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JAMA Pediatrics Patient Page
November 2013

The Controversial but Common Practice of Bed Sharing

JAMA Pediatr. 2013;167(11):1088. doi:10.1001/jamapediatrics.2013.4150

Bed sharing, also known as co-sleeping or co-bedding, refers to a caregiver sleeping in the same bed as an infant. This practice takes place in many cultures including the United States. In this month’s JAMA Pediatrics, a large research study found that between 1993 and 2010 the number of US caregivers who bed share with infants had increased from 6% to 13.5%.

For parents who decide to bed share, there are several safety practices to consider:

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    3 Comments for this article
    You've got to be kidding me!
    Merrily Wholf | Public Health Nurse
    What happened to the AAP recommendations to reduce the risk of SIDS and sleep-related deaths?? While this article pays lip-service to making sure the bed sharing arrangement is as safe as possible, the accompanying graphic shows a sweet baby in a death trap of blankets, pillows and a sleeping adult's arm dangerously draped over the infant. Ask any child fatality review board how many deaths they have reviewed with similar scenarios. As public health professionals, we need to advocate for the highest standard of health and safety In a non-judgemental manner. This article appears to advocate the opposite.
    Improper parent education
    Scott Krugman | MedStar Franklin Square Medical Center
    The safest sleep position for infants is alone, on their back, and in a crib (ABC of safe sleep). The relative risk of dying in a adult bed for infants under 6 months is so significantly higher than placing a child in a safe position that to recommend \"safe bedsharing\" is not appropriate. The recent AAP policy statement clearly states that \"there is insufficient evidence to recommend any bedsharing as safe.\" (Pediatrics 2011;128:e1341–e1367) To promote bedsharing in this journal, especially coupled with the recent commentary that bed sharing per se is not dangerous runs counter to current AAP policy and what is known by everyone who is working on preventing sudden unexpected deaths in infants. The ABC safe sleep message works, bedsharing does not.
    Bed Sharing is not a Safe for Infants
    Eileen E. Tyrala, MD FAAP | Medical Director, Cribs for Kids, PIttsburgh, PA
    In 2011, the American Academy of Pediatrics Task Force on Sudden Infant Death Syndrome issued an expansion of its' 2005 recommendations for a safe infant sleeping environment. The purpose of both of these statements was to reduce not only the risk of SIDS but also infant deaths that occur due to accidental strangulation and suffocation in a sleep environment. These recommendations, among other things, emphasize the importance of maintaining a separate but proximate (and uncluttered) sleep environment for an infant for maximum safety. Dr. Moreno 's comments on bed sharing imply that because bed sharing (or at least our knowledge and/or awareness of it) is becoming more common, that this makes it a more legitimate sleep practice for infants and parents. As opposed to a safety check, the reality check here is that in 2010 alone, 3610 infants died a sleep related death, many of which could have been prevented if the infant had been in a safe sleep environment. Bed sharing with an infant in an adult bed is not a safe practice and can result in the death of an infant. Dr. Moreno's comments do not emphasize the real hazards of this practice and I fear may reassure many unsuspecting parents that this is a safe and reasonable practice for them to adopt. Nothing could be further from the truth.Eileen E. Tyrala, MD FAAPMedical Director, Cribs for KidsPittsburgh, PA