In terms of co-sleeping, or as it’s now known sharing a sleep surface, there is a lot of debate around this topic. It is a complex issue where many factors come into play. That said, SIDS and Kids SA believe there is no evidence that clearly shows that parents can safely share a sleep surface with an infant, whether this is by modifying the bedding or their own behaviour. Adult bedding environments are not designed with infant safety in mind and contain hazards for infants including overlaying, entrapment, suffocation and falls. The safe sleep guidelines in many countries, Australia included, recommend and promote the placing of an infant into their own safe sleeping environment such as a cot.
Parents may choose to share a sleep surface for many reasons including parental beliefs, cultural beliefs, easier breastfeeding, difficulties with settling or by accident, but it is really important to consider information about YOU as the parent, YOUR sleep environment and YOUR infant when thinking about sharing a sleep surface. Each individual circumstance needs to be taken into account as the level of risk varies depending on a number of factors. So let’s look at these different factors.
PARENTAL factors to consider
It is generally accepted that it is not safe to share a sleep surface with a baby if:
– Either parent is a smoker
There is evidence that babies exposed to tobacco smoke during pregnancy and after birth are at increased risk of SIDS.
– Either parent is under the influence of alcohol or illicit drugs
– Either parent is under the influence of medication that causes sedation or the parent is excessively tired.
Any situation where a parents arousability from sleep is affected can result in a reduced awareness of their surroundings and reduced ability of the parent to respond to their baby.
SLEEP ENVIRONMENT factors to consider
If parents choose to share a sleeping surface with their baby, they should keep the following things in mind:
– Sleep baby on the back from birth – never on the tummy or side.
– If baby lies on his or her side to breastfeed, baby should be returned to the back position for sleep.
– Make sure the mattress is firm and flat (not tilted or elevated)
– Make sure that parents bedding cannot cover baby’s face or overheat baby (use lightweight blankets and remove pillows, quilts and other soft items from the environment that could cover baby)
– Sleep baby beside one parent only, rather than between two parents, to reduce the likelihood of baby becoming covered by adult bedding, being rolled on or overheating.
– Ensure partner knows baby is in the bed.
– Do not wrap baby if sharing a sleep surface as this restricts arm and leg movement.
– Make sure baby cannot fall off the bed. A safer alternative is to place the mattress on the floor (be aware of potential situations where baby can become trapped). Do not place pillows at the side of the baby to prevent rolling off as these pose a suffocation risk if baby rolls onto/into them.
– Pushing the bed up against the wall can be hazardous. Babies have died after being trapped between the bed and the wall.
– Never place a baby to sleep in a bed with other children or pets.
– Babies must never be left alone on an adult bed.
INFANT factors to consider
It is generally accepted that some infants are more at risk of sudden unexpected death when sharing a sleep surface. These include infants who were/are
– Premature
– Low birth weight
– Under 3 months of age
– Had neonatal health problems
At the end of the day the final decision as to what a parent does/doesn’t do lies with the parents, but it is important for parents to be provided with information about possible risks and how to manage them and best practice recommendations, so that they can make an informed decision about the infant care practices they choose to use with their baby. If sleep and settling is an issue connecting with appropriate services to get help is important. Services such as the Parent Helpline 1300 364 100 or CaFHS 1300 733 606 can provide information and support to new parents.