Co-Sleeping

Anyone who is a parent, wants to be a parent, or is friends with parents knows that sleep is one of the most central themes of raising an infant. As new parents adjust to having a baby in their home, one of the biggest challenges is promoting an environment where their baby can sleep safely and soundly - and ideally where the parents themselves can get as much sleep as possible, too.

One key decision that new parents make is where their infant will sleep. Co-sleeping is a term that is used in different ways but generally refers to having a baby sleep in the same room, and in some cases the same bed, as the parents. In this guide, we’ll review the basics about co-sleeping and what experts say about it. We’ll also provide specific information about creating a safe sleeping environment for an infant.

What is Co-Sleeping?

Co-sleeping can mean different things to different people. One common association is that co-sleeping means having a baby sleep in the bed and on the same sleeping surface as its parents. The truth is that co-sleeping can also include having an infant asleep in the same bedroom but on a different sleeping surface. For this reason, we break co-sleeping down into two main categories and use this terminology through this guide:

  • Room-sharing: this is when the infant sleeps in the same room but on a sidecar mattress or a separate crib. They are never asleep on the same surface as the parents.
  • Bed-sharing: this is when the baby does sleep in the bed and on the same surface as the parents.

What Are the Benefits and Drawbacks of Co-Sleeping?

Since bed-sharing and room-sharing are distinct practices under the umbrella of co-sleeping, it’s easiest to consider the benefits and risks of each of these separately.

What are the Pros and Cons of Bed-Sharing?

Potential benefits of bed-sharing may include:

  • May help soothe some children to sleep: for some infants, being right next to their parents in bed may increase calm and make it easier for them to sleep.
  • Facilitates breastfeeding in bed: for many moms, it’s less disruptive to their valuable sleep if they can breastfeed while in bed. This is more easily done with the infant in bed.
  • Waking up next to the baby: there’s a lot of joy for many new parents in waking up with their baby right there next to them.

Potential drawbacks of bed-sharing may include:

  • Risk of SIDS: the most important potential drawback is the possibility of Sudden Infant Death Syndrome (SIDS). SIDS is the sudden death of an infant, and it is most common during months 2-4. Researchers estimate that the risk of SIDS may be up to 50% higher with bed-sharing.
  • Requires careful communication and coordination: partners who want to sleep with their infant in the bed need to be working together to reduce safety risks and to care for the baby in the night. This requires additional communication above and beyond what’s already needed with having an infant.
  • May interrupt sex life: the presence of a sleeping infant in bed can obviously put a dent in intimacy and further disrupt what is in many cases an already diminished sex life.
  • More wake ups in the night: some babies will self-soothe and just fall back asleep when sleeping on their own. But with the baby so close at hand, it’s likely that parents will wake up before the infant has any chance to self-soothe.

What Are the Pros and Cons of Room-Sharing?

Potential benefits of room-sharing may include:

  • Improves development: some research indicates that room-sharing may improve cognitive and behavioral development in infants.
  • Easier to ensure baby safety: by having a separate sleeping surface, room-sharing makes it easier to prevent accidents or other issues associated with sharing a bed.
  • Easier nighttime breastfeeding: while not as convenient as with bed-sharing, room-sharing still makes it easy for a mother to get the baby and breastfeed in bed without having to leave and go to another room.
  • Wake up next to the baby: even if the baby isn’t right in the bed, most parents who room-share can easily look over and see their smiling child when they wake up in the morning.
  • Reduced separation anxiety: some infants struggle with being in a separate room, and for this reason, this arrangement can help decrease this separation anxiety.

Potential drawbacks of room-sharing may include:

  • Interference with sex life: as with bed-sharing, having an infant in the same room, even if on a separate surface, can still cause some interruptions or at the least changes to the sex life of some parents.
  • More sleep disruptions: with the baby close at hand, parents who room-share are likely to wake up before a baby has a chance to self-soothe, meaning more total wake-ups in the course of the night.

What Are Common Myths About Co-Sleeping?

There's a lot of misinformation out there about co-sleeping. Here are three main myths:

Myth #1: Co-sleeping means bed-sharing

As we mentioned early in this article, one myth is that “co-sleeping” means “bed-sharing.” This can bias some people against the whole idea from the get go when co-sleeping can also include room-sharing that offers more reassurance when it comes to safety.

Myth #2: Breastfeeding at night causes ear infections 

One myth is that nursing while lying down can make an infant prone to ear infections. While bottle feeding an infant who is lying flat may increase this risk, there is not evidence that indicates that it is applicable to breastfeeding that occurs at night.

Myth #3: Co-sleeping causes long-term mental health issues

Some people allege that co-sleeping creates long-term attachment issues, but there is no reliable scientific evidence that this is the case for either bed-sharing or room-sharing.

Are There Recommendations For or Against Co-Sleeping?

One common source of recommendations when it comes to infant health is the American Academy of Pediatrics (AAP), which is a group made up of pediatricians from across the country. AAP recommends against bed-sharing and in favor of room-sharing. The AAP makes these recommendations on the basis of careful reviews of existing scientific evidence and debate and discussion among experts in the field of pediatric health.

Despite this recommendation, some doctors do not recommend against bed-sharing. Research by the U.S. Centers for Disease Control and Prevention (CDC) also indicates that a significant percentage of parents do not heed these recommendations. A study in 2015 indicate that nearly 61% of parents have done some kind of bed-sharing and that many received incorrect or no advice from a doctor about infant sleeping arrangements.

How Can I Create a Safe Sleeping Space for My Baby?

It’s natural for parents to want to do all that they can to promote the safety of their children. In this section, we’ll review safety strategies in general and specifically for those who do decide to try bed-sharing.

General Safety Guidelines

These are general rules for creating a safe place for your child to sleep. These apply to room-sharing and bed-sharing.

Infants should sleep:

  • On their back and never on their side or stomach
  • On a firm surface
  • On a surface free of any kind of soft objects
  • On a clean surface
  • On a surface that has no gaps between it and any surrounding crib or frame
  • With only light blanketing that never goes over their head

Additional Safety Tips for Bed-Sharing

Parents who are interested in bed-sharing should heed all of the guidelines above. In addition, parents who are bed-sharing should follow these tips:

  • Do not use a very soft mattress or waterbed.
  • Keep any fluffy materials (like sheepskin) off of the mattress.
  • Openly discuss parent responsibility ahead of time including who is responsible for checking on the baby and waking up when the baby does.
  • Make sure that both parents are fully aware that the baby is in the bed before putting the baby in bed or going to sleep.
  • Ensure no other children are sleeping in the bed at the same time.
  • Avoid bed-sharing if either parent is using sedative medications, alcohol, or other drugs that might make it harder for them to detect an issue with the infant.
  • Long hair should be tied up tightly to prevent any risk of it wrapping around an infant’s neck or body.
  • Avoid bed-sharing if someone has any limitations on their ability to feel the exact location of the infant such as severe obesity or any issues with numbness in the limbs.
  • Do not bring the infant into bed if it a low-birth weight or premature and very small.
  • Do not bring the infant into bed if the mother is a smoker or smoked during pregnancy. Studies have shown this can increase the risk of SIDS.

While following these safety tips can help reduce risks to an infant that is bed-sharing, it still does not lower the risks to the level of room-sharing. Parents who choose to bring their infant into bed should be aware of the risks and communicate openly with another about this decision.

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