Parents have long been told that babies should sleep in their own crib to reduce the risk of sudden unexpected infant death (SUID), yet nearly one in five infant are still sleeping in their parents' bed, a new study finds.
To decrease the risk of SUID, or sudden infant death syndrome (SIDS), the American Academy of Pediatrics recommends that parents share their room with their baby until at least six months, and ideally up to one year. The AAP also advises against bed-sharing, but new parents may be getting varying advice on bed-sharing from their paediatricians, the study suggested.
The social norm
About 59% of new moms said they intended to share rooms without bed-sharing. But only 45% of those who said they planned to only room-share had done so in the past two weeks.
"We found a lot of mothers are bed-sharing despite AAP recommendations to room-share without bed-sharing," said study lead author Dr Ann Kellams, a professor of paediatrics at the University of Virginia.
Kellams said there are several reasons parents might still choose to bring baby to their bed. "There is a subset of people that really feel like bed-sharing is necessary for breastfeeding and, culturally, infants routinely sharing the bed is sometimes the social norm," she said. And, she noted there are some families that just don't have a separate safe place for the baby to sleep.
Why is it so important to keep baby out of your bed? "We worry about accidental suffocation. In our Western society, we love soft pillow-top mattresses and cosy thick comforters and pillows. Those things pose a risk of smothering and strangulation. People think they'll wake up, but when babies suffocate, it's usually a very quiet, silent event," Kellams explained.
Dr Jillian Parekh, a paediatrician at Children's Hospital at Montefiore said that bed-sharing is one of the biggest risk factors for SUID. She was not involved with the study.
"Adults rolling over or something covering the baby's mouth can suffocate, but even just sleeping next to other people leads to lower oxygen levels that put babies at a higher risk," Parekh said.
To bed-share or not
The study included nearly 3 300 new mothers from 32 US hospitals. They completed a survey when their infants were between two and six months old – most were between eight and 11 weeks old. The moms answered questions about infant sleep locations during the past two weeks, and intended sleep locations for the next two weeks.
Two-thirds of moms reported room-sharing at least part of the time. Fifty-one percent of mothers said they exclusively room-shared with their infants. Another 11% said their babies exclusively slept in another room.
Twenty percent of moms said they bed-shared with their baby at least part of the time. Ten percent exclusively bed-shared, and 18% both room-shared and bed-shared.
When asked about the sleep habits they intended to practise in the next two weeks, slightly more moms were going to have their babies sleep in another room, and about 24% of moms said they intended to bed-share.
Black and Hispanic mothers were less likely to plan on having their infants sleep in another room compared to white mothers.
When doctors told women to room-share without bed-sharing, they were less likely to plan on bed-sharing.
Having a plan is key
Kellams said she hoped the study highlighted the possible differences between what parents plan on doing and what they actually do. "Paediatricians need to be skilled at these conversations to find out what the barriers might be for safe sleep. Ideally, you want these conversations to happen before parents have the exhaustion and stress of having a new baby," she said.
"We spend so much time preparing mothers for birth, and that lasts just a few minutes to a couple of days. But we hardly spend any time preparing people to be parents," Kellams said.
Parekh agreed that having a plan is key. "The study showed that even with the best of intentions, it can be hard to follow the best sleep practices. Start thinking about this and safe sleep before the baby is even here and commit to a safe plan. Have a crib or bassinet in the room to help make breastfeeding more accessible," she said.
If cost is an issue in having a separate bed for baby, Parekh said to talk to a paediatrician. She said there are programmes that provide safe cribs to parents.
The study was published in Pediatrics.
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