Health Facts and Tips

Co-Sleeping with Baby - New Warnings on Risks, Dangers and Precautions Required

Co-sleeping is a controversial subject with many conflicting arguments and research findings. There is no definitive review or advice for parents because there are many circumstances that contribute to the dangers of co-sleeping and also for babies sleeping alone.

These circumstances complicate the analysis of the research data, but they provide a list of do's and dont's for parents to consider.

In Australia, the Victorian Coroner, John Olle has warmed that parents should avoid sleeping with their young babies for a period of least the first six monthsafter they were born.

He also advised that health authorities and nurses should give new parents consistent and clear warnings of the risks involved in co sleeping and the ways to reduce those risks.

Research Findings on Co-Sleeping with Babies

In Victoria, a court study of a total 72 infant deaths in Victoria from 2008 to 2010 found that 33 infants (46%) died in circumstances where the babies were co sleeping with parents.

• maternal smoking,
• placing infants on pillows,
• sleeping with adults other than the mother,
• sleeping with mothers that were exhausted,
• alcohol or drug use, including prescription drugs.

Yeliena Baber, a pathologist based at the Institute of Forensic Medicine in Victoria, gave evidence at the inquiry that for 4 of the 5 cases, there was evidence that the babies that died had been exposed to smoke. She also reported that for 70 % of sudden infant death syndrome cases, there was exposure to maternal smoking.

Dr Baber also stated that major epidemiological studies had reported that sleeping in the same room as an infant could reduce the risk of SIDS (Sudden Infant Death Syndrome) by as much as 50 % and that not leaving a baby to sleep alone in a room was advocated for the first six to 12 months. However co-sleeping with parents was an inherently risky. She said that the recommended sleeping environment for young infants was:

• a cot fitted with firm mattress,
• no use of soft bumpers or pillows
• the infant should be position in a supine position (facing upwards) rather than a side-sleeping or prone position (facing downwards).
• the recommended bedding was a sheet with a one or more lightweight blankets, which could be tucked in at the sides.
• The sleeping area should be neither too cold or too hot (about 16-18 degrees C) with adequate ventilation.

The Public Advocate for the City of New York in the September 2005 report entitled “A Patten of Preventable Deaths, 2004 Child Fatality Report”, found that the prominent cause of preventable deaths of infants was inappropriate positions when sleeping and most of these deaths were associated with co-sleeping. The study found that 15 children has died in 2004 as a result of co-sleeping.

The American Academy of Pediatrics (AAP) specifically advocates that young infants up to 12 months old should be placed on their backs to sleep; care should be taken to ensure that the baby's head remains uncovered during sleep; the infant should not be bundled in clothing and blankets; overheating the infant should be avoided; and the child should sleep in a safe, properly approved crib.

The AAP does not specifically recommend against co-sleeping or bed-sharing. However the AAP has warned that this practice increases the risk of the infant being suffocated by overlying especially where the co-sleeping adult is in a depressed state of consciousness induced by alcohol or mind-altering drugs. AAP also recommends against co-sleeping on a sofa.

The New York State Office of Children and Family Services (OCFS) also suggested that caretakers and parents should avoid co-sleeping if they were very tired or were using prescribed on no-prescribed medication, illegal drugs or alcohol. (see: "Child Abuse Prevention Section: Back to Sleep and Safe to Sleep" at www.ocfs.state.ny.us).

Precautions for Co-Sleeping with Your baby

Below is a summary of various precautions, do's and dont's that should be considered for co sleeping.

Situations that Increase the Risk of Babies Suffocating When Sleeping

• Getting trapped by the bed frame, headboard or footboard
• Getting trapped between the bed and the wall, furniture or other object
• Falling from the bed onto piles of clothing, plastic bags or other soft materials
• Suffocating on a waterbed, mattress or soft bedding (pillows, blankets, quilts, etc.)
• Having a parent (especially a parent who has used alcohol or dnigs) roll on top of the baby

Precautions for Co Sleeping with Babies

• Remove cords and drapes from nearby windows.
• Always place your baby on his or her back to sleep.
• Place a tight-fitting fitted sheet on the mattress.
• Always leave your child's head uncovered while sleeping.
• Remove any strings or ties from your and the baby's night clothes
• Remove soft bedding. Make sure your mattress fits snugly in the bed frame.
• Make sure that there are no spaces between the bed and the wall or furniture.
• Make sure there is nothing near the bed that could suffocate or strangle the baby.
• Be sure there are no openings in the bed's headboard or footboard where your baby's head could get trapped.

Things to Avoid when Co-Sleeping with Babies

• Never let a baby sleep with other children
• Never put a baby to sleep in an adult bed alone.
• Never overdress your baby for sleep or overheat the room.
• Never place your baby on a waterbed, sofa, soft mattress or other very soft surface.
• Never place pillows, comforters, quilts or other soft/plush items on top of or under your baby.
• Never sleep with your baby if you smoke, have been drinking, or have used medicines or drugs that make it hard for you to wake up.