A Parent’s Guide To Co-Sleeping And Bed-Sharing

Few parenting topics spark as much passion and ire as co-sleeping. The term refers to the practice of babies sleeping close, within “sensory range,” of their caregivers at night. Co-sleeping can but doesn’t necessarily mean that babies sleep in the same bed as their parents; alternatively, babies can sleep in a separate bassinet in the same room or in one that attaches to the parents’ bed. Keeping babies in the same room during the night until they’re 1 year old is the recommendation of the American Academy of Pediatrics (although families really into co-sleeping might do it for years).

The Arguments for Co-Sleeping

It’s the most natural thing in the world to sleep with your baby, even a “biological imperative,” according to co-sleeping’s major proponent, University of Notre Dame anthropologist James McKenna, Ph.D., author of Sleeping With Your Baby: A Parents Guide To Co-Sleeping. It’s commonplace in Asian and Scandinavian countries, which have lower rates of Sudden Infant Death Syndrome (SIDS) than we do in the U.S. Co-sleeping helps infant-caregiver bonding, keeps babies safer because parents are close enough to hear any breathing problems babies might have during the night, and the arrangement is ideal for babies who are breastfed because the more-frequent feedings will be less disruptive for both mother and child. Breastfed babies will need to feed more often during the night because breast milk is not as calorically dense as cow’s milk, he also notes.

Co-sleeping isn’t just practical, it’s important for kids’ emotional development, according to McKenna’s website. Addressing criticism that co-sleeping might make children overly attached to or too dependent upon their parents, he cites a 2004 study finding that kids who began co-sleeping in infancy were more self-reliant and independent than kids who weren’t.

Why Co-Sleeping Isn’t Right for Everyone

Critics of co-sleeping have just as many counterarguments, however. Parents can create strong bonds with their babies without co-sleeping, they say, and there isn’t sufficient evidence to conclude that kids will suffer emotionally if parents don’t sleep in the same room or bed with them, says Roseanne Lesack, PhD., a psychologist, board-certified behavior analyst and director of the Unicorn Children’s Foundation Clinic at Nova Southeastern University in Fort Lauderdale, Florida.

“I don’t know if there’s much good research showing a significant difference between babies who slept with their parents versus babies who slept in a separate room,” Lesack says. “It’s important to not jump to conclusions, and saying there’s only one way to be a good parent doesn’t take into account the variability among humans.”

Parents who are very light sleepers and babies who are particularly loud sleepers (most babies are pretty noisy during the night), for example, might not be a good co-sleeping match so those babies should be moved out of the room after a few months, she says.

“If you’re literally not sleeping because your child is in the room with you, don’t kill yourself trying to make co-sleeping work,” she says, noting that each of her three children called for different sleep arrangements when they were babies and they all turned out fine. “There are a lot of ways to raise healthy children while staying sane.”

In addition, breastfed babies don’t need to feed more often than bottle-fed babies, says Janet Kennedy, Ph.D., a clinical psychologist, founder of NYC Sleep Doctor, a sleep-consultation service and author of The Good Sleeper: the Essential Guide to Sleep for Your Baby (and You).

“People say that breastfed babies can’t sleep through the night because breast milk is digested faster than formula, but that’s just not the case,” Kennedy says. “I’m all for breastfeeding, and it definitely helps to have the baby nearby whether in co-sleeper attached to bed or a bassinet or crib. But the problem is that at a certain point, the baby will wake up more and feed more when they don’t need to. What that does is end up interfering with the ability of the baby to go back to sleep independently.”

Kennedy says she doesn’t think the AAP recommendation of co-sleeping for the first year is feasible for many parents, and the authors of a 2017 study published in Pediatrics questioned the recommendation as well, noting in their paper that kids who slept separately by 4 and 9 months got more and safer sleep. Kennedy recommends that most parents move their babies into another room by the age of 6 months.

“If the object is to teach the baby to return to sleep, that will be better done farther away from the mother, not in a co-sleeper,” she says. “It’s a difficult transition to make, but it’s also important to think about your longer-term goals and whether you can accomplish them with the baby sleeping next to you.”

But the biggest problem critics have with the type of co-sleeping in which babies share a bed with their parents is the well-documented risk to the baby’s safety.

“Co-sleeping is a major cause of sleep-related deaths in the U.S.,” says Emily Scott, MD, medical director of the Well Newborn Nursery at Indiana University Health Methodist Hospital, assistant professor of clinical pediatrics for Indiana University School of Medicine and co-chair of the Indiana American Academy of Pediatrics Perinatal and Infant Mortality Committee. “When parents co-sleep with their babies, especially in the first 4 months of life, the chance of the baby dying during their sleep rises significantly.”

Babies can die from suffocation, either in the bedding or if the parent rolls over onto the baby, she says. Babies can also roll off the bed or get wedged in between the bed and the wall. The risk of the baby dying while co-sleeping rises even more when co-sleeping occurs on a couch, chair, or waterbed. There’s also a risk that a baby could be strangled by a parent’s long hair (yes, really) if they sleep in the same bed with you.

Parents should keep the “ABCs” of safe sleep in mind, which are that babies should sleep: All by Myself (no co-sleeping, no stuffed animals, pillows, or fluffy blankets), On my Back (no side or stomach sleeping), and In my Crib (or bassinet with a flat, firm mattress), Scott says.

Experts know parents aren’t perfect, but they urge them to be as careful as they can when it comes to sleep safety. If you want your baby to sleep in bed with you, you need to be absolutely sober and not have taken any medications that can cause drowsiness, in addition to the ABCs of sleep safety. Co-sleeping also is considered less safe for smokers. McKenna recommends using Arm’s Reach co-sleepers, but note that the AAP says there isn’t enough evidence supporting their safety to recommend them.