Co-Sleeping: Benefits and Drawbacks

A baby sleeping in a co-sleeper attached to their parent's bed

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Co-sleeping is the practice of parents and children sleeping in the same room, often with one’s baby in arm’s reach. There are multiple ways to co-sleep, including having your baby's crib in your room (room-sharing), using a co-sleeper or sidecar attached to your bed, or sleeping with your baby in your bed (bed-sharing or family bed). Many parents like co-sleeping because it keeps their baby close, making nighttime care and breastfeeding more efficient and offering intimacy, togetherness, and attachment.

What Is Co-Sleeping?

Though many may assume that co-sleeping means that parents and their baby share the same bed, Dr. William Sears stresses that definition is a bit too narrow. Sears, a well-known pediatrician, and author of many popular parenting books defines co-sleeping as sleeping within arm's reach of the baby. So, as noted above, this includes having the baby in their own sleeping space but within the same room, which is the sleep practice advocated by the American Academy of Pediatrics.

Sleeping in close proximity to your baby is a parenting practice that has been around for as long as people have been having babies. Cultures all around the world continue with this practice of keep babies within arms reach during sleep, sometimes in a family bed, other times with the baby in a bassinet or other independent sleep space.

Over time, the practice of separating babies and their parents at night took hold in Western cultures. However, over the past few decades, many families in the West are returning to this traditional sleeping arrangement. In particular, proponents of attachment parenting, a practice that centers on developing a closely bonded parent-child relationship, tend to embrace co-sleeping and its benefits.

Co-Sleeping Arrangements

Parents can find a co-sleeping arrangement that they feel comfortable with and works for them. Shared sleep can take on many forms and is adaptable to many lifestyles. You can also be free to modify your arrangement depending on your family's current needs and preferences and what is working best (or not).

  • Shared Room: Parents and baby have their own beds that are located in the same room.
  • Sidecar Arrangement: The baby's crib or co-sleeper bassinet is placed directly up against the parent's bed. Three sides of the railing surround the crib mattress, but the side abutting the parent's bed is left open. (Care needs to be taken to ensure that the baby's bed is secured right next to and/or attached to the side of the parent's bed so that they can't slip between the two beds.)
  • The Family Bed—as Needed: Parents sleep in the same bed with the baby during specific times, such as when the baby is sick or during other circumstances that make sharing the bed more convenient or otherwise preferred.
  • The Family Bed: Parents sleep in the same bed (bed-sharing) with the baby.

Expert Recommendations

The American Academy of Pediatrics (AAP) encourages room-sharing but does not recommend sharing a bed with a small infant due to the potential for injury or death of the baby. Risk peaks between two and four months of age, but the warning to avoid the family bed extends until a baby turns one. The AAP cites that bed-sharing may pose an increased risk of SIDS and warns about the potential for suffocation from soft bedding, a soft bed mattress surface, or a parent rolling over on them.

However, there are reputable medical and parenting organizations such as Attachment Parenting International, La Leche League, and the Academy of Breastfeeding Medicine that do support the family bed. They point out that when other safe sleep rules are being followed, the risks of bed-sharing are much lower and argue that breastfeeding in combination with bed-sharing may be protective. In fact, there are studies to support the safety of bed-sharing, particularly in conjunction with breastfeeding.

According to the Academy of Breastfeeding Medicine, "Existing evidence does not support the conclusion that bed-sharing among breastfeeding infants (i.e., breastsleeping) causes sudden infant death syndrome (SIDS) in the absence of known hazards." These hazards include soft bedding, sofa-sleeping, smoking, alcohol or drug use, premature infants, sleeping in a prone or side position, and not breastfeeding.

Organizations that promote bed-sharing believe that the benefits of the practice, including promoting breastfeeding frequency and duration, outweigh any potential increase in the risk of infant sleep-related injury or death when all other safety protocols are being followed. Additionally, they argue that since cultures with high rates of bed-sharing in conjunction with low rates of maternal smoking and drug use have lower SIDs rates, the APA's rule should only apply to those in the high-risk categories.

The American Academy of Pediatrics advises against bed-sharing in any circumstance.

It's important to note that the above groups do agree that bed-sharing is not safe in the presence of the SIDS risk factors listed above. Ultimately, parents are left to weigh the benefits and risks for themselves to decide which type of sleep arrangement makes the most sense for their family.  All families are different and there is no one-size-fits-all approach to sleeping arrangements. Additionally, families who choose not to bed-share can still co-sleep by simply having their baby's crib in their room.

Benefits

Many parents, both those who specifically consider themselves to be attachment parents and those who do not, believe that co-sleeping or shared sleep (whether in the same bed, using a co-sleeper, or having the baby's bed in their room) has many advantages.

  • Co-sleeping advocates and the AAP point to research that suggests when parents take sleep safety precautions, sleeping in the same room with your child reduces the risk of Sudden Infant Death Syndrome. (As noted above, the AAP does not endorse bed-sharing but does recommend other versions of co-sleeping.)
  • Infants who co-sleep may go to sleep faster and stay asleep longer.
  • It promotes breastfeeding by making night feedings quicker, less disruptive, and more accessible.
  • More mothers who co-sleep report feeling better rested.
  • Some research suggests that infants who co-sleep develop stronger emotional relationships with their parents and with other people.
  • Studies show that co-sleeping (and particularly bed-sharing) has physiological benefits for the baby, for example by synching their breathing to the adult's and helping to regulate their body temperature.
  • The psychological benefits of co-sleeping may include enhanced parental emotional regulation and feelings of closeness to their baby and lower stress levels for babies.

Potential Drawbacks

Conflicting research and recommendations can make it challenging for families to decide whether or not co-sleeping (and which type) is right for them. Some experts argue that there simply isn't a great enough body of research on the short-term and long-term benefits of co-sleeping for ironclad recommendations and believe more research is needed to verify the claimed benefits or drawbacks of shared sleep. However, some potential drawbacks of the practice include the following:

  • Babies who co-sleep may sleep for shorter durations and have less sleep consolidation than those sleeping in their own rooms.
  • Co-sleeping may become a "sleep crutch" for your baby, meaning that they have trouble falling asleep on their own without the presence of the parent.
  • Co-sleeping may be disruptive to adult sleep, as many parents sleep less deeply with their child in the same room.
  • Co-sleeping may require an earlier bedtime than the adults may prefer.
  • When bed-sharing, co-sleeping may increase the risk of SIDs or sleep-related injury to your baby.
  • Parents may be uncomfortable having sex with their child in the room, which may impact the parental relationship.

Cultural Differences

There is no doubt that there is a difference in how well the practice of co-sleeping is accepted across cultures as well as in how it is practiced, such as whether bed-sharing is more prevalent compared with having the baby close by. Western culture largely has frowned on the family bed arrangement, whereas co-sleeping seems to be the norm in developing countries.

Anthropologists have also noted a difference in the acceptance of the practice based on the general attitude of society. Collectivist cultures, meaning cultures that place greater value on the good of the group as opposed to the individual, are more likely to co-sleep than societies that emphasize the individual.

Sleep Safety Precautions 

It's important to note that sleep arrangements are an intimate choice and there are a wide variety of options to weigh. Co-sleeping isn't for every family, and the various ways co-sleeping can be practiced may work differently for different families. For those that choose co-sleeping, it is imperative that specific sleep safety precautions are followed, including placing the baby to sleep on their back and removing any loose or soft items from the sleeping area.

Sleep Safety Precations

For parents who share a bed with their baby, these guidelines are advised:

  • Parents should not be under the influence of alcohol and drugs, including medications that affect their sleep.
  • Pillows, blankets, any other soft or loose bedding, and anything that could obstruct a baby’s breathing or cause overheating (all associated with SIDS) should be taken out of the baby's sleeping area.
  • Parents should not co-sleep if they have sleep disorders.
  • Parents should not smoke in the bed or room.
  • They should not co-sleep in a waterbed or on a very soft mattress. Preferably, use a queen or king-sized mattress.
  • They should not share a sleep space with their baby if they are obese as this increases the risk of rolling over on to the baby.

A Word From Verywell

Clearly, the decision of how and where you baby sleeps is a very personal one that may be informed expert medical advice, scientific research, cultural heritage, convenience, trial and error, parenting style, practical considerations (like the size of your living space), and personal preference. All of these factors are valid and can be used to create the sleep practice that best suits your family. Ultimately, as long as safety precautions are taken, you can rest well in whichever sleep arrangement you choose.

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Article Sources
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