While I knew that bed-sharing was the most instinctual thing for me and my son to do — and I had several new mom friends at the time doing the same — I was never convinced that it was safest. Just because something feels natural doesn’t mean it offers the best odds of survival, does it?
The truth is that about 3,400 infants under age 1 die every year in the U.S., according to the Centers for Disease Control and Prevention. These deaths are labeled under Sudden Unexpected Infant Deaths, and the CDC breaks them down into three categories: Sudden Infant Death Syndrome (SIDS), unknown cause, and accidental suffocation or strangulation in bed.
In 2020, 41% of these deaths were categorized as SIDS, 32% as unknown, and 27% as accidental suffocation or strangulation.
The rate of SIDS waned significantly in the 1990s, after the AAP came out with its safe sleep recommendations, and the Safe to Sleep campaign blanketed the country in public safety messages. But the rates of unexplained suffocation or strangulation deaths have held steady over the past few decades, even rising slightly — though this may have to do with how the deaths are classified more than their cause, which in many cases is unknown.
While many of the deaths — such as those from SIDS — were not preventable, what if some of them were? 3,400 is a lot of shattered families.
Emily Oster, an economist and author, examines and contextualizes the risk of bed-sharing in her bestselling book Cribsheet. Using data from a 2013 meta-analysis (a study of studies) published in the British Medical Journal, Oster shows that the risk of infant death increases significantly when bed-sharing occurs with an infant who is bottle-fed, whose parent smokes, or when a parent has been drinking.
While it remains quite small, the risk of SIDS does increase for a baby who bed-shares, even in the absence of these factors, going from 0.08 deaths per 1,000 births to 0.22 deaths per 1,000 births. This is significantly lower than the overall infant mortality rate of 5 deaths per 1,000 births. Oster explains in the book, “A perhaps more useful way to say this is that among families with no other risk factors, roughly 7,100 of them would have to avoid co-sleeping to prevent one death.”
The question is, is it feasible or realistic to keep that many babies out of their parents’ beds, all night, every night, for the first year of their lives? And, perhaps more urgently, how do the AAP guidelines limit what pediatricians are able to say to their patients?
Dr. Jill Wright, a pediatrician at UNC health, told HuffPost that she sticks to the AAP guidelines when talking to families about infant sleep.
“I have had that happen to a patient, to an infant, and it’s a tragedy — a preventable tragedy,” said Wright.
“There is good evidence that bed-sharing can increase the risk of infant death,” she said, adding that “there are a lot of things that further increase the risk.”
As to the idea of safer bed-sharing, Wright reiterated that the AAP “said no bed-sharing under any circumstances,” and that she would advise families to “have that safe surface easily accessible in the parents’ room.”
Other American doctors quoted in the media implore parents not to bed-share, saying that there is “no reason” to do so.
As Dr. John Cox in Ohio recently told a local TV news station, “I know moms are tired, and you’re nursing frequently, and you’re feeding frequently throughout the nighttime. You can easily have that bassinet right in your room right next to you, so when you’re done, you put that baby there so you can get the proper rest.”
But you can only get rest if the baby remains asleep. Otherwise you’re just lying there listening to them cry, wondering what on earth you’re supposed to do next.
“The reality that parents quickly learn when they’re breastfeeding is that something’s gotta give in the first few weeks,” Diana West, an international board certified lactation consultant and the author of Sweet Sleep, told HuffPost.
Some parents turn to infant formula or attempt to sleep-train their babies. And some of us bring the baby into the bed.
