course, keep breastfeeding.”
1. No smoking
One of the greatest risk factors for Sudden Infant Death Syndrome (SIDS) is exposure to smoking. The greater and more often a baby is exposed to smoke, whether during pregnancy or once born, the higher its risk of SIDS.
Bottom line: If you want to co-sleep with your baby, only do so when you’re a non-smoker (even if you have smoked outside of the baby’s living space).
2. No alcohol or substance abuse
Being sober is an absolute prerequisite of a safe bedsharing practice. This includes no alcohol whatsoever, no medication that could potentially make you drowsy and no drugs. Basically anything that makes you less alert and attentive is a huge risk factor for SIDS, similarly to having your baby sleep in a separate room too far away from you.
Bottom line: Make sure to be completely conscious and not under the influence of any substances if you’re bringing your baby into your bed.
3. A breastfeeding parent
Studies have shown that breastfeeding actually decreases the risk of SIDS by about 50% (and even more so if breastfeeding is done exclusively). Formula-feeding, on the other hand, doubles the risk of SIDS.
If you are a breastfeeding parent, you can absolutely co-sleep with your baby in the so-called ‘cuddle curl’, a C-shaped position where the mother gently wraps herself around the baby in a curled up way (see image below). Her arms will prevent the baby from sliding up into the pillow, her legs will prevent the baby from sliding down, and the baby is encouraged to stay close to the breast, thus keeping nightly milk supply up.
In some cases, this safe co-sleeping position can also mean that the mother can sleep while feeding her baby – a situation that’s unthinkable when feeding your baby on unsafe sleep surfaces like sofas or recliners.
Bottom line: If you primarily breastfeed your baby, co-sleeping has just gotten so much safer (as long as you follow what’s recommended). If you bottle feed your baby, please do not co-sleep as the baby will not naturally seek out the breast and will likely jiggle away and out of the safe sleep zone.
4. A healthy and full-term baby
Co-sleeping is absolutely not recommended for babies who were born prematurely, have chronic health issues or and otherwise seriously ill. Any serious health condition will increase the risk of SIDS.
Bottom line: Do not co-sleep unless your baby was born full-term and is generally healthy.
5. Baby on the back
Part of the ABC’s of sleep is always putting baby on their back to sleep and avoiding sleep on the tummy.
Even when co-sleeping, this can be practiced safely because breastfeeding mothers and their babies first tend to lie on their sides when co-sleeping. Once babies are done nursing, they will usually roll back onto their backs automatically, and both mother and baby can doze off safely and with the knowledge that safety rules are respected.
Bottom line: If you want to co-sleep with your baby, make sure to place your baby on the side while nursing and give them the opportunity to roll back on their back once they’re done.
6. Baby lightly dressed
Another major risk for SIDS is overheating. While co-sleeping, the baby will automatically be warmer than on a separate sleep surface. In fact, there’s no need at all for warm sleep sacks, blankets or swaddles – not just to prevent overheating, but also to avoid suffocation hazards.
Bottom line: Drop the extra layers when deciding to co-sleep and dress your baby lightly in a simple pajama, instead of adding on too many layers. It’ll definitely get cozy just by having your two bodies together.
7. Baby on a safe sleep surface
This point is so important, especially because most ‘adult beds’ are not inherently safe for infants to sleep in. They’re too soft, have too many sheets, pillows, or even stuffed animals…
(And no, the sleeping environment pictured below is not safe at all!)
Should you decide to co-sleep, make sure that:
you have a firm (not soft!) mattress
your bed is not directly against the wall, causing your baby to accidentally get squished in a gap (if there is a gap, stuff it tightly with a rolled towel or blanket)
remove any cables or cords from the sleep surface to prevent strangulation
take away extra pillows, heavy comforters or any other soft and squishy elements (stuffed animals, infant sleep props, etc.) - even if they look cute
if you like, you can place your mattress on the floor to prevent falls or place a soft ‘landing pad’ on the floor just in case.
And lastly, please don’t put your baby in between you and your partner. Your partner will not have the same protective instincts as a breastfeeding parent, so it is always best to have your baby be sleeping only next to you.
Bottom line: Before you co-sleep, make sure that your bed is 100% childproof. For further reading, I recommend the safe sleep guidelines of James McKenna, Ph.D.
The benefits of co-sleeping
If practiced safely, co-sleeping can be incredibly enriching for families.
Personally, I have been co-sleeping with my daughter for almost 2 years and still love it. Although I would have never thought that I’d actually end of co-sleeping, it just turned out to be the most beneficial decision for our family.
Here’s why:
It strengthened the beautiful bond that I have with my daughter
It helped soothe my daughter’s separation anxiety
It helped keep up my milk supply thanks to countless night feeds and provided optimal nutrition for my daughter
It was much easier to breastfeed lying down than to get up every single time
It prevented me from having to physically get up and transfer her back to her crib up to 12x a night (yes, she was a very frequent waker for the longest time!)
Now that my daughter is older, my husband can also enjoy nighttime snuggles
It improved my sleep deprivation so much and helped me get so much more sleep (thanks, breastsleeping!)
I became less obsessed with forcing my daughter to sleep in a way that I thought was appropriate
In closing
Whether you decide to co-sleep safely or are more comfortable having your baby on a separate sleep surface will be entirely up to you. There is no right or wrong way of where you put your baby to sleep, as long as you do so safely.
If co-sleeping with your baby feels right and natural to you, go for it. If you prefer to have your baby sleep in a crib, go for it.
Regardless of what you choose to do, please remember to educate yourself about both options first. This will help you make an informed decision that works for your family.
Sources
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La Leche League International. Safe Sleep for Breastfeeding Babies. La Leche League International. 2022. (Source)
Liebert, Mary A. New recommendations released on bedsharing to promote breastfeeding. NeuroscienceNews.com. 2020. (Source)
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