Co-Sleeping Truths: What Parents Should Know

Co-sleeping can be a controversial topic among parents and pediatricians. Here's what you need to know about the risks of co-sleeping and why some families choose it.

sharing bed with baby
Photo: Pixabay/smpratt90

The topic of co-sleeping can be challenging, because officially, leading parenting organizations have public stances against the practice. However, some cultures regularly practice co-sleeping and some parents feel co-sleeping is the only way they can catch any sleep themselves. The divide between the official stance and what parents actually do can lead to a lack of honest conversation between doctors and parents. That's why it's important for parents to equip themselves with the actual facts about co-sleeping and talk to their doctors about the concerns they are having about their baby's sleep.

The difficult truth is that co-sleeping is associated with an increased risk to babies.

The American Academy of Pediatrics (AAP) safe sleeping guidelines, updated in June 2022, state that parents should never let their baby sleep in the bed with them—citing the risk of suffocation, sudden infant death syndrome (SIDS), and other sleep-related deaths.

Indeed, according to data compiled by NPR in 2018, a low-risk baby (meaning the baby doesn't have any medical conditions that interfere with breathing, or other risks) has a 1 in 16,400 chance of dying from SIDS in a parent's bed. The likelihood decreases to 1 in 46,000 while sleeping in a crib in the parent's room. A 2021 review of the evidence from the UK on the risks of co-sleeping found that the risks are higher when:

  • co-sleeping is done on a sofa vs. a bed
  • the baby is under 98 days old
  • co-sleeping is done all night vs. some of the night
  • if the adult co-sleeping has drank alcohol
  • If the adult co-sleeping has smoked

Despite the evidence that points to risks to a baby, some parents do choose co-sleeping. For instance, the CDC's latest reported data in 2015 found that nearly half of mothers surveyed reported co-sleeping. Why do parents still co-sleep? Well, along with some cultural practices, the purported benefits of co-sleeping are that it promotes bonding, helps children feel safe, and makes nursing easier. Read on to learn more about what data shows about co-sleeping, and considerations your family should make.

Safe Baby Sleep

If you're worried about fostering a close relationship with your baby at night, or that putting your baby to sleep in a crib or bassinet is somehow abandoning them, don't. "Location is not as important as relationships—how parents build attachment and love," says James McKenna, Ph.D., an anthropologist specializing in infancy and development and director of the mother/baby behavioral sleep laboratory at the University of Notre Dame in South Bend, Indiana. He also makes the point that gaining independence is something that a child will learn over time from her parents in many different ways.

What parents should consider, adds McKenna, is that the wrong location can be dangerous. For instance, the worst place for a newborn to doze is on a couch, armchair, and other soft, lumpy surface, which can create air pockets that make it difficult for her to breathe. This is especially dangerous during late-night feedings when both parent and baby are drowsy.

"If you think that there's even the slightest possibility that you may fall asleep [during a feeding], feed your baby on your bed, rather than a sofa or cushioned chair," said Lori Feldman-Winter, M.D., FAAP, member of the Task Force on SIDS and co-author of the AAP's 2016 report on safe sleep guidelines for infants, in a statement. "If you do fall asleep, as soon as you wake up be sure to move the baby to [their] own bed," she added.

The AAP recommends infants sleep on their backs in cribs outfitted with only a mattress covered with a tightly fitted sheet. There also shouldn't be any other items, such as toys, crib bumpers, or blankets, in the crib.

Why Parents Choose Co-Sleeping

Even when doctors and leading health organizations do not recommend co-sleeping, some parents still choose it for reasons they see as beneficial. For instance, not only are parents physically close by to respond to the baby if something goes wrong, but co-sleeping can make it easier for the breastfeeding parent to nurse throughout the night.

"There is an instinctive need for the mother to be close to her baby," says Cynthia Epps, M.S., a certified lactation educator at the Pump Station in Santa Monica, Calif. Plus, there are real benefits to babies being physically close to their parents. "Keeping the baby close, with skin-to-skin contact, calms the baby," says Epps. "And it can cement the emotional bond between mother and child."

Proponents of the family bed say the benefits of co-sleeping can include:

  • There's a historical and cultural precedent for the practice. In many cultures all over the world, children have shared a bed with their parents for centuries.
  • Nursing parents get more sleep this way. Some breastfeeding parents find it easier to have their child nearby for nighttime feedings with minimal interruption of sleep for both parties.
  • It helps children feel safe and secure. Some parents believe that children derive a greater sense of security and well-being from sleeping near their parents.

Additionally, some families co-sleep with older children, when the risk for babies are not present. For instance, Samantha Gadsden, a birth doula in Caerphilly, Wales, shares a bed with her three children, even though the U.K.'s National Health Service shares the AAP's stance against co-sleeping.

The Drawbacks of Co-Sleeping

On the flip side, Lynelle Schneeberg, Psy.D., director of the behavioral sleep program at Connecticut Children's Medical Center, tells that sharing a family bed almost always, eventually, becomes problematic for a variety of reasons. Helping kids become confident, independent sleepers is more important than any positive effects of co-sleeping, says Dr. Schneeberg. In fact, according to Dr. Schneeberg, some of the risks of co-sleeping outside of the physical risks include:

  • Your kids may develop a sleep crutch. Always having a parent around at bedtime can become a strong "sleep onset association," also called a sleep crutch or sleep prop—something your kid can't drift off without. "Children need to learn how to fall asleep without a parent nearby," says Dr. Schneeberg.
  • Your kids may display anxious behaviors. In addition to developing the sleep crutch, some children will come to expect interactions like back rubbing, patting, and being held to fall asleep. "They may be misdiagnosed as anxious because, since they have a hard time falling asleep without a parent nearby, they sometimes display anxious behaviors to convince a parent to stay nearby at bedtime," Dr. Schneeberg explains.
  • One bedtime doesn't fit all. Children of different ages need different amounts of sleep, and their bedtimes vary accordingly. In families that share a bed, parents and older children end up turning in much earlier than they might wish, based on when the youngest children need to, explains Dr. Scheeberg. This situation easily becomes frustrating for everyone involved.
  • Your sleep quality may suffer. As notoriously restless and active sleepers, children can disrupt their parents' sleep by kicking or thrashing around, Dr. Schneedberg explains. "I've seen many families in which one parent—most often, the father—ends up sleeping in a different room entirely," she says. "The parent with the children often becomes exhausted by either the restless sleep of the kids or the needs of each kid after an awakening."
  • Your relationship may suffer. For many couples with children, evenings are the only time they have to be alone together. When you're sharing a bed with your kids, however, they're literally separating you from your partner. The co-sleeping arrangement could lead to limited time or space for intimacy.
  • It increases the risk of SIDS and suffocation. And of course, don't forget that co-sleeping increases the risk of sudden infant death syndrome. Parents or objects (like pillows) may unknowingly roll onto the baby at night, leading to injury, suffocation, or death. The AAP says co-sleeping is especially dangerous if the baby is younger than 4 months, was born prematurely, or had a low birth weight. The risk also increases if someone in bed smokes, drinks, or takes drugs—or if the co-sleeping surface is soft and has bedding.

Considerations to Make About Co-Sleeping

If you are considering co-sleeping, the first thing you should know is that you don't have to be afraid to talk to your doctor about your concerns over you and your baby's sleep. For instance, if you're having trouble sleeping or your baby won't nurse unless they're attached to you all night, your doctor may be able to recommend resources that can help. Many of the reasons that lead parents to consider co-sleeping in the first place could have solutions, so talk through those concerns with your doctor.

It may also be helpful for you to consider the potential of long-term implications from co-sleeping For instance, children who start co-sleeping at an early age aren't likely to "grow out" of it once it has become as commonplace as sleeping with a pillow to them, Dr. Schneeberg warns. The long-term effects can be socially damaging too. "As the child grows up, they may not be able to participate in activities that other children the same age are enjoying like sleepover parties, summer camp, and overnight field trips," she says. If you've been sharing your bed because you feel it will be easier for your little one to sleep that way, it's not too late to break the habit. You can certainly teach your child to fall asleep in their own bed within a few days.

And don't forget that there are some ways you can keep your child close to you but not share a bed together. In fact, the AAP actually recommends room-sharing: the organization says sharing a bedroom (just not a sleeping surface) with your baby is beneficial. For optimum benefits, the AAP recommends that infants sleep in a separate sleeping area in the same room as their parents for up to a year, optimally, but at least for their first 6 months of life.

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