In early April, Cook Children’s Medical Center in Texas sounded the alarm on a possible surge in infant deaths. Since January 2022, the hospital reported 30 mortalities stemming from unsafe sleeping situations. And while the cause of death may not have been the same for every baby, most involved sharing a bed with a caregiver.

“We’re doing a better job at identifying what the causes are,” says Susan Katz, a nurse practitioner and the infant apnea program coordinator at Stony Brook Medicine in New York, about the report. In regards to bed-sharing, she and other experts say that though there are many reasons why parents might end up sleeping with their newborn, it’s never recommended. “The scream of a mom or dad who’s lost their baby because of something like bed-sharing outweigh any benefits,” adds Gina Posner, a pediatrician at MemorialCare Orange Coast Medical Center in California.

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About 3,500 babies in the US die each year from sleep-related incidents, including from suffocation and sudden infant death syndrome (SIDS). Bed-sharing increases the chance for these fatal events. And while the number of sleep-related infant deaths has gone down since the 1990s, reports like the one from Cook Children’s Medical Center are a reminder that there’s still work to do in preventing these accidents. 

Why is sleeping in a bed with a baby dangerous?

First off, babies need to lie on firm surfaces, like a crib pad, says Posner. A soft adult mattress can be harmful because it conforms to the shape of the baby’s head, creating pockets of space that can cover their nose and mouth if they turn over in their sleep. A 2019 study published in the journal Pediatrics reported 14 percent of SIDS cases were from suffocation. Of these, 69 percent of the suffocations were from regular mattresses.

Bed sharing also exposes infants to other soft materials like pillows and blankets that can easily smother children, explains Posner. What’s more, pillows that are slightly elevated can force a baby’s head down so their chin rests on their chest. This position can block the baby’s tiny airways and make it hard for them to breathe. The American Academy of Pediatrics warns that any surface inclining over 10 degrees is not safe for a baby.

Another danger is the adult itself. A lot of accidental deaths happen when a caregiver rolls over on a baby, pins the baby down under blankets, or traps the baby between a wall and a bed. “I’ve seen even the best of parents who are just exhausted accidentally suffocate their child,” says Posner.

Is there any way to make bed-sharing safer?

There are multiple reasons why people might want to sleep in the same bed as their child. For example, some caregivers find that infants sleep better when next to them. “Sometimes [the babies] really do,” explains Posner. “They were inside you for nine months and it can be a hard transition to be outside.” Other parents might do it for the convenience of breastfeeding and immediately getting to go back to sleep. For sleep-deprived adults, a few extra minutes of sleep matter.

But both Katz and Posner say there’s no way to keep your infant completely safe when bed-sharing and caution against it, at least until the child turns one. The American Academy of Pediatrics also doesn’t recommend bed-sharing with infants “under any circumstance,” and recommends other alternatives.

How to practice safe sleep

Instead of bed-sharing, Katz advises caregivers to keep the baby’s crib or bassinet in the room that they’re sleeping in. Room-sharing might make it easier to breastfeed; if you prefer to do it in bed, Katz says there should be another support person awake and keeping eyes on the baby to make sure no one accidentally falls asleep.

One downside to room-sharing is that babies—and by extension, caregivers—don’t sleep well. A 2017 study in the journal Pediatrics found that infants who slept in separate rooms from their parents before the age of four months rested longer than those who shared a room (and got fed more throughout the night). The solo-napping babies also slept up to 100 minutes longer at the age of nine months. 

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The idea of losing a few winks might make room-sharing an unappealing option. However, waking up from your baby’s cries could be a way of making sure they’re protected against SIDS. A 2014 study in the journal Acta Neuropathologica found that nearly 42 percent of infants who died from SIDS—which includes causes beyond bedsharing—had brain abnormalities that affected the hippocampus, an area in charge of controlling breathing and heart rate during sleep. Spending the night in the same room but in different sleeping areas gives adults the opportunity to check on babies and ensure there are no hazards nearby that would compromise their breathing.