Co-Sleeping: Benefits & How To Do It Safely

Imagine you just brought your newborn baby home from the hospital. You go to get your unbearably cute little bundle of joy to sleep, but you’re stopped cold in your tracks.

Why did the doctors, nurses, and most every other well meaning advice giver tell you to NEVER sleep with your baby? After all, continuing the closeness you felt all throughout your pregnancy seems and feels like the right thing to do.

Well, you’re not alone in feeling this way. Co-sleeping, as the practice is called, is broadly accepted around the world in most cultures.

In fact, despite all of the scaremongering and judgmental opinions, the Centers for Disease Control (CDC) found that almost half (44%) of American babies aged 2-9 months experience co-sleeping on any given day.

So, what is co-sleeping exactly, anyways? I’m glad you asked!

What Is Co-Sleeping?

In its simplest definition, co-sleeping is the practice of parents sleeping in close proximity with their children.

There are any number of different arrangements and variations for accomplishing this simple goal, but the one that many people assume when they hear the term co-sleeping is actually bed sharing.

Bed sharing is just as it sounds, having a baby or child sleep in the same bed as their parents.

As we’ll be explaining in the next sections, though, bed sharing is hardly the only (actually not the preferred) method of co-sleeping. As a matter of fact, the following link from Nemour’s hospital discusses the safety risks of bed-sharing.

So, read on with an open mind and don’t feel like you’re limited to just one approach.

Different Methods To Co-Sleeping With A Baby

1) Unlimited Bed Access

In this scenario, children are put to sleep in their own beds, either in the parent’s room or the child’s own room.

If at some point during the night the child walks back in and climbs up into the parent’s bed, then they are allowed to stay.

Similarly, if a baby cries for their parents and won’t go back to sleep alone, then they too are permitted to sleep in their parent’s bed.

2) Room Sharing With Separate Sleep Surfaces

If this category seems a bit long winded, it’s because it is a broad definition.

Suffice it to say, if your child is in your room but not sleeping on your actual bed sheets right next to you, then it qualifies for this category.

Some arrangements that fit this type include:

A) Separate Kid Beds

For many, the ideal setup is to provide their children with their own small beds right next to the parent’s bed.

This eliminates any risks involved with bed sharing, while still keeping kids close enough to respond quickly when they wake at night.

For babies, moving a crib or bassinet right next to the parent’s bed accomplishes the same thing.

B) Bed Within A Bed

For others who fear full bed sharing but wish to have their babies right there with them, a Moses basket is the answer.

Moses baskets are essentially mini cribs with handles so you can pick them up and put them wherever in the house you need them to be.

With one of these in your bed, your baby is protected while staying within arm’s reach.

They are bulky to have in bed, but make up for it with safety.

C) Attaching A Sidecar

Maybe a Moses basket is too large or obtrusive for you to fit in your bed. If so, then consider a sidecar crib.

Just as a sidecar is attached to a car but remains separate too, a sidecar crib stands right up against or gets connected to the parent’s bed.

For easy access to your baby, these specialized cribs have one side able to be dropped down lower than the other three.

With the side facing the parent’s bed lowered to just a few inches above the level of the crib mattress, the nearby parent can easily reach an arm over to soothe the baby.

D) Suspended Cribs

If you’re a fan of sidecar cribs, then you’ll love this one! This takes the idea of sidecar cribs to new heights.

Rather than attaching a standing crib to the main bed, suspended cribs hang from a secure anchor point in the ceiling. The straps or ropes come down from the anchor and support the crib in the air.

This allows you to choose any position in your room to have your baby, whether right over the middle of the bed, off to the side, or anywhere nearby.

It also has the perk of letting you rock the crib back and forth to better soothe your baby to sleep, all without you having to even sit up.

3) Same Bed Sleeping

This last way is the one most criticized and most feared by some, but also has been the norm for thousands of years of human history.

Having your baby in the bed right next to you is a natural instinct, and one that is thought of as completely normal in certain countries.

In fact, people from other cultures tend to react with horror or just pity when hearing that some Western parents keep their babies in another room at night.

Outside of the United States, Canada, and Northern Europe, babies and even older children are kept with a parent or family member at all times.

With that being said, this is not advised. If you’re worried about the safety aspect, you should be! There are no reliable ways to make bed sharing safer.

Note from Dr. Leah Alexander, M.D., F.A.A.P.: “Don’t be fooled by anyone who tells you you can make bed sharing safer. There really aren’t ways you can do that, and stating this is confusing for parents.

Adult bed mattresses are not the proper firmness for infants, blankets/sheets are suffocation risk, and then there is the risk of the parent rolling over onto the baby.

Here is the policy statement from UNICEF.

Also, since it’s mentioned that non-Western cultures are more accepting of bed-sharing practices, here is a research article from the WHO which studied breastfeeding and bedsharing in 46 countries. They did not find any benefit to bed-sharing.

What Are The Dangers That Co-Sleeping Involves?

Now if you’re a new mom bringing home your newborn from the hospital for the first time and you’ve read this far, you may be wondering what sane person would ever refuse to co-sleep.

Well, if so, this next section is when things could start getting downright scary. As a parent, you deserve to learn all the facts no matter what, so you can make your own well-informed decision.

A Quick Look At Some Statistics

Accidental strangulation or suffocation of infants under the age of 1 year has been deemed the cause of over 900 deaths a year in America.

There have been deaths due to suffocation when a parent rolls over onto the baby. There have been babies falling off high beds, parent’s long hair causing strangulation, and an increased risk of SIDS when babies end up lying prone on a soft surface.

At first glance, you would think nightmare scenarios like these would be enough to never chance your baby’s life by bed sharing. Who cares if the rest of the world is okay with it, right?

Well, as frightening as 900 deaths a year sound, a deeper dive into the statistics is warranted.

In recent studies, most of these bed sharing deaths are found to have at least one other independent risk factor involved – which you should know about.

What Risk Factors Should You Consider?

The majority of bed sharing deaths have occurred when the parent was being otherwise unsafe (whether knowingly or unknowingly) or negligent.

The following are a handful of the top reasons.

1) Drug And/Or Alcohol Use

If an adult has been drinking or taking any drugs that can affect their alertness or ability to wake, then they should NEVER be sleeping on the same surface with a child.

This includes prescription medications such as pain pills, muscle relaxers, and of course sleeping pills.

An intoxicated or medicated person very well may not notice when they roll onto or otherwise threaten their baby’s health.

2) Prone Sleeping Position

Evidence has been shown for a higher SIDS rate happening when infants are laid down on their bellies, or prone.

When a baby is too young to roll over easily on their own, they should be kept on their back. This is why there exists the famous saying “back is best.”

Here is the AAP’s policy statement on this, encouraging infants sleeping on their backs.

3) Bed Too Soft

Adult beds, at least those in many Western cultures, are not built with a baby in mind at all.

They are fluffy and cushioned to the extreme, which makes a horrible sleeping surface for a baby.

Perhaps this is an explanation of why other cultures embrace co-sleeping more. The beds in most of these other cultures are much harder and safer for both adults and infants alike.

4) Older Children In Bed

Having other kids sleeping in the same bed as an infant is a very risky choice. Kids flail and roll all over the bed at times, and they could easily injure or kill an infant by accident.

This is why having kid beds in the same room is an appealing option for some multiple child families.

5) Long Hair

As we mentioned earlier, a parent with long hair will not be aware of it if their hair gets tossed over the face of the baby.

Hair can get wrapped around their throat or cover their mouth and nose, causing strangulation or suffocation as a result.

It may not seem likely, but cases of SIDS have often seemed to stem from causes such as these. A simple ponytail or hair bun is usually all it takes to nearly eliminate this risk factor.

6) Large Bed Sheets Or Comforter

Similar to the last issue of long hair covering the baby, bedding has caused babies to suffocate or die from SIDS.

The sleeping bags mentioned above are a safe alternative.

7) Obese Parent

For parents who are extremely overweight, it can be much harder to feel or be aware of when an accidental rolling over the baby happens.

Again, sleeping bags might help greatly reduce the chance of an unfortunate accident happening.

8) Premature Birth

Preterm babies are often developmentally behind other healthy full term babies.

Their lungs and other organs are still weaker than most, which puts them at a greater risk for SIDS and other accidental deaths.

So, What’s The Takeaway Here?

When all of these preventable risk factors are taken into account and eliminated, the danger of SIDS and other accidental deaths drops drastically.

If parents employ the same room but separate surfaces method of co-sleeping, the American Academy of Pediatrics (AAP) found the chance for SIDS is reduced by as much as 50% over separate room sleeping.

Dispelling Co-Sleeping Myths

Alright, so if some versions of co-sleeping are actually as safe as (or even safer than) separate room setups, perhaps you’ve heard about some other myths that make you hesitate.

We’ll go through a few of the ones most often given as reasons not to co-sleep, and why each one is either blown way out of proportion or just plain wrong.

1) “It Will Make Your Child Too Clingy”

One typical reason people avoid co-sleeping is a fear of the child becoming too dependent on being with their parent at all times.

The assumption here is unless your child learns to be independent in their own room at a very young age, it will lead to developmental delays and behavior issues down the line.

Well, despite a lack of quality studies on this subject, what evidence we do have nowadays points to the opposite being true.

Having a parent close at all times during infancy and even early childhood has been shown to improve levels of independence and lessen the rate of psychological problems later in life.

The idea is that children who bond closely with their parents through co-sleeping feel more self assurance and have higher levels of confidence, which then helps them be more secure to develop their own independence.

Note from Dr. Leah Alexander, M.D., F.A.A.P.: “There are medical authorities that report benefits of room sharing. Others, however, report better quality of infant sleep when in a separate room from the parent.

For example, the journal “Pediatrics” published a study that shows the benefit of separate sleep arrangements after 4 months old.

In clinical practice, I find that older infants and toddlers learn to self-soothe at a younger age when they sleep in a separate room from their parents.

Having a baby monitor allows the parent to observe what is going on when the baby wakes at night without having to go into the room.

I find that, if the crib is kept in the parents room, they see the parent and immediately look to him/her for comfort. In my opinion, this prolongs the process of learning how to self soothe.

That said, each patient and family situation is different. It is best to have a discussion on what works best for the family and what is safe for the baby.”

2) “Your Kid Will Never Learn To Sleep Alone”

All children will make the transition to falling asleep alone in their own rooms at some point. There’s no valid reason to claim babies who co-sleep are in for a rougher switch over.

Parents generally know when it’s the right time for their child to make the change.

Listen, getting a kid to start going to sleep alone is no easy task for anyone. Whether coming from co-sleeping or getting their night’s rest in a crib, all children need to feel safe and secure.

When it’s time, help them ease the transition by laying near them as they fall asleep. A favorite blanket or bedtime song will also help relax them.

Regardless of where they’re sleeping, establishing a routine is far more important than if you’re co-sleeping or not.

Note from Dr. Leah Alexander, M.D., F.A.A.P.: “This brought to mind a few cases of patients who are grade school-aged and still sleep with their parents. The most extreme is an 11 year old who is 5 feet tall and still sleeps with his parents.

The parents are frustrated and exhausted, mostly because he takes up so much room in the bed. He is an otherwise normal 11 year old without any psychological issues.

In this case, after explaining to the patient that he is old enough to sleep in his own room and bed, I suggested that the parents get a lock for their bedroom.”

3) “It’ll Be The End Of All Romance”

This excuse has to be the funniest one by far (or the saddest one, depending on how you look at it).

Co-sleeping means that during nighttime hours, your baby will be close enough to be attended constantly.

Now for the unimaginative out there, this might spell the end of the parent’s love life. But we’re fairly certain there are other hours of the day and other rooms in your house in which you can keep the spark alive.

Besides, during the first couple months of the baby’s life, the mother may not be physically or mentally ready for any funny business.

Parents with very young children are regularly exhausted as well, so spend your nights getting some much needed sleep and bonding with your little one.

If romance is on your minds, we have full confidence a little co-sleeping is not going to be able to stop you.

What Are The Benefits To Co-Sleeping?

We’ve talked so much about the negatives that co-sleeping with a baby involves, now let’s discuss all the reasons why co-sleeping can be very beneficial to both you and your baby.

After all, this method has been the standard for thousands of years and has stood the test of time for a reason.

Back in caveman times, it made a lot of sense to keep babies very close and soothe them before any predators heard. Nowadays, the risk from sabre tooth tigers has disappeared, but there are still plenty of other amazing benefits you need to know about.

1) Improved Breastfeeding

For mothers who are breastfeeding, there are numerous advantages that come with co-sleeping, the most obvious of which is easy access.

With your little one close enough to touch, feedings can happen naturally (especially direct breastfeeding).

Since babies don’t have to get upset enough to cry out and wake themselves up, it will cut down on the time spent putting them back to sleep.

The frequent and less stressful feedings leads to better bonding and increased milk supply.

2) Better Sleep For Everyone

This may seem counter-intuitive to those who have never incorporated co-sleeping, but both adults and babies enjoy greatly improved sleep.

Parents are able to sense so much more of their baby’s movements, from seeing and hearing their breathing to noticing every tiny toss and turn. Such peace of mind is priceless.

This works both ways. Just as a parent can sleep easier having their baby within arm’s reach, children can feel and even smell when their parent is close. This soothing effect is even more pronounced when their breastfeeding mother is near.

3) Lowered Separation Anxiety

People from countries where co-sleeping is accepted will attest that the idea of sleeping in different rooms from their baby would cause them a great deal of stress.

Parents in the U.S. and northern Europe feel this separation anxiety, as do their babies, but norms scare them into sticking to different rooms.

Having your baby close to you means everything as a parent, and it lowers everyone’s stress levels when there’s the instant ability to soothe and be soothed.

At What Age Should I Start Co-Sleeping With My Baby?

As with most decisions, there is usually no right “one size fits all” answer for everyone. Each and every case is unique and involves different factors that should be taken into consideration. Finding your unique path as a parent is part of the challenge.

What we can do, though, is give you some suggestions based on plenty of research available out there and personal parenting experience.

Starting Right From Birth

Co-sleeping should be done starting at birth, and should continue until you and your child are ready to transition away from it.

As we’ve covered, though, co-sleeping has a broad range of definitions.

What’s recommended right from birth is co-sleeping in the same room with separate surfaces. This just so happens to be what the AAP now recommends as being best too.

Here is the AAP article about suitable sleeping sites.

No Bed Sharing At First

What’s not recommended is bed sharing with an infant, and especially not one younger than 6 months old. After age is when the risk of SIDS and accidental suffocation starts to drop precipitously.

We realize that for some parents, particularly those who are breastfeeding, nothing anyone says will stop them from sleeping curled right up around their baby – but please do your research about this for your own baby’s well-being. 

For those who insist on bed sharing on the same surface, consider using a harder bed, sleeping bags, or any other previously mentioned safety technique. Above all else, never share a bed with an infant after you’ve had drugs or alcohol.

Some Last Words Of Advice

The truth is, the odds of anything bad happening if you take all of the above into consideration and act responsibly are vanishingly small.

Remember that statistic earlier saying roughly 900 babies die in America each year from accidental sleep related deaths? Well, there are nearly 4 million births in America each year as well.

Put the 2 numbers together and you can see the risk is somewhere in the vicinity of dying from a bee sting or by a lightning strike.

Parenting is full of difficult choices to make, this much we can all agree. Make your own decision on whether to co-sleep, but be well informed first and make sure it’s based on solid facts – not myths.

Talk it over with your spouse or any other primary caregiver and have both of you agree on the plan moving forward.

It seems even the Western medical establishment is finally coming around to what humanity has been practicing for millennia. So give safe co-sleeping a chance, and spread the word.

Note from Dr. Leah Alexander, M.D., F.A.A.P.: “As a medical professional, it’s not that we are trying to make life difficult for parents. We are just trying to make sure infants are safe and prevent SIDS.

Over the years I have practiced pediatrics, I have had three patients who have died from SIDS. I can tell you that these were truly awful experiences for me and the parents. Based on these experiences, I cannot, in good faith, recommend bed-sharing for infants.”

Wanting to sleep beside your baby is not something you should feel as if you need to hide from the world and be ashamed of. On the contrary, it’s completely normal. Wanting the opposite is abnormal.

As more Western doctors become accustomed to its benefits, co-sleeping can shed its taboo status and enter the mainstream really soon.

Do you have any tips on successful co-sleeping or advice for those thinking of trying it out? We’d love to hear from you!

Note from the KidSimplified Team: As you can see by now, we want to be inclusive of all practices in our article.

We’ve shared both sides of the story for you, including the opinions and recommendations of a board certified pediatrician that has been in practice for more than 20 years.

Now that you know the facts and have listened to both sides of the story, the choice is yours!

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Medically Reviewed By: Leah Alexander, M.D., F.A.A.P.

Medically Reviewed By: Leah Alexander, M.D., F.A.A.P.

Leah Alexander, M.D. FAAP began practicing pediatrics at Elizabeth Pediatric Group of New Jersey in 2000. She has been an independently contracted pediatrician with Medical Doctors Associates at Pediatricare Associates of New Jersey since 2005. After graduating from Kalamazoo College and Michigan State University College of Human Medicine, she completed her pediatric residency at Overlook and Morristown Memorial Hospitals. She is board certified in General Pediatrics.

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