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AMERICAN ACADEMY OF PEDIATRICS
POLICY STATEMENT
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Bed sharing between an infant and adult(s) is a
highly controversial topic. Although electrophysiologic and behavioral studies offer a strong case for its effect in facilitating breastfeeding and the enhancement of maternal-infant bonding,35,36 epidemiologic studies of bed sharing have shown that it can be hazardous under certain conditions. Several case series of accidental suffocation or death from undetermined cause suggest that bed sharing is hazardous. 34,37–39 A number of case-control studies of SIDS deaths have investigated the relationship of SIDS with parent(s) and/or other adults or children sleeping
Some of these studies have found the correlation between death and bedsharing to reach statistical significance only among mothers who smoked.41,47 However, the European Concerted Action on SIDS study,42 which was a large multisite study, found that bed sharing with mothers who did not smoke was a significant risk factor among infants up to 8 weeks of age. Similarly, a more recent study conducted in Scotland48 found that the risk of bed sharing was greatest for infants younger than 11 weeks, and this association remained among
infants with nonsmoking mothers. The risk of SIDS
seems to be particularly high when there are multiple
bed sharers31 and also may be increased when
the bed sharer has consumed alcohol or is overtired.
42,47 Also, the risk of SIDS is higher when bed
sharing occurs with young infants.40–42 It is extremely hazardous when adults sleep with an infant
on a couch.31,40,41,48 Finally, the risk of bed sharing is higher the longer the duration of bed sharing during the night.41,47 Returning the infant to his or her crib was not associated with an increased risk in 2 studies, 40,41 and in another, the risk was significant only when the bed sharing occurred for more than 1 hour or for the whole night.16 There is growing evidence that room sharing (infant sleeping in the parent’s room) without bed sharing is associated with a reduced risk of SIDS.41,42,43,48 Data from the European
Concerted Action on SIDS42 study led to the recommendation by its authors that the most protective sleep setting for an infant is in a crib in the parents’ room. On the basis of their study results, investigators in Scotland48 endorsed the United Kingdom Department of Health’s advice that the safest place for an infant to sleep is in a crib in the parents’ room for the first 6 months of life.