The first few months of parenthood can bring so much joy. Sometimes nothing feels better than snuggling up next to your newborn. With that joy also comes many moments of extreme tiredness.
Before you bring baby into your bed, it's important to know the official recommendations for safe sleep practices for your baby, as well as the safest way to approach infant sleep in your most sleep-deprived moments.
Safe Sleep for Babies
Approximately 3,500 infants die annually in the United States from sleep-related infant deaths, including sudden infant death syndrome (SIDS). The American Academy of Pediatrics recently updated its recommendations on creating safe sleeping environments for infants in 2016.
The basics are still the same:
- Infants should be put to sleep on their backs
- Choose firm sleep surfaces with only a fitted sheet (no other bedding or soft objects)
- Room sharing (without bed-sharing) is recommended for the first six months and preferably until one year
- Additional risk-reducing factors include avoidance of exposure to smoke and alcohol, breastfeeding if possible, routine immunizations, and the use of a pacifier
Bed Sharing Products
With these new guidelines, the AAP also addressed infant sleep products called in-bed and bedside sleepers. Bedside sleepers are firm sleep surfaces attached to the side of a parent's bed. In-bed sleepers are raised sleeping areas that parents place next to them on their bed. Here is what we know about both:
- The US. Consumer Product Safety Commission (CPSC) has published safety standards for these products.
- The AAP could not recommend for or against the use of bedside sleepers because there have been no studies evaluating the association between these products and sleep-related infant deaths (insufficient evidence).
- The CPSC does not have safety standards for in-bed sleepers. Without these guidelines, these products could potentially result in less product validation and study.
- The AAP could not recommend for or against the use of in-bed sleepers because there have been no studies evaluating the association between these products and sleep-related infant deaths (insufficient evidence).
Considering the lack of evidence suggesting that in-bed or bedside sleepers are safe, parents are highly encouraged to follow the safe sleeping practices listed at the beginning of the article.
Feeding Your Baby Safely
"Infants do need frequent feeding, often provided by sleep-deprived parents," says Alanna Brickley, MD, a pediatrician at University of Utah Health. "In their guidelines, the AAP acknowledged that parents do frequently fall asleep while feeding infants."
Couches and armchairs are extremely dangerous places for infants to sleep. Given this, the evidence suggests that it is less dangerous to fall asleep with a baby in an adult bed with no pillows or blankets on it than on a sofa or armchair. If a parent does fall asleep, the infant should be placed back on a separate sleep surface as soon as the parent wakes up.
Sleeping With Your Baby
Despite the risks, many parents still choose to co-sleep out of personal preference or exhaustion. If parents choose to co-sleep with their babies, Brickley recommends placing the baby in a bedside sleeper. It is important to note that the risk of bed-sharing is especially high under four months.
While co-sleeping can be a sensitive and controversial topic, many parents still choose to co-sleep despite these recommendations.
"Co-sleeping is considered positive by many—in terms of parent-infant bonding and potentially improved maternal sleep as breastfeeding may be easier," Brickley says. "Parents are entitled to make whatever decision they choose is best for their family. I think my role as a pediatrician is to make sure to discuss the evidence behind recommendations so that parents can make informed decisions."
Pediatricians can help parents navigate newborn sleep and other topics. If you have questions or concerns, share them with your pediatrician.