Mother and newborn baby in bed

Study Summary

Bedsharing and Breastfeeding

Bedsharing and breastfeeding

Blair PS, Ball HL, McKenna JJ, Feldman-Winter L, Marinelli KA, Bartick MC and the Academy of Breast Feeding

Protocol #6, Revision 2019, Volume 15, Number 1, 2020. DOI: 10.1089/ bfm.2019.29144.psb

Conclusion

The American Academy of Pediatrics continues to discourage bedsharing (baby sharing a bed with parents) in its guidelines.1 In its sixth protocol (Revision 2019), the Academy of Breastfeeding Medicine conversely concludes that sharing a bed has a positive effect on breastfeeding. However, one important fact remains: parents at high risk must, under no circumstances, share a bed with their baby because the risk of sudden infant death syndrome in a shared bed (SIDS2) significantly outweighs the benefits for breastfeeding. On the other hand, safe bedsharing encourages breastfeeding and – according to the summarized protocol here – should therefore be included in the guidelines for pregnancy and postnatal care.3

Background

Approximately half of all SIDS cases occur when infants sleep next to an adult.4 However, a longitudinal study conducted in the United Kingdom found a decline in the number of SIDS cases in babies who shared a bed with their parents.5 The 50% decrease in this study is attributed to the ”Back to sleep campaign“6 and only applies to parents without risk factors who share a bed with their baby. There is currently advise both for and against bedsharing. Bedsharing is discouraged in the USA, Canada and Germany. However – based on the primary studies – countries such as the United Kingdom and Australia argue in favor of safe bedsharing in the context of encouraging breastfeeding.

Methods

The authors of these studies therefore summarize the advice, which comes from recent studies, as well as various recommendations and protocols from all over the world, in order to be able to make a statement regarding to what extent bedsharing encourages breastfeeding or increases the risk of SIDS.

Key Findings

  • Risk-free bedsharing encourages readiness to breastfeed and does not constitute a risk for SIDS.
  • Parents must preemptively be made fully aware of all the risks of bedsharing.
  • Parents with risk factors, e.g. such as smoking or drug abuse, should be advised and should take measures to reduce risks.
  • Bedsharing is strictly discouraged until all risk factors have been eliminated.
  • Clear and comprehensive information regarding the risks and opportunities of bedsharing should have already been given at an early, prenatal stage.
  • Both parents must be involved in this consultation.
  • The for/against advice of bedsharing must be compassionate and non-judgemental, as well as considerate over the living conditions of the (expecting) parents.

MAM Service

You can find the full study at: mambaby.com/professionals 

1Blair PS et al. Bed-Sharing in the absence of hazardous circumstances: Is there a risk for sudden infant death syndrome? An analysis from two case-control studies in the UK. PLoS Onje 2014;e107799
2SIDS: Sudden Infant Death Syndrome
3Li DK et al. Infant sleeping position and the risk of sudden infant death syndrome in California, 1997-2000. Am J Epidemiol 2003;157:446-455
4Zhang K, Wang X. Maternal Smoking and increased risk of sudden infant death syndrome: A meta-analysis Leg Med (Tokyo) 2013;15:115-121
5Erck Lambert AB et al. Sleep related infant suffocation deaths attributable to soft bedding, overlay, and wedging. Pediatrics 2019;143:e20183408
6Lagon E, Moon RY, Colvin JD. Characteristics of infant deaths during sleep while under non parental supervision. J Pediatr 2018;197:57.e36-62.e36