Know the Risks – Cleveland Clinic


It’s understandable that parents want to be close to their baby while they sleep at night. But being too close sharing a bed increases an infant’s risk of injury or death – a warning highlighted in the Safe Sleep Recommendations.

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The solution? Set up your baby as a roommate instead of a bedmate. It’s a distinction that could save lives, says pediatrician Heidi Szugye, DO, IBCLC. Here’s why.

The risks of bed sharing

There’s nothing subtle about this advice from the American Academy of Pediatrics (AAP): “Never sleep with your baby.

The AAP recommends that parents do not share a bed with their baby. The reason? An infant’s risk of sleep-related death during bedsharing is five to 10 times higher during this early stage of life, Dr. Szugye says.

Simply put, an adult bed is not installed with the safety of babies in mind. Parents can accidentally roll over their babies when they are sleeping. In addition, high, soft pillows, bedding and mattresses increase the risk of Sudden Infant Death Syndrome (SIDS) or injury or death by:

  • Suffocation.
  • Strangulation.
  • Trapping.
  • Falls.

“Bed sharing is linked to SIDS. There is no doubt about it,” says Dr. Szugye. “We don’t recommend it for babies of any age.”

(As an aside, the term “co-sleeping” is often used for bed-sharing. However, the phrase is also used to describe the recommended practice of room-sharing, which we’ll get to in a moment. ‘AAP and many pediatricians avoid the term co-sleep to avoid confusion.)

What if you slept on sofas and chairs?

Falling asleep with a baby on a soft sofa or armchair is even more dangerous than sharing a bed with him. The AAP reports that an infant’s risk of sleep-related death can be up to 67 times greater in this situation.

Other risk factors when sleeping with a baby

Sharing a sleep surface with a baby is cause for concern in itself, but the arrangement becomes even more dangerous if the adult is overtired or has been:

  • Drinking alcohol.
  • Consuming marijuana.
  • Taking medications or drugs that make you groggy.

“You especially want to avoid bed sharing in any of these situations,” Dr. Szugye points out.

Are the risks of bed sharing higher with some babies?

Absolutely. Sharing a bed with a baby is riskier if the child is under 4 months old, says Dr. Szugye. Also, the level of risk increases if your baby was born premature or with a low birth weight.

Room sharing: a safer option

Keeping your baby close while sleeping doesn’t mean they have to be in the same bed, says Dr. Szugye. Instead, consider a “room sharing” approach, where you place your child’s crib or bassinet next to your bed.

This configuration allows your baby to be next to you but in their own sleeping environment. The AAP reports that room sharing can reduce the risk of SIDS by up to 50%. (Learn seven ways to reduce your baby’s risk of SIDS.)

“It’s a good alternative to bed sharing,” says Dr. Szugye. “It maintains the closeness that can make life easier for parents while allowing your baby to sleep in a safer space that meets their needs.”

Tips for Creating a Safe Sleep Environment for Babies

To reduce the risk of sleep-related infant death, the AAP recommends the following:

  • Place babies on their backs to sleep.
  • Babies should sleep in their own space without anyone else.
  • Make sure your baby’s crib meets current standards with a firm, flat mattress that fits snugly in the crib.
  • Use only a fitted sheet and keep blankets, pillows, or stuffed animals out of the sleeping space. (Also avoid using padded crib bumpers.)
  • Breastfeed, if possible.
  • Avoid smoking.

How often is bed sharing?

Despite the warnings, studies show that bed sharing with babies is still a common practice. In fact, 61% of caregivers of infants reported some form of bedsharing with babies, according to the Centers for Disease Control and Prevention (CDC).

Reasons given for bed sharing include:

  • Cultural practices and tradition.
  • Convenience for food.
  • Comfort a child who is not feeling well.
  • Parent-child bond.

Deep feelings for bedsharing have made recommendations warning against the practice somewhat controversial. There are also studies showing that bed sharing can promote breastfeeding and help calm infants.

But that doesn’t erase the clear evidence that bed-sharing increases the risk of sleep-related death for babies.

“The recommendation against bed sharing is based on data,” says Dr. Szugye. “It’s something parents need to consider when making decisions about how best to care for their child.”


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