Bed-sharing Practices Research Articles

Bedsharing among breastfeeding physicians: Results of a nationwide survey.

Bedsharing is common but advised against by the American Academy of Pediatrics. It is unknown if breastfeeding physicians bedshare more or less than the general population. To determine the prevalence of bedsharing among physicians, their reasons for bedsharing or not, and whether bedsharing was associated with a longer duration of breastfeeding. An online survey was adapted from surveys administered by the Centers for Disease Control and Prevention. The survey was administered to physicians and medical students who birthed children from October 2020 through August 2021. Respondents were asked to report on a singleton birth, and questions centered around sleep practices and breastfeeding. Survival analysis was used to examine the association between bedsharing and breastfeeding duration. Of 546 respondents with bedsharing data, 68% reported some history of bedsharing, and 77% were in specialties that involved caring for pregnant people and/or infants. Those who bedshared breastfed an average of four months longer than those who never bedshared (18.08 versus 14.08 months p<0.001). The adjusted risk of breastfeeding cessation was markedly lower for those who bedshared compared to those who did not (Hazard Ratio 0.57, 95% Confidence Interval 0.45, 0.71). The primary reason for bedsharing was to breastfeed (73%); the primary reason for not bedsharing was safety concerns (92%). Among those who bedshared (n = 373), 52% did not inform their child's healthcare provider. Bedsharing is common among our sample of mainly breastfeeding physicians, including those who care for pregnant people and/or infants. It is also associated with a longer duration of breastfeeding, which has implications for population health. Practicing bedsharing implies cognitive dissidence and may affect how physicians counsel about bedsharing. Additionally, lack of disclosure of bedsharing practices has implications for practical guidance about having open non-judgmental conversations and may be a missed opportunity to counsel on bedsharing safety.

The Impact of Breastfeeding and Safe Sleep Mobile Health Messaging on Breastfeeding and Bedsharing.

Mobile health (mHealth) safe sleep messaging increases rates of safe sleep. Bedsharing is more common among breastfeeders. Advice to not bedshare may negatively impact breastfeeding. We compared the impact of safe sleep or breastfeeding mHealth messaging on bedsharing and breastfeeding at 2 to 5 months. This is a secondary analysis of mothers who initiated breastfeeding from a cluster randomized clinical trial of mHealth messaging for safe sleep or breastfeeding. A multi-ethnic sample of 1600 mothers was recruited from 16 US birth hospitals and surveyed at 2 to 5 months regarding the previous 2 weeks' breastfeeding and bedsharing practices. Data on 997 mothers who initiated breastfeeding were analyzed with multivariable generalized estimating logistic regression models to examine the association of mHealth messaging with infant care practices. Overall, exposure to breastfeeding versus safe sleep messaging was not associated with a difference in any breastfeeding at 2 to 5 months (69.3% vs 65.5%, respectively; adjusted odds ratio [aOR]=1.33 [95% confidence interval, 0.91, 1.94]). Women with shorter planned duration of breastfeeding who received breastfeeding messaging had increased odds of breastfeeding at 2 to 5 months (50% vs 31%; aOR 3.13 [95% CI, 1.47, 6.65]). Mothers who received safe sleep messaging had lower rates of bedsharing overall when compared to breastfeeding messaging (24.8% vs 35.2%; aOR=0.58 [95% CI, 0.44, 0.78]). In this large multi-ethnic US sample, receipt of safe sleep mHealth messaging was associated with lower rates of bedsharing without negatively impacting breastfeeding rates. Future research should focus on continued development of interventions to improve adherence to both safe sleep and breastfeeding recommendations.

Population-Based Survey Showing That Breastfed Babies Have a Lower Frequency of Risk Factors for Sudden Infant Death Syndrome Than Nonbreastfed Babies.

Justification: Breastfeeding provides the best infant food, and closeness to the mother is crucial for successful breastfeeding. However, sharing parents' beds and sleeping on the stomach poses a high risk for sudden infant death syndrome (SIDS). There is little information on these practices regarding the Spanish population.Objective: To explore breastfeeding and bed-sharing practices in the study populationMaterials and Methods: A cross sectional observational study was conducted through an anonymous telephone survey with a representative random sample of babies born in the Health Area of La Marina Baixa, Alicante, between 2018 and 2019. A previous-day strategy was implemented to determine the feeding and bed-sharing variables.Results: The total breastfeeding and formula-feeding rates were 47.0% and 52.9%, respectively. The overall bed-sharing rate was 66.5%. The breastfeeding rate was 86.4% with bed-sharing and 13.6% without bed-sharing. The rate of prone sleeping position in children younger than 6 months of age was 9.3–3.5% with breastfeeding and 5.8% with formula feeding. Lower frequencies of tobacco, alcohol, and nonsupine sleeping positions were observed among mothers who practiced breastfeeding and bed-sharing.Conclusions: We found a close relationship between breastfeeding and bed-sharing and a lower frequency of SIDS risk factors associated with both practices. Families should be informed about the risk factors associated with SIDS to encourage safe bed-sharing while avoiding recommendations that discourage breastfeeding.

Bedsharing in Early Childhood: Frequency, Partner Characteristics, and Relations to Sleep

Bedsharing (sharing a bed with others during sleep) in early childhood (3–5 years old) is common across Western and non-Western societies alike. Though prior work indicates that bedsharing may relate to impairments in child sleep quantity or quality, the majority of studies conducted in young children are limited to parent-child bedsharing and rely almost exclusively on caregiver reports to measure child sleep. Here, the authors endeavored to gain further insights into the diversity of bedsharing practices among children in the United States, including how different bedsharing partners (caregivers, siblings) might impact actigraphy-derived measures of children’s sleep. Using a sample of 631 children ages 2:9 to 5:11 years, we found that over 36% of children bedshared in some form overnight, with approximately 22% bedsharing habitually. In a subset of children for whom actigraphy measures were collected (n = 337), children who bedshared habitually (n = 80) had significantly shorter overnight sleep, later sleep and wake times, and longer naps than solitary sleepers (n = 257), even when controlling for socioeconomic status. Despite supplementing their shorter overnight sleep with longer naps, habitually bedsharing children had significantly shorter 24-hr sleep time than did solitary sleepers, though differences in sleep efficiency were nonsignificant for all sleep periods. Additionally, sleep efficiency, onset latency, and duration did not differ between children who habitually bedshared with siblings versus those who habitually bedshared with parents. The present results add to prior work examining family contextual correlates of sleep differences in early childhood and provide a more objective account of relations between bedsharing and child sleep.

Associations between mother-infant bed-sharing practices and infant affect and behavior during the still-face paradigm

Parents in the United States increasingly report bed-sharing with their infants (i.e., sleeping on a shared sleep surface), but the relationship between bed-sharing and child socioemotional outcomes are not well understood. The current study examines the links between mother-infant bed-sharing at 3 months and infant affect and behavior during a dyadic challenge task at 6 months. Further, we examine nighttime mother-infant contact at 3 months as a possible mechanism that may mediate linkages between bed-sharing and infant outcomes. Using observational data from a sample of 63 mother-infant dyads, we found that infants who bed-shared for any proportion of the observation period at 3 months displayed significantly more self-regulatory behaviors during the still-face episode of the Still-Face Paradigm (SFP) at 6 months, compared to non-bed-sharing infants. Also, infants of mothers who bed-shared for the entire observation period displayed significantly less negativity during the reunion episode than non-bed-sharing infants. There was no evidence that the relations between mother-infant bed-sharing practices and infant affect and behavior during the SFP were mediated through nighttime mother-infant contact. Results suggest that infant regulation at 6 months postpartum may vary based on early nighttime experiences, with bed-sharing potentially promoting more positive and well-regulated behavior during dyadic interaction.

Women Who Bedshare More Frequently at 14 Weeks Postpartum Subsequently Report Longer Durations of Breastfeeding.

Breastfeeding rates in the United States continue to fall short of Healthy People 2020 goals. Bedsharing has been promoted as a way of increasing breastfeeding durations. We used prospectively collected Oregon Pregnancy Risk Assessment Monitoring System (PRAMS) and PRAMS-2 data from 2276 women to explore whether bedsharing frequency predicts age at weaning. Bedsharing was assessed at 14 weeks after birth (PRAMS), and duration of breastfeeding was assessed at 2 years after birth (PRAMS-2). Cox proportional hazards models controlled for primiparity, cesarean birth, marital status, employment status, maternal race and ethnicity, and pregravid body mass index. Women in this sample reported high rates of bedsharing: only 15.7% of PRAMS respondents said they never shared a bed with their infant. We also observed a dose-response association between bedsharing frequency and breastfeeding duration when the analysis controlled for covariables: women who reported more frequent bedsharing at 14 weeks postpartum were more likely to wean later. Hazard ratios ranged from 1.18 (95% CI, 1.02-1.35) for "often" versus "always" bedsharing to 1.92 (95% CI, 1.66-2.24) for "never" versus "always." In other words, at any given infant age, women who always bedshared were more likely to keep breastfeeding. Women who always bedshared at 14 weeks postpartum breastfed their infant for a median of 13 months (95% CI, 12-14), compared with 10 months (95% CI, 9-11) for women who never bedshared at 14 weeks. Although we cannot rule out confounding by breastfeeding intention, our results suggest that bedsharing in early infancy might lead to later weaning. Regardless of infant feeding method, given the frequency of bedsharing reported by women in this and other samples, clinicians encountering pregnant and postpartum women should teach safe bedsharing practices.

Bed-Sharing in the First 8 Weeks of Life: An Australian Study.

Background As the evidence continues to emerge about the relationship between sudden unexpected death in infancy (SUDI) and the way an infant sleeps, providing consistent and evidence-informed recommendations on how best to sleep infants is an ongoing challenge. A recent case series study in the state of Victoria, Australia, identified 45.8% of sleep-related infant deaths occurred whilst bed-sharing. This study prompted the need for further exploration of infant sleeping practices, including bed-sharing, in this population. Methods A cross-sectional survey of 2745 mothers attending the Maternal and Child Health (MCH) Service across Victoria, Australia was conducted. Data included the prevalence and circumstances of bed-sharing, family demographics, and SUDI risk and protective factors. Associations between bed-sharing and SUDI risk and protective factors were examined using univariate and multivariate analyses. Results Bed-sharing prevalence was found to be 44.7%, with 21.5% reporting that this was intended. Multivariate analyses showed bed-sharing was less likely amongst those with an annual household income above $AUS104, 000 (OR 0.72; 95% CI 0.54-0.96) and more likely amongst mothers who breastfed (OR 1.71; 95% CI 1.23-2.37). Conclusions Bed-sharing prevalence in this population compares closely with the Victorian case series study and a previous cross-sectional study in the state of Queensland, Australia, in 2002. Noted gaps in how families are implementing current recommendations about reducing the risk of SUDI were identified for sleep position, sleep location and the sleep environment. Further consideration needs to be given to addressing these gaps and applying these findings of current bed-sharing practices to the development of infant safe sleeping policy and programs.

Prevention Messages in Parent-Infant Bed-Sharing: Message Source, Credibility, and Effectiveness.

Objective. Despite educational outreach, bed-sharing prevalence is rising. Mothers’ and fathers’ bed-sharing practices, prevention message source, perceived source credibility, and the effectiveness of the prevention message were evaluated. Methods. Data were collected from 678 community parents via an online survey. Results were analyzed using descriptive statistics and phi tests. Results. Bed-sharing reasons focused on comfort and ease. Mothers were more likely to receive prevention messages from individual professionals or organizations, whereas fathers were more likely to hear prevention messages from spouses/coparents and grandfathers. Physicians were the most common source, and physicians and grandmothers were rated as the most credible and effective. Conclusions. Prevention message source varies between mothers and fathers, highlighting the need for continued research with fathers. Grandmothers and physicians are effective and credible sources of prevention messages. Although less frequent, prevention messages from grandmothers were most effective. There was no evidence of effective messages from educational campaigns.

Factors That Influence Where Babies Sleep in the United States

Overview: Bedsharing is common in the United States in spite of numerous public health campaigns telling parents not to do it. This suggests that generic, never-bedshare messaging does not result in safe-sleep behavior. It also suggests we know little about the characteristics of mothers who bedshare. This study addresses this gap by examining demographic characteristics of mothers including race/ethnicity, income, education, partner status, and maternal age.Sample: The sample was the U.S. cohort (N = 4,789) of the Survey of Mothers’ Sleep and Fatigue.Results: Consistent with previous findings, we found that African American and American Indian mothers were more likely to bedshare, as were lower income and single mothers. We also found that bedsharing mothers were more likely to have lower education levels, be younger age at first birth, and were less likely to be currently employed. There were also striking racial/ethnic differences on location of night feeds, where mothers think babies should sleep, and their reasons for engaging in their nighttime parenting practices.Conclusion: Our findings suggest that the mothers’ demographics are related to bedsharing practices. Furthermore, simply describing bedsharing in terms of “cultural differences” oversimplifies a complex set of behaviors and beliefs. Safe sleep messaging, including safe bedsharing, needs to be tailored to address the various subgroups of mothers living in the United States.

Sleep-Related Infant Deaths in Victoria: A Retrospective Case Series Study.

There is general agreement that in some circumstances, sharing a sleep surface of any kind with an infant increases the risk of sudden unexpected death in infancy. There is a paucity of research conducted in Australia examining this issue. This study examines the frequency and distribution of sleep-related infant deaths in a defined population, and reports the proportion that occurred in the context of bed-sharing. A retrospective population-based case series study was conducted of infants (≤365 days) who died in a sleeping context during the period 1 January 2008 to 31 December 2010 in the state of Victoria, Australia. Information about the infant, caregiver, sleeping environment and bed-sharing was collected from a review of the coroner's death investigation record. During the 3-year study period, 72 infant deaths occurred in a sleeping context. Of these, 33 (45.8 %) occurred in the context of bed-sharing: n = 7 in 2008; n = 11 in 2009; and n = 15 in 2010. Further analysis of the 33 deaths occurring in the context of bed-sharing showed that in this group, bed-sharing was largely intentional, habitual and most often involved the mother as one of the parties. Given the case series nature of the study design, a causal relationship between bed-sharing and infant death could not be inferred. However the fact that nearly half of all sleep-related deaths occurred in the context of bed-sharing, provides strong support for the need to undertake definitive analytic studies in Australia so that evidence-based advice can be provided to families regarding the safety of bed-sharing practices.

Exploratory study of bed-sharing and maternal-infant bonding.

Bed-sharing with an infant is controversial due to the increased risk of sudden unexpected death in infancy versus postulated benefits of the practice such as enhanced breastfeeding and maternal-infant bonding. This study evaluated the association between bed-sharing and maternal-infant bonding. Four hundred randomly selected mothers who had delivered in a large maternity unit in Auckland and whose infants were between the ages of 6 weeks and 4 months were sent a postal questionnaire asking about their bed-sharing practices last night, usually, and in the last 2 weeks. Included in the questionnaire were factors 1 and 2 questions from the Postpartum Bonding Questionnaire to assess maternal-infant bonding. Responders totalled 172 (43%), and infants were a mean age of 11 weeks. Fourteen per cent of infants slept in a bed-sharing situation last night, 8% usually, and 41% had slept with an adult in the last 2 weeks. Nine per cent of mothers scored above the cut-off for factor 1 for impaired maternal-infant bonding. Infants of these mothers were more likely to bed-share last night, usually, and in the last 2 weeks, and were less likely to use a pacifier and to breastfeed. Bed-sharing mothers scored more highly on individual questions relating to being annoyed or irritated by their baby. There is an inverse association between bed-sharing and maternal-infant bonding, which is contrary to the often expressed belief that bed-sharing enhances maternal-infant bonding.

Mother–child bed-sharing associated with more wheezing in early childhood

Household crowding, including the number of people sharing the child’s bedroom, may place young children at risk of acute lower respiratory infection [1]. However, crowding may also protect against asthma, according to the hygiene hypothesis [2]. Thus bed-sharing in early childhood might either increase or decrease the risk for asthma. On the other hand, parents may adopt bed-sharing practices that allow for closer monitoring of their already asthmatic children. In a recent review, Koinis-Mitchell et al. [3] suggested that asthma underlies sleep problems as a consequence of sleep disordered breathing and frequent awakenings at night. No studies have yet investigated the associations between bed-sharing and asthmatic symptoms. In the current study, we assessed whether bed-sharing practices protect young children from developing asthmatic symptoms, or place them at risk for these symptoms. In the current population-based prospective cohort study ( N = 5,543) we assessed bed-sharing at ages 2 and 24 months, and wheezing, the most important asthma symptom, at ages 1 through 4 years by questionnaires. Generalized estimating equation models (GEE) were used to assess repeated measures of wheezing, and multinomial regression analysis to assess patterns of wheezing over time. Results indicated that bed-sharing at 2 or 24 months were not associated with wheezing at later ages. However, assessing patterns of wheezing over the preschool years shows that bed-sharing at 24 months is associated with early-only wheezing (i.e. wheezing reported only at ages 1 and 2 years; OR 1.64, CI 1.13–2.37, p < .01), even after controlling for maternal educational level, history of atopy and asthma, smoking, body mass index (BMI), breastfeeding, parity, child ethnicity, gender, gestational age at birth, daycare attendance, pet keeping, eczema, and lower respiratory tract infections. Bed-sharing at 2 and 24 months of age was not associated with wheezing later in the preschool years, or with persistent wheezing over time. However, children who bed-shared with their parents at 24 months of age had higher odds to be in the early-only wheezing group. This suggests that bed-sharing children wheeze more, but only at early ages. The transient nature of these children’s wheezing might be associated with the relatively high prevalence of viral infections in the first years of life. It could also be that parents of early-only wheezers bring their child to the parental bed in order to monitor their breathing. This large longitudinal study is the first to explore the associations between bed- sharing practices and wheezing, and shows important associations between this sleep related parenting practice and children’s asthma symptoms. The Generation R Study is conducted by the Erasmus Medical Centre in close collaboration with the School of Law and the Faculty of Social Sciences at the Erasmus University, Rotterdam, the Municipal Health Service, Rotterdam area, and the Stichting Trombosedienst and Artsenlaboratorium Rijnmond (Star-MDC), Rotterdam. We gratefully acknowledge the contribution of general practitioners, hospitals, midwives and pharamacies in Rotterdam.

Ethnic differences in prevalence and determinants of mother–child bed-sharing in early childhood

BackgroundTo date few studies have examined how multiple layers of influences shape the emergence of bed-sharing practices in the first 2years postpartum. In our report, we examined bed-sharing in a large multiethnic sample, exploring the influences of three broad classes of influence on bed-sharing at single time points and across time: (1) sociodemographic and (2) contextual factors such as breastfeeding, maternal mental health and stress, and (3) child temperament and sleep habits. MethodsFrequencies of bed-sharing were assessed at two time points, 2 and 24months, in a population-based multiethnic (Dutch, Turkish or Moroccan, and Caribbean) sample of 6309 children born in the Netherlands. ResultsIn Dutch mothers, the majority of mothers did not share their beds with their child, and bed-sharing rates decreased from 2 to 24months. Other ethnic groups showed higher bed-sharing rates, typified by both increases in bed-sharing (the Turkish and Moroccan group) and persistence of bed-sharing over time (the Caribbean group). There were few family and child characteristics associated with bed-sharing in the non-Dutch ethnic groups. In contrast, bed-sharing in Dutch mothers was associated with child temperament and sleeping problems, maternal depression, and sociodemographic variables like crowding and maternal education. ConclusionsOur results suggest that mothers with a Turkish and Moroccan or Caribbean background were more influenced by cultural values, whereas bed-sharing practices were more reactive in the Dutch group.

Bed-sharing influences, attitudes, and practices

The purpose of this study was to examine the infant bed-sharing practices of mothers from the birth of the infant to three months of age. The study was a longitudinal descriptive design using a self-report instrument immediately after delivery with follow-up phone interviews at one and three months after discharge. While no mothers intended to bed-share with their infants immediately after delivery, 60 percent reported bed-sharing at some time at one month after discharge and 9 percent at three months. Only 19 percent of mothers reported receiving information about infant sleeping practices from their physician and 22 percent from their nurse. One month post discharge was identified as a high-risk period for infant bed-sharing. Interventions aimed at teaching new mothers about responding to infant cues and ways to manage a fussy infant may minimize the rate of bed-sharing.

Never Sleep with Baby? Or Keep Me Close But Keep Me Safe: Eliminating Inappropriate &amp;#x201C;Safe Infant Sleep&amp;#x201D; Rhetoric in the United States

Creating public health messages regarding how mothers should sleep close and safely with their babies is tricky and complex. It requires an appreciation of what exactly the term “sleeping with baby” and “co-sleeping” can mean. It also requires sensitivity to what parents will or can do if told emphatically “never sleep with your baby.” In the United States, well-intentioned public health messages from prominent government agencies about safe infant sleep have increasingly used language that equates “safe infant sleep” with the absence of the mother. Many messages seemingly imply that all forms of “co-sleeping” are dangerous and that those parents that practice it are acting irresponsibly. Messages such as “babies sleep safest alone” conflict with both laboratory and epidemiological findings as well as with recommendations from most medical organizations, including the American Academy of Pediatrics, who state that mothers and babies should sleep on separate surfaces close together in the same room. Moreover, studies reveal that breastfeeding and forms of co-sleeping, including both roomsharing and bedsharing, are functionally interdependent and that many mothers worldwide find that they can manage their own and their infants needs more easily by adopting at least intermittent bedsharing. Hence, simple, unqualified recommendations against ever bedsharing are not likely to be followed. According to recent studies the most effective public health recommendations are likely to be those that educate parents and facilitate parents in implementing bedsharing safeguards alongside their own choices. This approach does not exclude informing parents of what we know can be dangerous about some bedsharing practices, nor where and when it should be avoided altogether. Rather, it acknowledges that while separate surface co-sleeping in the form of roomsharing should always be recommended, nonetheless, many parents will appreciate and benefit from the opportunity to learn how to reduce the risks associated with bedsharing.

Infant Bed-Sharing Practices and Associated Risk Factors among Births and Infant Deaths in Alaska

The Alaska Division of Public Health has stated that infants may safely share a bed for sleeping if this occurs with a nonsmoking, unimpaired caregiver on a standard, adult, non-water mattress. Because this policy is contrary to recent national recommendations that discourage any bed sharing, we examined 13 years of Alaskan infant deaths that occurred while bed sharing to assess the contribution of known risk factors. We examined vital records, medical records, autopsy reports, and first responder reports for 93% of Alaskan infant deaths that occurred between 1992 and 2004. We examined deaths while bed sharing for risk factors including sleeping with a non-caregiver, prone position, maternal tobacco use, impairment of a bed-sharing partner, and an unsafe sleep surface. We used Pregnancy Risk Assessment Monitoring System data to describe bed-sharing practices among all live births in Alaska during 1996-2003. Thirteen percent (n=126) of deaths occurred while bed sharing; 99% of these had at least one associated risk factor, including maternal tobacco use (75%) and sleeping with an impaired person (43%). Frequent bed sharing was reported for 38% of Alaskan infants. Among these, 60% of mothers reported no risk factors; the remaining 40% reported substance use, smoking, high levels of alcohol use, or most often placing their infant prone for sleeping. Almost all bed-sharing deaths occurred in association with other risk factors despite the finding that most women reporting frequent bed sharing had no risk factors; this suggests that bed sharing alone does not increase the risk of infant death.

Maternal Bedsharing Practices, Experiences, and Awareness of Risks

The objectives of this study were to determine mothers' practices and experiences of bedsharing with their infants and also to determine their knowledge of the risks. A self-report questionnaire was mailed to 1,122 mothers of infants. Manitoba, Canada. The participants in this study were the mothers of infants aged 3 months whose contact information was obtained through the Manitoba Health Information Privacy Committee. Maternal-infant bedsharing practices and maternal knowledge of risks. There were 293 completed questionnaires received (26% return rate). Key findings suggest that although 89% of participants agreed that sleeping with one's baby has some risks associated with it, 72% reported that they bedshared with their baby on either a regular or an occasional basis. Mothers who breastfed were twice as likely to have bedshared. Approximately 13% of respondents who had bedshared reported an experience(s) with bedsharing in which they had rolled onto or partway onto their infant. Although the majority of participants agreed that bedsharing had risks for infants, almost three quarters of respondents reported bedsharing on a regular or an occasional basis. Reports by respondents of rolling onto or partway onto their infants support the conclusion that health care professionals should promote safe sleeping environments that include a separate sleep surface for infants.

A Longitudinal Study of Bed Sharing and Sleep Problems Among Swiss Children in the First 10 Years of Life

To study age trends, long-term course and secular changes of bed-sharing practices, and sleep problems among Swiss families. A total of 493 children were longitudinally followed between 1974 and 2001 by using structured sleep-related interviews at 1, 3, 6, 9, 12, 18, and 24 months after birth and at annual intervals thereafter until 10 years of age. Parents were queried about bed sharing, night wakings, bedtime resistance, and sleep-onset difficulties during the 3 months before each follow-up interview. Although in the first year of life relatively few children slept with their parents (<10%), bed sharing increased with age and reached a maximum at 4 years (> or =1 times per week: 38%). Bed sharing of at least once per week was noted in 44% of the children between 2 and 7 years old. Nocturnal wakings also increased from 6 months old to a maximum at 4 years, when more than half of all children woke up at least once per week (22% every night at 3 years). Less than 10% of all children demonstrated frequent bedtime resistance and sleep-onset difficulties. Bed sharing and night wakings during early infancy were not predictive for bed sharing or night wakings during childhood, whereas both bed sharing and night wakings during childhood tended to persist over time. In contrast, bedtime resistance and sleep-onset difficulties seemed to be rather transient phenomena across all ages. No consistent cohort trends were found except for bedtime resistance, which decreased significantly between 1974 and 2001. Bed sharing and nocturnal wakings are common during early childhood. Developmental changes in separation-attachment processes, cognitive capabilities to develop self-recognition and nighttime fears, and motor locomotion may contribute to the particular age trend of night wakings and bed sharing during early childhood.

Breastfeeding, bed-sharing, and infant sleep.

Expectations for infant sleep development and for the appropriate degree of parental proximity for infant sleep are culturally weighted and historically shifting aspects of parenting behavior, and are known to affect breastfeeding prevalence and duration. This paper examined how new parents managed night-time feeding in the first 4 months, with a particular focus on the relationship between breastfeeding, infant sleep location, and sleep bout duration. Sleep logs and semistructured interviews were used with a sample of 253 families in North Tees, United Kingdom, to explore how parents responded to their infant's sleep patterns, how breastfeeding parents managed night-time feeding, and whether bed-sharing was a common strategy. A clear relationship between breastfeeding and parent-infant bed-sharing was demonstrated. Some evidence indicated that bed-sharing may promote breastfeeding. An understanding of the role of infant feeding practice on infant sleep and parental caregiving at night is a crucial element in breastfeeding promotion and enhancement of infant health. Health professionals should discuss safe bed-sharing practices with all parents.

Sleeping Pattern Important in Reducing SIDS

To date few studies have examined how multiple layers of influences shape the emergence of bed-sharing practices in the first 2 years postpartum. In our report, we examined bed-sharing in a large multiethnic sample, exploring the influences of three broad classes of influence on bed-sharing at single time points and across time: (1) sociodemographic and (2) contextual factors such as breastfeeding, maternal mental health and stress, and (3) child temperament and sleep habits.Frequencies of bed-sharing were assessed at two time points, 2 and 24 months, in a population-based multiethnic (Dutch, Turkish or Moroccan, and Caribbean) sample of 6309 children born in the Netherlands.In Dutch mothers, the majority of mothers did not share their beds with their child, and bed-sharing rates decreased from 2 to 24 months. Other ethnic groups showed higher bed-sharing rates, typified by both increases in bed-sharing (the Turkish and Moroccan group) and persistence of bed-sharing over time (the Caribbean group). There were few family and child characteristics associated with bed-sharing in the non-Dutch ethnic groups. In contrast, bed-sharing in Dutch mothers was associated with child temperament and sleeping problems, maternal depression, and sociodemographic variables like crowding and maternal education.Our results suggest that mothers with a Turkish and Moroccan or Caribbean background were more influenced by cultural values, whereas bed-sharing practices were more reactive in the Dutch group.