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Safe Cosleeping With Baby: is it Bad or Can it Be Your Saving Grace?

Cosleeping with baby is one of the most controversial topics of parenting, these days. Despite all the questions surrounding the practice, a 2015 study[1] reports that 24% of parents in the U.S. co-sleep “often or regularly,” and another 37% report sharing their bed “sometimes or rarely.” This means over 50% of parents are cosleeping with baby at least some of the time.

Unfortunately, the same 2015 cosleeping study revealed that almost 50% of caregivers received either incorrect advice on safe sleep practices from their healthcare provider—or no advice at all.

So, is cosleeping bad? At what age is cosleeping safe? Does cosleeping cause SIDS? We’ll answer all these questions and many others you may have about baby cosleeping in this guide!

mom and baby co-sleeping

According to the American Academy Pediatrics (AAP), it is not safe to bed-share with an infant less than 6 months old, although room-sharing is considered a good option.

But just like every child is different, every family is different — what works for one family may not work for another. After 6 months, although room-sharing is the recommended practice by experts, you might decide that cosleeping is a viable option for your family.

Regardless of the decision you choose to make with your family when it comes to cosleeping with baby, it’s important to understand the facts and educate yourself on reducing risk with safe sleep practices. So, let’s get right into it - what is cosleeping?

What is cosleeping?

cosleeping is when you “sleep close enough to your baby that you can see, hear, touch, or smell each other.[2]” 

Although “cosleeping” and “bed-sharing” are used interchangeably, bed-sharing is when the parent(s) and the baby are sleeping together in the same bed. 

“Room-sharing” refers to having the baby sleeping in the same room as the parents, but not in the same bed. Bed-sharing and room-sharing are both different forms of cosleeping.

Co-sleeping

Sleeping in the same room or in the same bed/sleeping surface as your baby.

Bed-sharing

Sleeping in the same room and bed as your baby.

Room-sharing

Sleeping in the same room, but on a different surface than your baby. Your baby’s sleep surface (like a crib or bassinet) can be close to or next to your bed.

For the remainder of this article, the term cosleeping will reference bed-sharing, as they are most commonly used interchangeably. Now, is cosleeping bad? 

Is Cosleeping Bad?

Despite the growing spotlight on cosleeping in recent years, it’s not a new practice. According to anthropologists, bed-sharing has been practiced for more than 200,000 years. In some cultures, such as Japan, cosleeping is the norm. In western culture, however, cosleeping is advised against by various organizations and experts such as the American Academy of Pediatrics (AAP).

Those against cosleeping argue that it’s dangerous for the infant and can lead to potentially deadly situations, while advocates of cosleeping, including some prominent doctors and anthropologists, insist that the bonding, convenience and other benefits that accompany cosleeping outweigh the risks. This controversy leaves most parents wondering what the right choice is.

parents don't know if they should co-sleep or not

Most doctors recognize that the stigma around cosleeping only makes for more dangerous situations because parents are less inclined to share their decision with their doctor. “For some families,” says Toronto pediatrician Daniel Flanders, it is virtually impossible to make it through the night without bringing baby into bed,” Fearing judgement, they often hide this from their doctor, which means professionals miss out on the chance to educate families on how to reduce risk.

From the experts

“We make the statement for the first time that health care providers should first and foremost have open and nonjudgmental conversations with families about their individual preferences, sleep patterns, sleep environment and be able to have a dialogue about doing the best they can do,"

- Lori Feldman-Winter, MD, MPH, Co-author of AAP’s Safe Sleep Recommendations

When announcing the 2016 recommendations for safe infant sleep, Lori Feldman-Winter, co-author of the guidelines and professor of pediatrics at Cooper University Health Care, expressed that the AAP would rather parents be honest about their practices, and encouraged pediatricians to have an open and judgment-free dialogue with their patients about co-sleeping.

Baby Co-sleeping facts you should know[Infographic]

Co-sleeping vs Room Sharing

At What Age is Cosleeping Safe?

If you’ve decided you want to try safe cosleeping with baby, it’s important to understand the role of timing. So, at what age is cosleeping safe?

Newborns (babies under 4 months old) are considered “high-risk” even if they were born at a normal weight and in perfect health, which means cosleeping is not the ideal scenario. If your baby was born pre-term or with a low birth weight and is under 4 months old, cosleeping is highly discouraged.

The Link Between Cosleeping & SIDS

The link between Sudden Infant Death Syndrome (SIDS) and cosleeping has been thoroughly studied over the years to determine the safety of the practice. 

SIDS is defined as an unexpected, unexplained death of an infant under 1-year-old that occurs during sleep. SIDS is a type of Sudden and Unexpected Infant Deaths (SUID), which also includes cases of accidental suffocation or strangulation in bed and any other unknown cause.

More than 3,500 infants under 1 year old die each year in the U.S. from sleep-related causes. While cosleeping is not the sole cause of all SIDS or SUID cases, sleep environments do play a major role. 

Investigations of SIDS cases by Child Fatality Review Teams have shown that the majority of infants who die of SIDS or asphyxiation (suffocation) are found in an unsafe sleep position or environment. A safe guide to cosleeping from the University of Notre Dame can be found here.

From the experts

The rates of SIDS and other sleep-related deaths, particularly those occurring in bed-sharing situations, are highest in the first 6 months.”

Bed sharing when parents do not smoke: is there a risk of SIDS?

A healthy, normal weight infant can be brought into the parent’s bed to be fed or for comfort. But since this age range is more vulnerable, parents should try their best not to fall asleep with the baby in their bed, and consider using a bedside bassinet or co-sleeper instead.

Factors that increase the risk of SIDS

  • Overheating
  • Soft or plush sleeping surfaces
  • Loose bedding, pillows(may use co sleeping pillow post consulting the doctor), and blankets
  • Placing your baby on their side or stomach to sleep

Co-sleeping typically exposes babies to one or more of these SIDS risk factors.

A 2015 study that examined over 1,000 SIDS cases and monitored close to 5,000 families’ sleeping practices revealed that bed sharing does increase the risk of SIDS, even when the infant is “low risk,” meaning the parents of that infant are not smokers and do not take any drugs or alcohol.

So, when can I stop worrying about SIDS? Typically, the risk lowers around 6-12 months, and continues to drop substantially after that age. Until then, though, you’ll need to take precautions.

From the experts

Bed sharing for sleeping when the parents do not smoke or take alcohol or drugs increases the SIDS risk. Risks associated with bed sharing are greatly increased when combined with parental smoking, maternal alcohol consumption and/or drug use. A substantial reduction of SIDS rates could be achieved if parents avoided bed sharing.

Bed sharing when parents do not smoke: is there a risk of SIDS?

The Prevalence of cosleeping in Japan

Across the globe, Japan has one of the lowest SIDS rates in the world and one of the highest rates of cosleeping. More than 60% of parents in Japan practice cosleeping. Despite this, Japan has half as many SIDS deaths as the U.S.

However, the typical Japanese family bed doesn’t look like most Western beds:

  • Futons are commonly used, which are much firmer than regular mattresses
  • Beds/futons are usually placed on the floor, which removes the risk of falling off the bed

Reports show that as cosleeping and breastfeeding rates increase in Japan, SIDS rates have decreased, which suggests that the way cosleeping is practiced might be more dangerous than cosleeping in general.

Benefits of cosleeping

While there are inherent risks involved in cosleeping, there are also benefits. Some studies have linked cosleeping to:

  • Prolonged breastfeeding
  • Better bonding between parent and child
  • Improved emotional health, such as less baby separation anxiety and higher self esteem

Most importantly, cosleeping is convenient for most families. Instead of getting out of bed to check on or feed your baby every few hours, they're already in the parents' bed with you. This can lead to easier bedtimes and longer, sounder sleep for all.

mom and baby co-sleeping with the Zen Sack

 

Cosleeping with a toddler: A few pros and cons

Now, let’s quickly touch on the cosleeping pros and cons. The benefits are obvious. The desire for closeness. Exhaustion from the drama of struggling with a fussy toddler at bedtime. 

There are many reasons parents may choose to bed-share with a toddler. Bed sharing can cut down on the time, energy, and effort it takes to get a little one to nod off. And parents have to pick their battles.

However, there are a few downsides to cosleeping with your toddler or child—even when safety is not the red flag it was when your baby was an infant. Here are just a few drawbacks to keep in mind:

  • Poor quality sleep: Many toddlers are active sleepers; they change positions frequently and little legs and arms ted to flail around, making it difficult for you to get a good night's rest. (In fact, cosleeping means neither of you will sleep as well as you would alone.)
  • Loss of parental control: Letting toddlers call the shots about where they want to sleep can make sleep training more difficult in the long run.
  • Loss of private time with your partner: There are a few downsides to cosleeping with your toddler or child—even when safety is not the red flag it was when your baby was an infant.

You should never practice cosleeping…

  • On a sofa, waterbed, armchair, etc. as this increases the SIDS risk by more than 60%. cosleeping in your bed is advised over other furniture options.
  • If you or your partner are current smokers, even if neither of you smoke in bed or in the room.
  • If you or your partner is impaired due to medications or substances that may effect your ability to arouse from sleep, such as pain medications, antidepressants, sedatives, drugs, alcohol, etc.
  • If you are not the infant’s parent or primary caregiver and especially if the parent or caregiver has not given explicit permission.
  • If your baby has any health concerns that might increase the risk of death while sleeping.

Tips for Safe Cosleeping With Baby

Even though it's not as safe as sleeping separately, there are steps you can take to reduce risk while practicing cosleeping. If you choose to co-sleep once your baby is 6 months or older, you can reduce risk by making sure to:

  • Place your baby on their back to sleep to reduce the risk of SIDS
  • Keep the room at a comfortable temperature and don’t overdress your baby for sleep
  • Use a headboard and/or foot-board that doesn’t have any openings or rails wide enough to trap your baby. Or remove headboards, foot boards, and bed frames altogether.
  • Limit the use of blankets and pillows as much as possible in your adult bed and remove any other plush objects or toys.
  • Keep your baby uncovered by any blankets or sheets that are being used on your bed.
  • Remove any pillows
  • Avoid cosleeping with multiple children and don’t allow an infant and older child to co-sleep unsupervised.
  • Remove any blinds, cords, or anything else that could wrap around your baby is near the bed.
  • Try not to fall asleep with your baby on your chest (always place them on their back)
  • Put your baby between two parents to reduce the risk of rolling off the adult bed
  • Consider placing a barrier between you, your baby, and your partner (but remember the CPSC does not endorse any product claiming to reduce risk while cosleeping)

Eventually, though, you’ll need to make the crib transition. We can help you find the right time in our guide to when should baby sleep in own room. Just as with the swaddle transition or the transition out of sleep sack, this can lead to interruptions to your newborn’s sleep schedule

So, watch out for the signs of sleep regression in baby. Our weighted newborn swaddle and weighted sleep sacks can help ease the transition, mimicking your touch with gently weighted pads. This design helps improve sleep in just a few nights and has helped millions of parents worldwide!

Learn more about the importance of how to dress baby for sleep in our blog. Then, discover firsthand what a difference the best baby pajamas, the best transitional sleep sack, best bamboo sleep sack, best sleep sack for winter, or the best transition swaddle can make in your newborn bedtime routine!

Final Thoughts on Safe Cosleeping With Baby

Cosleeping with baby isn’t recommended by most professionals, but it’s the reality for many parents. Babies are safer sleeping on a separate sleep surface than in their parents bed, and you should always give room-sharing a try before resorting to cosleeping or bed-sharing, as studies show that bed-sharing does increase your baby’s risk of SIDS.

However, if cosleeping is what works best for your family, do your research. And be sure to talk about your choice with your pediatrician, so you can take every precaution to make sure you’re sleeping with baby as safely as possible. 

We have more advice on how to get baby to sleep through the night if your newborn won’t sleep or they cry when put down. Learn about how to help a teething baby sleep, the ideal baby nap schedule, sleep training baby, how to hold a newborn, when do toddlers stop napping, and more.

Otherwise, take these insights on safe cosleeping with baby and determine what makes the most sense for your family. If you do decide to try and cosleep with your baby, just remember the risk of SIDS and the safety advice we’ve shared above!