SAFE BEDSHARING
many parents swear they will never share their bed with their baby.
A bassinet right next to the bed is basically the same thing, right?!
aaaand then the baby is born.
Unless you’ve experienced it for yourself, it’s hard to imagine there are babies who will not spend one second asleep unless they are on or next to their caregiver. But it’s true. And when this is the case, families are left with very few options for getting sleep safely.
The thing is, sleeping in proximity to caregivers is what our babies were wired to expect… and demand. From their perspective, their survival is hinging on being as close to a caregiver as physically possible. For thousands of years there was little chance our babies, unable to create their own body heat, secure their own food, and left exposed to insects, reptilians and other creatures, would have survived long sleeping on the other side of the cave away from their parents.
What’s more, people in countries the world over continue to bedshare today, safely and happily sharing their sleep space with their baby. Not only is it the norm in these countries, more often than not, bedsharing is encouraged… least of all because it helps everyone get more sleep.
These countries consistently have lower rates of SIDS than countries like the US, who takes an abstinence-only approach to bedsharing (Bartick and Tomori, 2019; McKenna and McDade, 2005). In light of this, more and more countries are moving away from abstinence-only messaging; authorities in Spain, the United Kingdom, and Norway have recently changed their stance on bedsharing when no hazards exist (Bartick et al., 2022).
So whether you’re bedsharing by choice, or out of necessity, read on to learn how to do it safely.
If you’ve been bedsharing up until now and you’d like to start gently and slowly transitioning your baby or toddler to their own sleep space without any cry-it-out, timed checks, or ‘self soothing, join us for the Gentle Shifts to Solo Sleep Workshop happening Saturday March 2 at 9:00 am Eastern Standard Time (replay available!).
Below, the safe bedsharing guidelines as of 2024:
before the baby is born:
Stay sober. It is important that, as a birthing person, you do not drink alcohol, smoke, or take illicit drugs during pregnancy. If you have, bedsharing is not a safe option for your baby. A bedside co-sleeper is a great alternative.
If you live with family members who smoke, ask them to do it outside. If this is not possible, keep the door to your bedroom closed at all times to prevent as much smoke from entering the bedroom as you can. Third hand smoke (that is, residual nicotine and other chemicals left on indoor surfaces by tobacco smoke) is a big SIDS risk.
the room:
Best practice is to remove the mattress from the bedframe and to place it on the floor. This way, should your baby accidently roll off the bed the fall is minimal and there is little chance of them seriously hurting themselves. If you cannot place your mattress on the floor, you might want to invest in a bedside rail . However, it’s important to remember that even pre-crawling babies can pull themselves up and over these rails and fall to the floor, making the fall even higher than the mattress height and very dangerous. Never leave a sleeping baby unattended on your bed, even if you have rails in place. If there are any gaps between the rail and the mattress, stuff them with rolled up towels or sheets. Even the smallest of openings can pose an entraptment risk.
Place the mattress in the middle of the room, at least two feet / twenty four inches away from any walls or nightstands. Again, this helps ensure that if your baby accidentally rolls off the bed, they don’t become entrapted between the mattress and the wall or the mattress and a nightstand. If this is not possible, then push the mattress up against a corner wall. Pack any gaps that exist between the mattress and the walls using rolled up sheets or towels to minimize the chance of baby becoming entrapted should they roll away from you. It’s usually the smallest of openings that pose the biggest entraptment risk.
Remove any cords or wires from reach. Think: cell phone chargers, lamp cords, baby monitor cables, cords from the blinds, etc. These all pose a strangulation risk. If you cannot remove them, then fasten them securely against the wall using cable clips (however, best practice is to remove all together).
Ideal room temperature is 61 - 68 degrees fahrenheit / 16 - 20 degrees celcius, to avoid baby overheating. Overheating is a big SIDS risk.
the bed:
Your mattress must be firm in order for it to be safe for baby to sleep on. A firm mattress will help ensure your body doesn’t create an indentation in the mattress, which could cause your baby to roll into you / the mattress - this can pose an entrapment or re-breathing risk. For this reason, a memory foam mattress is not a safe option for a bedsharing family. Remember - even the firmest adult mattress on the market is not as firm as infant crib mattresses.
Strip your bed down to the basics. A fitted sheet, a light comforter, and one pillow for beneath your head.
If you find sleeping in the cuddle curl position hard on your hips or back, you can place a pillow between your knees or behind your back for more support. However, if you are changing sides to nurse your baby, you need to remember to move these pillows to the other side of you. The more pillows you bring into your sleep space, the higher the risk of suffocation, so be intentional about the number and location of the pillows in your bed.
Bedsharing must take place in an actual bed. It is much, much more dangerous to fall asleep with your baby in a rocking chair, glider, or on the couch. These environments are never safe for baby sleep.
you:
Must be sober each and every time you sleep next to your baby. You cannot have consumed any alcohol, cigarrettes or drugs, including medications that make you drowsy (including cold medications). If you have, your baby cannot share a surface with you tonight. A bedside co-sleeper is a great alternative.
You must lie in the cuddle curl around your baby. The cuddle curl position means sleeping on your side, facing your baby, with your knees pulled up underneath their feet and your lower arm under your pillow. Your upper arm can be placed along the side of your body, tucked between your knees, or nestled under your chin. If you feel most comfortable draping your arm across your baby, make sure your hand is resting on the mattress beyond them, and your weight is on your hand, not your arm. Your arm should not lay across your baby’s chest, as this can easily compress their lungs, making it difficult for them to breathe. Instead, it should reach across their belly. The cuddle curl is a very protective position - it keeps your baby next to your chest, which allows them to smell your breastmilk and makes them instinctively stay close to you. This position also ensures you don’t accidently roll onto your baby, since your tucked up knees get in your own way of rolling over your baby.
If you have long hair, it must be tied back. Loose hair poses a strangulation risk for baby (yes, unfortunately this has really happened). What’s more, most postpartum people experience hair loss in the first year after giving birth, and there is a risk of stray hairs wrapping tightly around the baby’s fingers or toes, creating a hair tourniquet. These often go unnoticed but can easily and quickly cut off circulation.
You must wear tight fitting pj’s. Pj’s that are really loose and baggy could pose a suffocation risk (much the same as loose bedding does).
your baby:
Must be full term and healthy. Premature babies seem to have less ability to arouse themselves, and we aren’t quite sure at what age this vulnerability disappears. For this reason, bedsharing is not recommended for preemies.
Should be exclusively breastfed, as an exclusively breastfed baby will instinctively stay close to the breast, but there is a risk that a formula-fed baby may move from this position if they are not attracted to the scent of the milk. Unfortunately, we don’t have any research on if / when it’s safe for formula fed babies to bedshare. If you choose to bedshare with your formula fed baby anyway, it’s important to continue to follow all the safe bedsharing guidelines.
Must not be swaddled. If you choose to swaddle your baby, they need to sleep in their own crib, bassinet or co-sleeper.
Must be lightly dressed. Remember, overheating is a big SIDS risk. Your baby will absorb body heat from sleeping next to you. If you choose to use a sleep sack while bedsharing, make sure they only have one layer (ie: pj’s) underneath.
Bedsharing babies must sleep on their back for the entire first year. It’s ok for them to be on their side when nursing in the side-lying position, but once the feed is over you need to roll them back onto their back for sleep. If you wake up and find baby has rolled onto their side or belly in their sleep, roll them back onto their back each time . Yes, a baby who sleeps in a crib and who can roll forwards and backwards confidently can be left to sleep on their side or belly, but this is not true when bedsharing, since adult mattresses aren’t as firm as crib mattresses are and this poses a suffocation and / or rebreathing risk.
Your baby should sleep next to the breastfeeding parent only for the first four monnths (but six months is best practice). If your partner is sleeping in the bed with you, this means your baby will be on one side of the bed, you will be in the middle in the cuddle curl around your baby, and your partner will be on the other side of you. After six months it’s safe for baby to sleep between two caregivers, provided both caregivers are aware the baby is in the bed and agree to assume responsibility for the baby’s safety.
your partner:
Must be aware the baby is in your bed with you. If they are sleeping when you bring the baby into your bed, you must wake them up and get confirmation that they’re aware you’ve brought the baby into your bed.
Must be sober, non-smoking, and drug free (including over the counter medicines that could make them drowsy), even if they’re sleeping on the other side of you. If they’re not, either they need to sleep in another bed, or your baby does.
Must agree to share the responsibility of keeping your baby safe in the night.
Must also tie long hair back if they have it, and wear tight-fitting pjs.
your other kids and family pets:
Pets are not allowed to share your bed with you if your baby is. They might nestle in too close to your baby, posing a suffocation risk. They could also move the blankets around while trying to make their little ‘nests’ or moving around, unintentionally covering the baby’s face without you noticing.
Officially, it is not recommended to bedshare with a baby and older siblings. However, I recognize that for many families this is simply not an option and the family bed is where everyone sleeps. If you need to bedshare with your baby and your other child(ren), you need to make sure you are between your older child(ren) and the baby at all times. This might look like having your baby sleep on the outside, with you in the cuddle curl position around your baby, and your older child(ren) sleeping behind you (yes, this means you’ll be sleeping with your back to them). Alternatively, you can have your older child(ren) sleep on the outside of the bed next to your partner, with you in the middle, and your baby on the outside next to you. Under no circumstances should older siblings be allowed to sleep next to their infant sibling - while you are aware of your baby in your sleep, young children do not have this same awareness / sensitivity. Allowing them to sleep next to the baby poses a suffocation risk for your baby.
Have a separate blanket for your older child(ren). This way if your children move their blankets around while sleeping, you don’t have to worry about it accidentally covering your baby’s face.
Ok - that covers it! Remember, there is no increased risk of infant death from bedsharing in the absence of hazards (Bartick et al., 2022) . When the above guidelines are followed, bedsharing can be a completely safe, unremarkable approach to getting more sleep for your family.