For new parents, the sheer volume of guidelines and warnings about caring for baby can be overwhelming. One area that gets pretty contentious is whether or not you should let your baby sleep in the same bed with you.
While many cultures consider a family bed to be a normal thing from the minute a baby is born, many scientific and medical organizations in the United States frown upon the idea of bed sharing (sometimes called co-sleeping) — especially with younger babies.
But can your baby sleep in the same bed as you? And if so, what steps should you take to ensure that you’re bringing them into a safe sleeping environment?
Safe Sleep Seven is a series of guidelines designed to make bed sharing safer for a baby and their parents. The concept originated in 1999 in the book “Sweet Sleep” by Diane Wiessinger, Diana West, Linda J. Smith, and Teresa Pitman.
The general concept is to normalize the idea of bed sharing, especially for new parents or parents of young breastfeeding infants. During the early days, frequent feedings and wakings along with the associated exhaustion parents experience can make the process of moving baby in and out of a separate sleeping space a logistical nightmare.
Mentioned frequently by La Leche League (LLL), Safe Sleep Seven is often promoted for nursing moms, but can also be used by parents that are bottle feeding.
The American Academy of Pediatrics (AAP) does not recommend having an infant sleep in an adult bed with parents or caregivers because of the risk of sudden infant death syndrome (SIDS) and accidental infant suffocation and strangulation. The AAP recommends sharing a room without sharing a bed.
Written like a rhyme and sung to the tune of “Row, Row, Row Your Boat,” Safe Sleep Seven outlines key factors parents must prioritize if they want to safely bed share with their babies. While the scientific and medical community generally doesn’t recommend bed sharing, many of the Safe Sleep Seven protocols are supported through peer-reviewed research.
Additionally, according to the AAP, the risk factors that may contribute to SIDS include some behaviors both during and after pregnancy, such as smoking or using drugs or alcohol, along with choosing to formula-feed rather than breastfeed.
So, let’s discuss each line in the rhyme and whether it’s supported by the scientific community.
No smoke, sober mom
As a rather straightforward statement, if you’re going to bed share with your baby, don’t smoke and don’t consume alcohol before bed. This is a fact that’s supported by research, as many cases of bed-sharing-related infant deaths have occurred when one or more parents were smokers or went to bed after consuming alcohol or taking medications.
The AAP, in addition to not recommending bed sharing, also warns against smoking while pregnant and exposing infants to smoke as it can increase a child’s risk of SIDS.
Baby at your breast
This line references that your baby shouldn’t be propped up on pillows. Note that this rhyme is geared more toward those who are breastfeeding or chestfeeding. So, the idea is that your baby has direct access to your breast or chest, which makes nursing easier to accomplish.
Rather than having your baby on your pillows directly in front of your face, they should be flat on the mattress with their face near your breast or chest. Research has found that those breastfeeding instinctively take on a protective posture when they nurse while laying down.
Known as a “cuddle curl,” they protectively surround their baby with their legs and arms bent in such a way that rolling over the child is nearly impossible to do. This claim is supported by research published in a 2019 study that found the cuddle curl is more commonly found in those breastfeeding as opposed to those that formula feed.
Keep in mind, though, that even formula-fed babies shouldn’t be propped up on pillows. You also shouldn’t prop a bottle to aid in feeding.
Healthy baby on his back
Most frequently, SIDS is associated with babies that are put to bed in a non-supine — or not on their back — position. Regardless of whether you bed share or put your baby to bed in a separate space, on their back is the safest position.
All major medical groups, including the
Keep him lightly dressed
Along with sleeping on their backs, babies can get easily overheated. This is another documented contributing cause toward SIDS. According to the AAP, the best way to dress a baby for sleep is in no more than one additional layer of clothing than you would as an adult to be comfortable.
Not too soft a bed
Not only should your baby sleep on their back, but the mattress shouldn’t be soft either. This is another safety feature of Safe Sleep Seven that’s in agreement with much of the medical community. The goal is that the surface should be firm and provide enough support to ensure that your baby’s airway is clear.
While you should avoid surrounding your baby with bedding or toys because they pose a suffocation risk, ensuring that the mattress is covered with a fitted sheet is OK. As a general rule, don’t put your baby to sleep on a couch, chair, recliner, or any surface that lacks sufficient support or where they could easily roll and fall.
Watch the cords and gaps
Cords can pose a choking hazard if you have an active sleeper. A bed that’s too close to a wall or furniture can pose a danger if your baby rolls or shifts during the night and gets wedged into a tight space.
While most medical organizations caution against having your baby sleep in bed with you, they do note that you should be mindful of your baby’s crib or sleeping area. In particular, if a crib has slats, they recommend that the slats are no more than 2⅜ inches apart to prevent a baby from getting stuck between them.
Keep the covers off his head
Just like if your baby was sleeping in a separate space, the Safe Sleep Seven supports the accepted guidance from organizations like the CDC and AAP that your baby’s sleep area shouldn’t be covered in bedding or toys that might cover their head.
As with babies that sleep alone, the risk is that a child might suffocate if the bedding gets pressed against their nose, and for some reason, they (or you!) aren’t able to move it.
Whether you call it bed sharing or co-sleeping, the choice to bring your baby into your bed is a personal one. Most medical organizations in the United States still maintain a strict stance against the practice.
However, more members of the community are recognizing that bed sharing — especially for those who are breastfeeding — is a fairly common practice around the world with many bonding and health benefits for parents and babies.
As a result, more efforts are being made to conduct more research to provide updated guidance that ensures parents who choose to bed share can do so safely.