Comforts, Dangers of Sharing Your Bed With an Infant: Pitt study reveals why parents, despite health risks, sleep with their babies

Infant bed sharing—or parents sharing sleeping space with their infants—is widely practiced even though it remains controversial. The American Academy of Pediatrics advises against bed sharing, because of accumulating research suggesting increased risks of accidental suffocation and sudden infant death syndrome (SIDS) for infants who bed share. However, many parents believe the perceived benefits of bed sharing outweigh concerns and warnings, according to a University of Pittsburgh School of Medicine study.

“For physicians to know how to more effectively counsel parents on safe sleeping practices for their children, we need to better understand parents’ beliefs, motivations and feelings about infant bed sharing,” said Jennifer Chianese, who led the study. Chianese was an assistant professor of pediatrics in Pitt’s School of Medicine at the time of the study and has recently joined the Children’s Community Pediatrics Bass-Wolfson affiliate of Children’s Hospital of Pittsburgh of UPMC.

The study interviewed 28 caregivers—all of whom bed share regularly—in four focus groups. In every focus group discussion, parents reported near-miss incidents of their infants suffocating. Some parents reported they would recommend against bed sharing to others, despite the fact that they bed share themselves. Other participants denied that bed sharing posed any risk to their infants, describing themselves as “light sleepers” and able to wake up if their children were near harm. Doctors’ recommendations against bed sharing did not dissuade any of the caregivers. However, parents did appreciate advice on how to increase the safety of bed sharing.

In addition, researchers identified five themes to explain parents’ motivations for bed sharing.

Better sleep—Parents overwhelmingly expressed the belief that bed sharing allows both parties to sleep better, despite research suggesting both parents and infants experience fewer nighttime awakenings when sleeping alone.

Convenience—Most participants used the word “convenient” when describing their reasons for bed sharing. Parents reported being able to tend to their babies’ needs without getting out of bed, and the three nursing mothers who participated believed bed sharing made breast-feeding more convenient.

Tradition—Participants often reported the traditional nature of bed sharing and found comfort in knowing their ancestors bed shared as well.

Child safety—Contrary to evidence that bed sharing is dangerous, most caregivers believed it protects their babies. Many parents even identified bed sharing as a form of prevention against SIDS because they would immediately know if their babies were to stop breathing.

Emotional needs—Parents reported a strong sense of bonding and described feelings of gratitude, closeness, comfort, and security when bed sharing. They also reported their infants as having strong-willed demands for bed sharing.

“These findings should give physicians a better idea of the reasons behind bed sharing, allowing them to offer more customized advice on the subject,” said Judy Chang, senior author on the study. “In addition to counseling against bed sharing, physicians should include suggestions for room sharing and reducing bed sharing risks. Room sharing may be an alternative to parents, as it allows them to watch over their infants while decreasing risks for SIDS.” Chang is an assistant professor of obstetrics, gynecology, and reproductive sciences at the University Of Pittsburgh School of Medicine, investigator with the Magee-Womens Research Institute, and a gynecologist at Magee-Womens Hospital of UPMC.

“Parents who do insist on bed sharing can benefit from counseling on how to avoid other SIDS risk factors by using a firm mattress, avoiding extra pillows and covers, and putting babies to sleep on their backs. Regardless of their perceptions on bed sharing, parents and other primary caregivers need to be educated on risks associated with SIDS and infant suffocation and the variety of ways they can improve the safety of their infant sleeping practices,”  added Chianese.

The focus groups, made up of parents or guardians of infants up to six months of age, were recruited from an inner-city primary care center in Pittsburgh. Prior research has found African American families of lower socioeconomic status to be more likely to bed share. A strong majority of participants were female and African American; half of the participants were single, and three mothers breastfed.

This study, published in the February 2009 Academic Pediatrics journal, was funded by the Department of Pediatrics, University of Pittsburgh School of Medicine.