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Is it safe to sleep with your baby?

What the experts have to say about your bed sharing questions

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Originally published in Today's Parent September 2005

That’s a huge emotionally and politically charged question for many parents, one that’s been hotly debated in North America in recent years. Supporting the No side are headlines such as “Suffocation risk 40-fold for babies in adult beds” (National Post, October 2003) and Canadian Paediatric Society guidelines released in November 2004 that recommend against bed sharing. On the other side are proponents who point out that in countries like Japan, where sleeping with baby is the norm, sudden infant death syndrome (SIDS) is extremely rare. Then there’s the simple reality playing out in so many Canadian households, where, as a recent Todaysparent.com report found, two-thirds of respondents said they sleep with their babies “sometimes,” “often” or “always.”

So does sharing a bed with your infant put her life at risk, or is it a completely healthy — even beneficial — practice when done right?

Here’s what the experts have to say about these and other bed sharing questions:

1. Is it safe to bring my baby into bed?
That depends on how you do it.

The concern about bringing babies into bed stems from a few studies during the 1990s that linked infant deaths with babies sleeping in adult beds. Obscured in much of the discussion is the distinction between deaths of babies in adult beds that occurred because babies encountered a fatal hazard — for instance, getting wedged between a bed frame and mattress — and sudden infant death syndrome, which is the unexpected death of a baby for which no cause can be found.

One study that received a lot of media attention was a 1999 report, by the Consumer Product Safety Commission (CPSC) in the US, attributing 64 infant deaths a year to suffocation or strangulation hazards associated with sleeping in an adult bed.

Shortly after the CPSC warnings, the Canadian Paediatric Society (CPS) community paediatrics committee, led by Montreal paediatrician Denis Leduc, sat down to develop guidelines for safe bed sharing. “Based on the evidence, we weren’t able to recommend the family bed,” says Leduc. Instead, in November 2004, the CPS recommended that, “for the first year of life, the safest place for babies to sleep is in their own crib.” It further recommended co-sleeping for the first six months, which it defines as a baby sleeping in a crib in her parents’ bedroom.

“What’s good about the CPS statement,” says anthropologist James McKenna, director of the Mother-Baby Behavioral Sleep Laboratory at the University of Notre Dame in Illinois, “is the acknowledgment that babies are safer when sleeping proximate to their mothers, which reduces the risk of SIDS by half. No one would argue with this.”

But McKenna does argue that sweeping prohibitions against bed sharing ignore the complexity of the evidence about risk factors for SIDS. “Bed sharing can be inherently protective. It’s how it’s done that overrides the protectiveness.”

Linda Smith, a lactation consultant and childbirth educator in Dayton, Ohio, and author of several textbooks on breastfeeding, puts it this way: “You can’t paint with the same brush a sober, non-smoking, breastfeeding mother, on a safe sleeping surface, and an intoxicated uncle, sleeping with the baby on a couch.”

Unfortunately, no one knows yet how to prevent SIDS, and these deaths do occur in both cribs and family beds. Parents have to make an informed decision weighing the odds, the evidence, their parenting goals and the reality of family life.

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