Bedsharing is a wonderful, biologically normal way to care for your baby at night. It’s also a big controversy in safe sleep. Since many pediatricians only focus on a “just don’t” attitude towards bedsharing, parents are stuck trying to navigate safe sleep messages and the reality of nighttime parenting. In this guide, I’ll answer some of the many questions I hear from parents about sleeping with their baby, cosleeping safety, bedsharing, and many questions that I also asked as a new parent.

What is Bedsharing, and is it the same as Cosleeping?

Bedsharing is sharing a bed with your baby; and in this article, I’m referring to a safely prepared bed. Just like crib sleeping, bedsharing can be safe and unsafe. We will cover all these subtopics.

Cosleeping is sleeping near your baby. Many parents use cosleeping interchangeably with bedsharing. (I did too, before I knew!) Cosleeping technically includes room sharing with baby on a separate surface such as a crib or bassinette. Some call this “rooming in” with their baby.

These definitions are important to understanding these definitions is important to the information in this article. Socially speaking, most parents mean the same things when they talk about cosleeping and bedsharing.

Is bedsharing safe?

Safe sleep messaging varies from organization to organization, country to country. Bedsharing can be done safely, but isn’t for every family. Here are a few quotes on bedsharing safety recommendations.

From the American Academy of Pediatrics Safe Sleep Guidelines:

“Infants may be brought into the bed for feeding or comforting but should be returned to their own crib or bassinet when the parent is ready to return to sleep.” (AAP 2016)

“However, the AAP acknowledges that parents frequently fall asleep while feeding the infant. Evidence suggests that it is less hazardous to fall asleep with the infant in the adult bed than on a sofa or armchair, should the parent fall asleep.” (AAP 2016) 

From the Academy of Breastfeeding Medicine Protocol 6 – Bedsharing and Breastfeeding

“Existing evidence does not support the conclusion that bedsharing among breastfeeding infants (i.e., Breastsleeping) causes sudden infant death syndrome (SIDS) in the absence of known hazards.” (ABM 2019)  

Nuanced safety messaging about bedsharing in America

In these quotes, you can see two very different views on bedsharing, and it’s understandable to wonder why this is. In the U.S. we aim our public health messaging at the most high-risk groups. We go for one message rather than nuanced messaging. However, not all parents have the same safety when it comes to bedsharing. It’s also important to note that the AAP approaches sleep from the western view that children should sleep separate from parents while the ABM is focused more on supporting breastfeeding – these are very different perspectives that frame their view of the research.

Regardless of the recommendations, however, parents bedshare, especially nursing parents. And when you are a bedsharing parent, you have a lot of questions about safety and also about how to navigate the journey of sleep as a bedsharing parent. It’s not always easy to find support and shared experiences along the way.

Reasons to Bedshare

Parents bedshare for so many reasons, and research shows us that bedsharing does have benefits:

• Increased breastfeeding duration and exclusivity even compared to room sharing babies.

• More stable physiological regulation for baby.

• Easier nighttime parenting.

• Better sleep for everyone.

• And some babies just won’t sleep separate!

Bedsharing safety in context

Before discussing bedsharing safety, some context is important. Like any health and safety statistics and recommendations, there’s nuance.

• Bedsharing is practiced around the world, including in countries with much lower sleep related deaths than the U.S. It is the cross-cultural, historical, and biological norm.

• Research shows us that many parents bedshare regardless of messaging, especially nursing parents.

• Every family has different risk factors. Some of these are things we control, and some are not.

• If you don’t plan to bedshare and decide to at 3am, you are much more likely to bedshare in an unsafe way.

• If you are concerned about falling asleep sitting up with your baby, you are much safer bringing them to a well-thought-through bed than falling asleep on a couch or glider.

Who is bedsharing for?

Research shows that certain groups have a safer experience with bedsharing. Drawing from the La Leche League International Safe Sleep Seven, with some minor word adjustment by me for inclusivity, this group is…

A parent who is:

• Nursing – baby sees the chest/breast as the primary food source.

• Sober – you are not under the influence of alcohol or any medication or substance that makes you sleep more deeply. Being excessively over-tired can simulate intoxication.

• A non-smoker – this includes during pregnancy, after baby is born, and other smokers in the family.

A baby who is:

• Healthy and full term.

• On their back when not nursing.

• Lightly dressed and not swaddled.

And that you are sharing a safe sleep surface. More on this below.

It’s also important to note that most professionals, even those who do not support bedsharing, recognize that risks shift around 4 months. By about 4 months your baby can share a safely prepared bed with other responsible non-smoking caregivers such as non-nursing partners. Before 4 months, baby needs to sleep next to the nursing parent.

How to set up a safe bedsharing environment

Troubleshooting your sleep environment is just as important as knowing your and your baby’s personal risks. The gold standard set up would be to drop your firm mattress to the floor and pull it into the center of the room. Not all families can do this, however, so here’s some more safety guidance for setting up a safe bedsharing environment:

• Never share sleep with your baby on a couch, glider, or chair.

• Use a firm mattress. Your mattress is too soft if: your mattress is soft enough to conform to your baby’s face if they were to roll on their tummy; the softness makes it difficult for them to lift their head free; or the mattress dips enough when you are lying next to your baby that they roll towards you.

• Be mindful of gaps between the mattress and bed frame, walls, or other furniture where a baby could get stuck.

• Check your bed area for anything dangling that a baby could get tangled in.

• Remove excess pillows, heavy comforters, or blankets. It’s ok to use a pillow; you just don’t want extra ones floating around the bed.

• Be mindful of how high your bed is and what your baby would land on if they fell.

• Keep pets off the bed.

How to position your baby safely when bedsharing

Bedsharing babies should be at your chest level, below pillows and above any light covers you are using. The classic position is the cuddle curl position which creates a safe place for baby with the parent on their side, with their arm above baby’s head between baby and the parent’s pillow, and the parent’s knees pulled up below baby. The space created from this C shape is free of any bedding. Baby is right by their food source so tends to stay oriented towards your chest.

Older babies and toddlers are a bit of a different story. Many littles will wiggle around a bit more in their sleep, taking up more room than you think they possibly should be able to! It’s common to find your little sleeping like a star fish or sideways between you and your partner. These creative sleeping positions mean that it’s important to be more mindful of falls out of the bed, gaps around the bed, and that there’s hopefully enough space for the adults to have some mattress room as well 😊

When should you not bedshare?

Your baby is safer sleeping on a separate surface if:

• You smoke or have smokers in the house.

• You formula feed.

• You have a soft mattress or otherwise cannot make the bed a safe surface.

• Your baby is premature or low birth weight.

• You’ve drunk alcohol or are taking any medications that would make you sleep more deeply.

• You are extremely sleep deprived, less than 5 hours of sleep in the previous 24 hours. This will affect how deeply you sleep and your awareness of your baby.

• You have pets who might sleep in your bed.

Nursing while bedsharing

Bedsharing supports the nursing relationship, making nighttime feeds easier. Bedsharing babies do tend to nurse more frequently than separate sleeping babies, but the feeds happen with less disruption to the parent’s sleep. Some research even shows that nursing, bedsharing parents get the most sleep (Kendal-Tackett, Cong, and Hale 2018). These extra night feeds support long term milk supply.

Feeding a baby or toddler while bedsharing is easy once you’ve figured out side-lying nursing. The same cuddle curl described above sets you up well for nursing at night. Baby can roll to their side for a feed and then gently rolled to their back afterwards. Toddlers and older babies will move around however they see fit!

Bedsharing with siblings

Babies under a year should not share a bed with other children, but the reality for many families is that they need to for everyone’s sanity and sleep. There are lots of options, but safety needs to guide the decision making. Here are some options to consider:

• Work on supporting independent sleep with your older child before the new baby arrives. Doing this several months ahead of the birth is a good time so that they don’t associate the new sleeping arrangement with the new sibling.

• Another option is to have the older child bedshare with one parent while the baby bedshares with the nursing parent. Making this change well ahead of the new baby’s arrival is ideal.

• A side car set up is another option, keeping everyone in arms reach but not all on the same surface. You can create a side car set up for your older child using a toddler bed or try having the new baby sleep in one. You may want a back up plan if going the second route in case the new baby doesn’t sleep well separate.

• If none of these options work, make sure there is an adult between the baby and your older child. It’s also important that your older child is able to understand and respect the limit of staying out of the baby’s sleep space. This is true even if your older child sleeps separate but sometimes joins you in your bed in the middle of the night.

What if you and your partner don’t agree about bedsharing or sleep arrangements?

In a perfect world, parents would agree about all big decisions, but this isn’t always the case. Bedsharing can be a point of contention between parents for a range of reasons, from safety concerns to beliefs about babies needing separate sleep to the adult bed being only for adults. The place to start is to listen to each other. Hear each other out without getting defensive or shutting the other person down.

Talk to your partner about:

• Why one parent wants to bedshare and why the other parent does not.

• What kinds of safety concerns are there from the perspective of bedsharing and not bedsharing.

• What are the concerns around the current sleep set up?

• How is everyone coping?

• How are you able to support each other and share the responsibilities of nighttime parenting?

• Does your family have any risk factors for bedsharing?

• Is the parent doing most of the nighttime parenting dangerously tired, and if so, are there other realistic alternatives.

• If your baby will only sleep touching you, are there other realistic alternatives.

Talking through both parents’ concerns and goals will help you understand each other’s perspectives. You can then decide if there’s a need for better resources and information or brainstorming around a compromise. It’s important that both parents are looking at evidence-based information before making a final decision. If you’ve never been exposed to the more biologically normative research on bedsharing, it’s understandable that your reaction might simply be no!

Ideally you can find a sleep set up everyone is comfortable with. Maybe it means waiting to bedshare until baby is older than 4 months. Maybe it means parents sleeping in separate beds until baby is a bit older. Maybe it means creating a floor bed in a very minimal room.

Transitioning away from bedsharing

There’s no perfect time to transition away from bedsharing. Some families do it for months and some for years. Cross-culturally, many countries bedshare throughout early childhood. You may want to consider transitioning away from bedsharing when it’s no longer working for your family or your little seems ready for more independent sleep. A floor bed is a natural shift from the family bed. This can be a floor bed in the parents room or in a your child’s room.

When bedsharing isn’t working

Bedsharing is a wonderful tool, but it doesn’t work for all families during all phases. Maybe your little is pushing you off the bed, sleeping super restlessly and kicking you, nursing all night long, or you have some safety concerns you just can’t troubleshoot away. It’s ok to stop bedsharing when it’s no longer working. As mentioned above, a floor bed is a great transition especially if you use a twin mattress so you still have the ability to lay down with your child when needed. If you need help navigating this transition, reach out and let’s talk about how I can help.