Following the publication of a press release from the Foundation for the Study of Infant Deaths (FSID) warning parents against the dangers of bed-sharing, UNICEF UK Baby Friendly Initiative has issued the following statement.

There is robust evidence that sleeping with a baby on a sofa or armchair dramatically increases the risk of Sudden Infant Death Syndrome (SIDS), as does sleeping with a baby when under the influence of alcohol or drugs or when parents smoke ¹. However, there is little evidence or expert consensus as to whether there is any risk to bed-sharing in the absence of known risk factors ^2,3.

Indeed, bed-sharing has several benefits, such as helping parents to cope with babies who wake frequently to be fed or who are unsettled in the night. Bed-sharing is also associated with an increase in breastfeeding - possibly because many mothers find it hard to get enough rest if they do not breastfeed lying down ⁴. Breastfeeding is universally recognised as one of the pillars of child health and survival with well established evidence regarding the many health benefits to both babies and mothers. Of particular note is a recent review of the impact of breastfeeding which identified that breastfeeding reduces the risk of Sudden Infant Death Syndrome (SIDS) by 36 per cent in the industrialised world ⁵. Strenuous efforts are now being made by the Department of Health and others to increase the UK’s low breastfeeding rates in order to improve public health ^6,7,8.

Young babies wake and feed frequently both day and night and tired parents are at risk of falling asleep with their baby, especially during the night, whatever their intention. Therefore, parents require full information regarding the various strategies for coping at night, along with the benefits and risks of all approaches in order to allow informed decision making.

In recognition of this, the UNICEF UK Baby Friendly Initiative has for some time been working to assist health professionals to discuss bed-sharing with parents. A sample bed-sharing policy has been developed for hospitals and a leaflet for parents produced with the Foundation for the Study of Infant Deaths (FSID). Both are designed to promote safety whilst protecting breastfeeding, by educating health professionals and parents on the benefits, contra-indications and safety issues surrounding this practice. UNICEF has also been urging NHS trusts to acknowledge the gap in health professional’s knowledge and provide training on all aspects of bed-sharing, including best practice for hospitals and how to communicate the key messages effectively to parents depending on their needs and circumstances.

Footnotes
1. Blair PS. et al (2006) Major epidemiological changes in sudden infant death syndrome: a 20-year population-based study in the UK. The Lancet.367; 314-20.
2. McKenna JJ, Ball HL, Gettler LT. (2007) Mother-Infant Cosleeping, Breastfeeding and Sudden Infant death Syndrome: What Biological Anthropology Has Discovered About Normal Infant Sleep and Paediatric Sleep Medicine. Yearbook of Physical Anthropology. 50; 133-161.
3. Horsley T. et al (2007) Benefits and Harms Associated with the Practice of Bed Sharing; A Systematic Review. Arch Pediatr Adolesc Med. 161; 237-245.
4. Blair PS and Ball HL (2004). The prevalence and characteristics associated with parent-infant bed-sharing in England. Arch Dis Child 89:1106-1110
5. Ip S. et al (2007) Breastfeeding and Maternal Health Outcomes in Developed Countries. AHRQ Publication. No. 07-E007.
6. HM Government (2008) PSA Delivery Agreement 12: Improve the health and wellbeing of children and young people.
7. Department of Health (2008) Healthy Weight, Healthy Lives A Cross Government Strategy for England. London: The Stationery Office.
8. Department of Health (2008) Health Inequalities: Progress and Next Steps. London: The Stationary Office