Bedsharing promotes breastfeeding, but many authorities recommend against bedsharing for all mothers, citing safety concerns, particularly risk of sudden infant death syndrome or suffocation risks. Here we will review the normal physiology of mother-infant sleep, and the historical context in which such recommendations evolved. In addition, many populations have high rates of bedsharing with low rates of death. In this context, we will review the evidence around bedsharing and the most current evidence-based recommendations. Some risk factors for SIDS are more powerful than others, and we will review the best ways to minimize such risks, including a social-determinants of health approach. In some circumstances, bedsharing may carry particular risks and it is important to be able to discuss these issues with parents without stigma. We will discuss counseling of all parents in the “risk-minimization” approach, which would also allow for promotion of breastfeeding.
Learning Objectives:
Objective 1: Describe the normal sleep patterns of breastfeeding dyads.
Objective 2: Describe the circumstances in which bedsharing might be hazardous.
Objective 3: Explain strategies for counseling parents on safe sleep.
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