Co-sleeping is good, safe, recommended, but bed-sharing is "bad," "dangerous," verboten. So what’s the difference between co-sleeping and bed-sharing? Many parents don’t actually know, but the difference of a few feet is crucial to infant safety, according to pediatric specialists.
The success of the "back to sleep" effort in the ‘90s reduced SIDS rates by half according to the American Academy of Pediatrics (AAP), but the rate of accidental suffocation and strangulation has quadrupled since that time (CDC) in part because parents now look to solve poor infant sleep by bed-sharing. Some of the parents who bed-share mistakenly believe they are following the American Academy of Pediatrics' safe sleep guidelines, which advocate "co-sleeping" for at least six months. And it’s not just a problem of terminology — bed-sharing is practiced in other cultures, and feels “natural” to many families.
The terms "co-sleeping," "bed-sharing," and "room-sharing" are often used interchangeably by parents when talking about the best sleep environment for their family. And while there are slight similarities between these three terms, it’s important for you to understand the considerable differences (especially as they relate to safety) before making the best decision for your family. So we spoke to experts who explained exactly what the difference is, and how to keep our babies safe.
What Is Bed-Sharing?
Bed-sharing is exactly what it sounds like: A sleeping arrangement where an infant or child sleeps in the same bed with their parents. Supporters of this sleeping arrangement prefer having their infant in bed with them for a variety of reasons.
Many believe it helps them feel more connected to their infant, especially if they have been away from them during the day.
Some say they prefer the ease and convenience bed-sharing provides for breastfeeding moms to nurse and get their sleep cycle in sync with their baby’s, while others say it can help babies fall asleep (and go back to sleep after waking up in the middle of the night) more easily. And many believe it helps them feel more connected to their infant, especially if they have been away from them during the day.
Lydia Smith, who is in her 40s, tells Romper that when her daughter was a baby, she chose bed-sharing because it “made nursing much easier, which helped both of them sleep better.” She says she never had any issues with safety and would do it again.
However, her opinion is not shared by the experts. “Bed-sharing increases the risk of infant death through overlay, strangulation, suffocation, and Sudden Infant Death Syndrome or SIDS," Cribs for Kids program manager Shauntay Murray tells Romper.
Dr. Rachel Prete, a pediatrician at Arnold Palmer Hospital for Children, tells us that bed-sharing has been associated with an increase in Sudden Infant Death Syndrome (SIDS) and other suffocation injuries due to the risk of a sleepy parent or caregiver rolling onto the infant or smothering them accidentally during a heavy sleep.
The American Academy of Pediatrics is against bed-sharing in any situation and cautions that there are certain situations that can make bed-sharing even more dangerous. These include having an infant fewer that four months of age, a baby born prematurely, parents who smoke, and the parent or caregiver taking alcohol or medication for sleeping.
What Is “Co-Sleeping” According To The AAP?
The AAP defines co-sleeping as sharing a room with your infant but lying on separate sleep surfaces. Since bed-sharing is often also referred to as co-sleeping, some experts use the term “room-sharing,” when describing co-sleeping arrangements. Room-sharing is when the baby is sleeping in their own safe sleeping environment within the parents’ or caregivers’ room. This could be in a crib, play yard, bassinet, or portable crib.
The AAP recommends co-sleeping (in the same room on separate sleep surfaces) for at least the first six months of an infant’s life, but ideally, up until the first year because it has been shown to decrease the incidence of SIDS by 50 percent.
All of the medical and sleep experts interviewed for this article recommend co-sleeping in a separate sleep space over bed-sharing.
Pediatric sleep psychologist, Dr. Lynelle Schneeberg, a psychologist, tells Romper that co-sleeping is not only considered safer for an infant, but also avoids “sleep onset associations,” where a child becomes dependent on a parent to help them fall asleep.
“If a parent wants a child to be a great sleeper — one who falls asleep quickly at bedtime and returns to sleep quickly after an awakening — the parent will want to teach a child to self-soothe,” Schneeberg says. “This is because all children wake up four to six times a night (usually at the end of a dream cycle) and, if the baby is able to self-soothe, he or she will just go right back to sleep,” she explains.
Schneeberg gives the example of a child that has learned to fall asleep at bedtime only if a parent is lying with them, patting them, signing to them, or holding their hand, for example, and will need all of those things again each time they wake in order to get back to sleep — which results in lost sleep for everyone.
Elizabeth Lutz, 36, of Brooklyn, New York, a mom to an almost 2-year-old, can’t stress enough how co-sleeping has benefited her family. “As a newborn, we co-slept with a bassinet that attached to the side of our bed, moving to a sidecar crib when my son got bigger. And now we have seamlessly transitioned into a toddler bed (still in our room) for the past three months,” explains Lutz. She adds that this arrangement has allowed her to continue breastfeeding her son far longer than anticipated.
Co-sleeping achieves many of the upsides that proponents of bed-sharing think are important: bonding through close proximity, a better response to your infant's feeding cues, and soothing environment for the baby when they can hear and smell their parents.
Tips for Parents Who Want to Co-sleep
All of the medical and sleep experts interviewed for this article recommend co-sleeping in a separate sleep space over bed-sharing, and offer these tips for parents who want to co-sleep via room-sharing.
- Always have a separate sleep space for your infant. This can include a co-sleeper that attaches to the side of your bed or a bassinet that is within arm’s reach.
- Use a firm sleep surface with a fitted sheet.
- Place your baby on their back at naps and bedtime.
- Decrease the risk of injury or death to your infant by not using a couch or armchair as a sleep surface.
- Do not use a car seat, stroller, swing, infant carrier, or other similar product in your bedroom as baby’s regular sleep area.
- Remove all pillows or blankets on the bed during feeding sessions.
- Move the baby to their own sleeping environment if you feel drowsy in an adult bed, couch, or chair with the baby, or if they fall asleep.
What To Do About Bed-Sharing?
Although continued education is important to reduce the incidence of bed-sharing arrangements, the AAP acknowledged that parents will continue to choose bed-sharing in its updated sleep guidelines from 2016. The guidelines emphasize the importance of co-sleeping arrangements on a separate sleep surface to the infant’s parents, but also teach parents that if a mother must breastfeed her child before returning the child to a separate sleep surface, it is safer for her to fall asleep nursing in a bed free of loose covers or sheets than to fall asleep nursing on a couch or arm chair, where the risks of suffocation are usually greater.
With my partner, baby, and me all in one room, the three of us constantly woke each other up throughout the night.
Kelsey Allan, 25, Salt Lake City, Utah, tells Romper she room-shared with her baby for the first several months, which had its own share of pros and cons. “On the plus side, it was easy to feed my baby at night by just pulling her into bed when she woke up. But with my partner, baby, and me all in one room, the three of us constantly woke each other up throughout the night.”
Because of the interrupted sleep, Allan says she moved her daughter to her own room around 4 months old. “It was best for our personal situation because we were finally able to implement a regular sleeping schedule without the constant wake-ups and disturbances that come with room-sharing.”
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