The American Academy of Pediatrics endorses and accepts as its policy the position on bed sharing as articulated below by a panel of experts convened by the National Institute of Child Health and Human Development (NICHD).* The Panel attended a conference sponsored by the NICHD entitled “Infant Sleep Environment and SIDS Risk” in Bethesda, MD, on January 9–10, 1997. After hearing presentations from a variety of experts from the United States and several other countries, the Panel prepared the following statement regarding the relationship of bed sharing and SIDS.
A variety of risk factors have been identified for sudden infant death syndrome (SIDS). Prone sleeping by infants has been one of the most consistent risk factors for SIDS and avoidance of prone sleeping has been the focus of several national campaigns to prevent SIDS (“Back to Sleep”). Recently, scientific studies have demonstrated that bed sharing, between mother and infant, can alter and synchronize sleep patterns of mother and infant. These studies have led to speculation in the lay press that bed sharing, sometimes referred to as co-sleeping, may also reduce the risk of SIDS. While bed sharing may have certain benefits (such as encouraging breastfeeding), there are no scientific studies demonstrating that bed sharing reduces SIDS. Conversely, there are studies suggesting that bed sharing, under certain conditions, may actually increase the risk of SIDS. Also, it should be noted that no benefits have been shown for infants sleeping with individuals other than the mother. Observations related to these issues include the following:
Soft bedding placed under a sleeping infant is also a risk factor for SIDS.
National campaigns aimed at reducing prone sleeping and soft sleep surfaces have been linked with a substantial decrease in prone sleeping and a significant decrease in SIDS rates.
Until more definitive studies evaluating the relationship between bed sharing and SIDS become available, the following considerations appear reasonable:
Unless otherwise directed by a physician, healthy infants should be placed down to sleep supine, whatever the sleeping environment.
If mothers choose to sleep in the same bed with their infants, care should be taken to avoid using soft sleep surfaces. Quilts, blankets, pillows, comforters, or other similar soft materials should not be placed under the infant.
The bed sharer should not smoke or use substances such as alcohol or drugs that may impair arousal.
Although SIDS is sometimes known as “crib death,” caretakers should be assured that cribs do not cause “crib death.”
Unlike cribs, which are designed to meet safety standards for infants, adult beds are not so designed and may carry a risk of accidental entrapment and suffocation.
There is no basis at this time for encouraging bed sharing as a strategy to reduce SIDS risk.
Task Force on Infant Positioning and SIDS, 1996 to 1997
John Kattwinkel, MD, Chair
John Brooks, MD
Maurice E. Keenan, MD
Michael Malloy, MD
Marian Willinger, PhD
* Panel members included: John Brooks, MD, Dartmouth Medical School, Hanover, NH; John Kattwinkel, MD, University of Virginia, Charlottesville, VA; Allen Mitchell, MD, Boston University, Boston, MA; Peter Scheidt, MD, Children's National Medical Center, Washington, DC; Bradley Thach, MD, Washington University, St. Louis, MO; Sally Davidson Ward, MD, Children's Hospital of Los Angeles, CA; Marian Willinger, PhD, National Institute of Child Health and Human Development, Bethesda, MD.
The recommendations in this statement do not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be appropriate.
- NICHD =
- National Institute of Child Health and Human Development •
- SIDS =
- sudden infant death syndrome
- Copyright © 1997 American Academy of Pediatrics