The term bed-sharing is when a baby sleeps in bed with another person or persons for either some or all of their sleep.
The term co-sleeping is sometimes used to refer to bed-sharing. In its true meaning co-sleeping is more correctly sleeping in close proximity including in the same room – but not sleeping on the same surface. Having your baby sleep in the same room as you but in their own cot for the first six months is safer than them sleeping in their own room on their own and also safer than them bed-sharing.
Some parents will choose to bed-share with their baby and this is their sleeping routine. Other parents bring their baby into bed to feed, by either breast or bottle, when they are unsettled or because they are unwell and they wish to comfort them.
Sharing a sleep space with a baby has an increased risk of SUDI. This risk is small (but real) when there are no other risk factors at all. The risks are enormous when there are multiple risk factors.
Adult beds, and more specifically adult mattresses are not designed for babies to sleep upon. A baby’s sleep environment is safest when the surface they are sleeping upon is firm and flat and is predictable; there is nothing in the baby’s immediate sleep space which could impede their breathing. Young babies less than three months of age appear to be most at risk when bed-sharing, likely because they have not developed strong enough motor skills to move their head if they are in a position which challenges their breathing.
Bed-sharing is a contentious issue. Ultimately, it’s about remembering that the safest place for baby when you are both asleep is in their own separate sleeping space. Bed-sharing in a ‘safe way’ is often discussed. Because bed-sharing in the absence of other risk factors carries risk of SUDI, the Scottish Cot Death Trust does not promote this as a safe practice. Taking baby into bed to feed, cuddle and settle is not an increased risk and in fact we advise breastfeeding to take place whenever possible. Risk is increased when the adult is also sleeping.
Once baby has fed and settled they should be placed in their own sleep space in the same room as parents.
Several studies have been conducted to try to answer the question whether bed-sharing with a term, non-low birth weight infant whose mother did not smoke during pregnancy and where parents do not smoke, drink alcohol or take drugs is safe. Studies from different groups across the world have shown that
There is inherent risk for infants 3 months or younger when bed-sharing .
For the first 6 months the safest place for your baby to sleep is in their own cot in the same room as you
There are other factors which add to this inherent risk.
Parents or care givers who:
- (1) Smoke
- (2) Have recently drunk any alcohol
- (3) Have taken medication or drugs that could make you sleepy
- (4) Are unusually tired to the point where you would find it difficult to respond to your baby.
The risks of bed-sharing are also increased if your baby:
- (5) Was premature (born before 37 weeks)
- (6) Was of low birth weight (less than 2.5kg or 5lbs 8oz)
There is also a risk that your baby might (7) overheat in your bed, or (8) you might roll over in your sleep and suffocate your baby. (9) Your baby could get caught between the wall and the bed, or (10) could roll out of the bed and be injured.
Other factors which parents might also consider
In addition to these 10 factors, the condition of parent’s mattress and bedding (duvet/pillows) should be considered (it is common practice to thoroughly assess the condition of a baby’s mattress for safety). Also, a mixture of mattress condition and/or parental weight may affect the level and firmness of the surface. An uneven surface may lead to a baby rolling. As your body creates slopes on the mattress, there is a risk of your baby rolling over onto their front and being unable to breathe.
Other children or pets sleeping in the parental bed either for part or all of a sleep can increase risks further for an infant in the bed.
Accidental suffocation in the absence of parental smoking, alcohol and drug use is not common but it can happen when bed-sharing. This information is not given to cause fear but to empower people to be aware and gather all the information they need to make an informed decision about what is safest for their baby.
If you are considering bed-sharing, it is important to be aware of all risks and make decisions about where your baby sleeps based on all of this knowledge.
With all of these factors considered, it is the view of the Scottish Cot Death Trust that an infant bed-sharing with the adult(s) sleeping should be avoided. We aim to be transparent and ensure that families and the professionals supporting them have all of the information available to inform discussions and decision making. We are aware of the change of Scottish government issued safe sleep information and have advised them of the concern of this change in message and omission information on risk of all factors which parents and care givers need to be aware.
For the first six months the safest place for a baby to sleep is in an separate firm, flat, and uncluttered space in the same room as you.
Things to consider
“cots that attach to our bed are popular, is this bed sharing?” – if one side of your cot drops down and attaches to your bed, then this technically becomes a shared sleeping space. We would encourage people to consider some of the above factors and ensure that bedding on the parent bed cannot enter baby’s sleep space.
“does this mean I can’t bring baby into bed at all?” – Not at all. It’s lovely to have your baby with you for a cuddle or a fed but it’s safest to put your baby back in their cot before you go to sleep.
Evidence For Our Message To Avoid Bed-Sharing
In 2013, an analysis of five major case control studies found a five fold increase risk of SUDI for breastfed infants under 3 months of age when bedsharing. A Scottish study found the risk to be as much as a ten fold increased risk Scottish Cot Death Trust recently reviewed the current evidence base and was involved in writing the following article alongside renowned researchers from the UK, New Zealand and the United Sates.
A Scottish study found the risks of bedsharing greatly increase when either parent smokes.