Flaws in the AAP’s “never bedshare!” recommendation.
I genuinely like to believe the AAP (American Academy of Pediatrics) mostly does have the best interest of families in mind. They provide many resources and sound recommendations regarding a wide range of parenting topics.
However, their hard and fast rule around bedsharing is largely flawed and impractical.
While co-sleeping is recommended by the AAP for at least the first six months (ideally for the first year), they strongly discourage against bedsharing. They largely make claims that bedsharing increases the chances of SIDS (sudden infant death syndrome) but look past many risk factors that contribute to infant death while in a bedsharing situation. (we’ll go over these risk factors soon as well as how to practice safer bedsharing!)
This abstinence only approach to bedsharing is quite honestly unsustainable for many families and is rooted in ablism, racism, classism, and ethnocentrism.
Bedsharing is a logistical necessity for many families. For parents who may be hard of hearing, visually impaired, or have physical limitations, bedsharing is often the safest way for them to respond to their babies and toddlers overnight. For many families, a separate sleeping space for a baby (such as a crib or bassinet- let alone a separate room for a baby) is financially not an option. It’s also an incredibly common practice worldwide, bedsharing is has been done for hundreds of years by a variety of cultures. Bedsharing is safely practiced in at least 70% of all documented cultures. Honestly some countries- with some of the lowest SIDS rates worldwide mind you- are baffled by the western idea that a baby would sleep separate from their caregiver(s) and consider it to be an act of cruelty or infant abuse.
So telling families to never bedshare and if they do they’re greatly increasing the risk of SIDS (when, in fact, it doesn’t) can be quite a damaging approach to educating families on safe infant sleep.
It’s like saying the best and only way to prevent pregnancy is to refrain from having sex at all. Which, we know, does nothing to reduce unwanted pregnancies. The best way to reduce unwanted pregnancies is to educate on safe sex practices and provide resources and contraceptives.
So, in my professional opinion, the same goes for bedsharing. When families are educated on how to approach it safely and are prepared to bedshare if need be (instead of doing it last minute out of sheer desperation) we’re able to reduce the risk of SIDS and empower parents to do what feels right for their family needs.
A few quick things to note about how the AAP approaches infant sleep:
they claim they cannot support bedsharing because they do not have the funds to research it’s safety- HOWEVER, they’ve also never requested funding or allotted research money for this topic.
the AAP ignores the fact that there are many modifiable factors that contribute to the safety of bedsharing, choosing instead to condemn the practice as a whole.
lactation consultants (and pediatricians) are often banned from sharing lifesaving information on safe bedsharing practices.
The AAP’s Infant Sleep Position and SIDS Subcommittee (which sounds like it should be made up of perhaps 100s of different experts) is only comprised of 10-12 trained medical doctors. None trained in psychobiology or the developmental or evolutionary sciences.
the AAP now recommends that parents breastfeed for two full years, however their recommendations against bedsharing completely undermine any parent’s ability to accomplish this goal. (especially for black families who already have some of the highest poverty numbers and have a 20% lower breastfeeding rate than that of white parents)
breastfed infants are 80% less likely to die before one year of age than those who’ve never breastfed.
research from the Breastfeeding Subcommittee of the AAP is ignored when creating their anti-bedsharing recommendtions.
Research has shown that there is a link between living in poverty and infant death.
many families living in poverty (who do not receive proper education on safer bedsharing) often practice what is known as chaotic bedsharing vs elective bedsharing.
CHAOTIC: chosen out of necessity, no other place for the baby, parents are unable to follow safety guidelines, predicted increased risk of SIDS or asphyxiation.
ELECTIVE: chosen as a childcare strategy, intention to nurture and breastfeed, parents knowledgable about safety precautions, can expect bedsharing to be protective and reduce the risk of SIDS.
Whether or not to bedshare should be a decision made on personal family values and interests, not out of fear instilled by the AAP (or “momfluencers” or your aunt Sally or your judgmental friends.) While I would never say there are NO risks associated with bedsharing, I would also never say that there are NO risks associated with crib sleep (as evidenced by the continuing epidemic of SIDS cases with babies who slept in cribs.) If the AAP is going to condemn bedsharing as a whole, they should also condemn crib sleep. (which of course doesn’t make sense.) Just as parents are provided with safer crib sleep guidelines, parents should also be provided safer bedsharing guidelines.
There isn’t a one size all approach to infant sleep and the AAPs recommendations do not align with evidence based medicine (as in they don’t take into account what parents want, think, or need.)
If you want to learn more about the reduce known risk factors and prepare yourself for safer bedsharing, please read my safer bedsharing post!
