Bedsharing promotes breastfeeding

Recognized risks

Often the decision to bring baby into the parental bed is in response to crying or being unsettled. During such stressful situations, care may not be taken to ensure baby's safety. 

Too much (and too soft) bedding and accidently covering the baby's head with bedding can be risky, especially if the parent is not able to respond and remove the head covering. This emphasizes the importance of not sharing a bed with baby when parents are incapacitated in some way - like being sick, overly tired or impaired by drugs or alcohol. 

Dozing off with baby on the sofa is another a no-no, as this is considered an unsafe sleeping surface. Studies also show that parental smoking and larger, heavier parents can also form a risk when bedsharing.

Longer breastfeeding

Done properly - with an eye to the risk factors - bedsharing can be a positive nightly routine. Top on the list of benefits reported was breastfeeding. As they slept, babies and mothers tended to face each other - at less that 30cm apart. The evidence shows that, with mom within arm's reach, bedsharing babies enjoy more frequent and longer night-time breastfeeding sessions - with mothers making more attempts to breastfeed.

Co-sleeping babies are also breastfed until an older age than those who sleep on their own. One study from the UK found that 46% of the bedsharing babies were still breastfeeding at 3-4 months - which is double the amount compared with infants separate from their parents.

O\In a hospital setting, newborn infants showed more effort to breastfeed when they were allowed to co-sleep, or were placed in a side-car crib (a crib with one side open, with the crib's mattress touching the adult's bed).

It appears that bedsharing is a natural concept for many mothers, who simply start doing it on their own, with no educational campaign. Even though some mothers share beds without necessarily breastfeeding - such as in Thailand - the practice is embedded enough in homes to inspire one researcher to call the practice "breastsleeping".

Sleep interruptions

However, along with the ease of breastfeeding comes a downside: sleep disruption. While it is normal for parents and newborns to wake frequently for night feedings - especially breastfed babies - during bedsharing, these babies are aroused more often, though for shorter periods of time than babies who sleep in separate beds.

Bedsharing appears to synchronize mother-baby sleep patterns, and the more frequent arousals may help protect babies from SIDS. But when parents don't sleep well, they become less engaged with their baby at bedtime - which disturbs baby's sleep. It's possible that bedsharing helps babies feel more safe and secure, so they sleep better. But this is difficult to conclude without further research.

Need for guidelines

The researchers state the need for broader guidelines around bedsharing, especially for infants with a higher risk for SIDS. One issue could be side-sleeping, which is more common when babies share beds - which could increase the risk of the baby rolling over to sleep on its stomach. The proximity to the breastfeeding parent could also cause a microclimate, with increased CO2 levels.

Another question that research could answer is why SIDS levels are low in some cultures, where bedsharing is common. Hopefully, future research will help midwives and other healthcare professionals better understand bedsharing, and ways they can help new parents make the right - and safe - choices for their family.

References
Baddock SA, Purnell MT, Blair PS, Pease AS, Elder DE, Galland BC. The influence of bed-sharing on infant physiology, breastfeeding and behaviour: A systematic review. Sleep Med Rev. 2019 Feb;43:106-117.