Safe Co-sleeping: Tips and Guidelines for Parents

Let's be honest: co-sleeping is a subject that often sparks lively debates among parents. Some families may swear by it, enjoying closer bonds and smoother bedtime, while others raise concerns about safety and potential negative impacts on both the child and parent's sleep quality. To help you understand both sides, we asked sleep experts to share their advice on how to co-sleep safely with your child.

What is co-sleeping?

Maria Lopez, a certified pediatric sleep consultant, defines co-sleeping as the practice of parents and their children sharing the same bed. She clarifies, "Co-sleeping generally means sharing the same sleep space or bedroom with your child, but it's often specifically used to refer to bed-sharing."

Why do parents co-sleep with their children?

Many parents choose to co-sleep with their little ones for various reasons. According to Lopez, "Breastfeeding mothers may find it easier to keep the baby close by for overnight feeds; having their little one in close proximity will undoubtedly eliminate the need to get up several times at night. Some parents may think their baby is safer when sleeping with an adult, and some families enjoy the snuggles and bonding.

For most families, however, co-sleeping is the only way to ensure a good night's sleep for everyone involved. Lopez adds, "Even when parents initially prefer separate sleeping arrangements, they may find themselves welcoming their child into their bed as a last resort to get some much-needed rest."

Is co-sleeping the same as bedsharing? 

Although co-sleeping and bedsharing may sound similar, there are actually some key differences between the two. Bedsharing, as explained by a 2022 Nemours KidsHealth, is when babies and their parents share the same bed, couch, or chair while sleeping.

Co-sleeping, on the other hand, is when a parent and child sleep close together, either physically touching or at least very near each other. The important thing is that both the parent and child can sense the other's presence and know they are close by during the night.

Benefits of co-sleeping

While co-sleeping may seem risky, there are some advantages. Kim Rogers, a pediatric sleep expert and founder of Sleeping Well Consulting, explains that co-sleeping can help breastfeeding mothers and their babies sleep better.

"Mothers can easily breastfeed throughout the night, and babies can nurse as needed," she says. "Plus, the mother's presence provides babies a sense of comfort and security during the night."

Concerns and risks associated with co-sleeping

While it's understandable why parents would want to co-sleep, Lopez says that the risks far outweigh the perceived benefits.

"The American Academy of Pediatrics is unequivocal in their position that infants and young children should not share a bed under any circumstances," Lopez explains. "There is ample evidence that bed-sharing poses a risk of suffocation and increases the risk of SIDS, especially during the first four months of life. This is why we suggest babies sleep on a flat, firm surface separate from others. "

Safe 7  co-sleep guidelines

Rogers explains that the "Safe Sleep Seven" is a set of criteria developed by breastfeeding advocates and lactation consultants to reduce the risks associated with co-sleeping. She outlines the following safe co-sleeping guidelines:

No Smoking

This applies both inside and outside the home. No one who resides in the household should smoke, regardless of location.

Sober Adults

Parents should abstain from alcohol and avoid medications that cause drowsiness.

Breastfeeding

The baby should be breastfed both during the day and at night.

Healthy Baby

The infant should be full-term and in good health.

Proper Positioning

The baby should be placed on their back with their face up.

Appropriate Temperature

The baby should not be overdressed or swaddled to prevent overheating.

Safe Sleep Surface

The sleeping area should have a firm mattress without pillows or bedding. It should be free of strings, cords, and gaps.

Transitioning from co-sleeping

If co-sleeping is no longer working for everyone in the family, it might be time for a new approach. Rogers suggests paying attention to how well everyone's sleeping and how it's affecting your day-to-day life. When you decide it's time for a change, there are lots of gradual ways to make the transition.

Daily floor play 

Rogers recommends, "I suggest lying beside your newborn while they are on their back on an activity mat on the floor. The more they experience being on a firm, flat surface, the more comfortable they will become in their bassinet."

Try nursing 

You can also nurse your child to help them fall asleep and then transfer them to a crib. "This is a gradual way to start the transition out of the parent's bed," says Rogers.

Keep the crib in the room

"Parents may choose to keep their child in a crib in the parent's room or move the child to a different room," explains Rogers. "Often, just sleeping on a separate sleep surface results in longer stretches of sleep for an older baby, regardless of how the child falls asleep, as demonstrated by the work of Dr. James McKenna."

Bring a small bed to the parent's room 

Some parents find success by bringing a small bed into the parent's room for their toddler. According to Rogers, "Parents may limit breastfeeding to bedtime and morning during this process. Limiting nursing may lead to some protest, but if parents show empathy and acknowledge their child's feelings, the end goal remains the same as with bed-sharing: secure attachment and better sleep."

How do you encourage independent sleep skills?

Rogers recommends a gradual transition approach to teach independent sleep skills.

She explains, "Parents should put their child to bed while still awake and remain nearby until the child falls asleep, both at bedtime and during night wakings. This presence allows parents to provide comfort and reassurance. After several nights, parents can progressively move further away - first to the middle of the room, then to the doorway and finally out of the room."

Parents can also give children a comfort item to help them fall asleep. Rogers adds, "Studies have shown that children who have a comfort item fall asleep faster, sleep better, and have a more secure attachment to their parents than those who don't."

Other tips for safe co-sleeping

No pets or siblings in the bed

Rogers recommends that only the mother and baby should be present during co-sleeping. Introducing pets or older siblings into the sleeping arrangement can heighten the risk of accidents such as suffocation or injury.

Tie up long hair

Rogers recommends securing long hair for parents before co-sleeping with their baby. "Tying up your hair can significantly reduce the risk of your infant becoming entangled or potentially suffocating," she explains. Additionally, this simple step will enhance your own comfort during the night."

Do not co-sleep if you are obese

Rogers advises against bedsharing for parents with extreme obesity. "This is due to the risk that they may not accurately perceive their proximity to the infant while sleeping," she says.

Do not co-sleep on couches and recliners

To reduce the risk of suffocation, Rogers says that co-sleeping isn't recommended on any soft surface, including pillow-top mattresses, sheepskins, blankets, memory foam and air mattresses. She continues, "Couches and recliner chairs are unsafe for infants to sleep on, whether alone or with a sleeping parent. Babies are more likely to slip into crevices or become wedged and suffocate."

When co-sleeping may not be appropriate

Rogers advises against bed-sharing in certain situations. "Co-sleeping is not advisable if anyone in the household smokes," she notes. "Cigarette smoke can damage a baby's developing brain and disrupt their breathing patterns, leading to apneas, which are pauses in breathing during sleep."

Additionally, bed-sharing is not recommended for premature infants. Rogers explains, "Premature babies are smaller, more delicate and still developing. The risks associated with bed-sharing for these fragile infants outweigh any potential benefits."

Lastly, Rogers cautions against bed-sharing if parents have consumed alcohol or taken sedatives. "Parents who are extremely tired should also avoid sharing a bed with their baby," she says. "Fatigue, intoxication, and certain medications can impair a parent's ability to wake up, increasing the risk of infant death due to entrapment, suffocation and injury."

Experts:

• Maria Lopez, a certified pediatric sleep consultant
• Kim Rogers, a pediatric sleep consultant and founder of Sleeping Well Consulting