Bed-Sharing and the Breastfed Baby

A decision that affects the ease of breastfeeding and therefore, encourages or discourages the likelihood of optimal breastfeeding is determining a location for the baby to sleep. Many parents find that bed-sharing (sleeping in the same bed) with their infant, supports their breastfeeding relationship. Most infants will need to feed at night and night feedings are much easier when bed-sharing. Rather than leaving the bed to feed the baby, the baby can be breastfed while lying down and the parent can sleep.

This can be especially helpful for employed parents. When parents are separated from their infants during the day-time, their infants may choose to take much of their nourishment at night and feed less when the parent is away. This is sometimes referred to as, “reverse cycle nursing,” a phrase coined by Gale Pryor, author of Working Mother, Nursing Mother. Bed-sharing is also a way for an employed parent and their infant to re-connect and spend time together that helps to make up for their separation during the day.

Many parents are concerned about the safety bed-sharing because of U.S. safe-sleep campaigns that advise against babies sleeping in adult beds. Research by Kathleen Kendall-Tackett, Ph.D., IBCLC, FAPA, shows that, in order to avoid falling asleep with their babies in beds, many parents are falling asleep with their babies on unsafe surfaces such as couches, recliners and chairs. She proposes that rather than proscribing bed-sharing, safe sleep campaigns should include information on how to make bed-sharing safer. The Academy of Breastfeeding Medicine has also blogged on this subject suggesting that, “The advice to never sleep with your baby has backfired in the worst possible way. Rather than preventing deaths, this advice is probably even increasing deaths.”

Babies expect to be close to their care providers day and night. Bed-sharing tends to help everyone sleep better and the whole family benefits from adequate sleep. Safe bed-sharing with a breastfeeding parent has even been associated with a reduction in SIDS while formula feeding increases SIDS risk. If parents are told not to bed-share and this affects the duration and exclusivity of breastfeeding, the risk of SIDS increases due to the need for artificial feeding.

A large study in the U.S. found that up to 22% of 1-month-old infants were bed sharing and that breastfeeding parents were three times more likely to bed share than parents who did not breastfeed. Breastfeeding and bed-sharing are strongly associated. In support of practices that encourage breastfeeding and in reference to bed-sharing, the Academy of Breastfeeding Medicine states that, “Because breastfeeding is the best form of nutrition for infants, any recommendations for infant care that impede its initiation or duration need to be carefully weighed against the many known benefits to infants, their mothers, and society.” ABM further provides guidelines for safe bed-sharing.

In 2014, Sweet Sleep, was published by La Leche League International. The authors of this book present bed-sharing research in a new light that can reassure families and health care professionals that bed-sharing can be done safely. Sweet Sleep, presents the “safe sleep 7.” These are 7 guidelines that create a safe bed-sharing environment.

If a mother is:

1. A non-smoker

2. Sober

3. Breastfeeding

And her baby is:

4. Healthy

5. On back

6. Lightly dressed and unswaddled

And they:

7. Share a safe surface

Then the baby’s risk of SIDS is no greater than in a crib, and any breathing hazards have been hugely reduced.

McKenna and McDade (2005) Why babies should never sleep alone: A review of the co-sleeping controversy in relation to SIDS, bedsharing and breast feeding PAEDIATRIC RESPIRATORY REVIEWS 6, 134–152

Hauck FR1, Thompson JM, Tanabe KO, Moon RY, Vennemann MM. (2011) Breastfeeding and reduced risk of sudden infant death syndrome: a meta-analysis. Pediatrics. 2011 Jul;128 (1):103-10. doi: 10.1542/peds.2010-3000. Epub 2011 Jun 13.

Academy of Breastfeeding Medicine (2008) ABM Clinical Protocol #6: Guideline on

Co-Sleeping and Breastfeeding BREASTFEEDING MEDICINE Volume 3, Number 1

© Laura Spitzfaden 2010 Edited 2012, 2016