What It Means
Co-sleeping is a loose term for a parent and baby sleeping near each other, and people use it for two different setups. (1) Bed-sharing: the baby sleeps on the same bed, sofa or chair as an adult. The American Academy of Pediatrics (AAP) says that, based on the evidence, it can't recommend bed-sharing under any circumstances. (2) Room-sharingRoom sharingHaving a baby sleep in the parents' room in their own crib, bassinet or play yard. The AAP advises it for at least the first 6 months, without bed-sharing. See more: the baby sleeps in the parents' room on a separate surface made for infants, which the AAP recommends for at least the first 6 months.
Try It: See the AAP's Risk Figure for a Sleep Situation
Pick a bed-sharing situation to see how much higher the AAP says the risk of a sleep-related infant death becomes.
5 to 10 times higher risk
More than 10 times higher risk
Up to 67 times higher risk
Room-sharing: the setup the AAP recommends
The AAP can't recommend bed-sharing in any situation. These are the ones it singles out.
How Parents Say It
- "We co-sleep, but she's in the bassinet by our bed."
- "He ended up in our bed again at 3 a.m."
- "I fell asleep feeding her on the couch."
The Breakdown
Four situations the AAP says raise bed-sharing risk
| Situation | Risk of a sleep-related death, per the AAP |
|---|---|
| Baby younger than 4 months | 5 to 1010,000 stepsA popular daily step goal that began as the name of a 1960s Japanese pedometer; later studies find health benefits begin well below it. See more times higher |
| Baby born preterm or at low birthweight | 5 to 10 times higher |
| Adult who is fatigued, has taken medicine that makes waking harder, or has used alcohol or drugs | More than 10 times higher |
| Sleeping with someone on a couch, soft armchair or cushion | Up to 67 times higher |
The setup the AAP recommends instead. Keep the baby's crib, bassinetBassinetA small bed made for a young baby, often kept beside the parents' bed. CPSC says it's for babies up to about 5 months or until they can push up on hands and knees. See more or play yard in your room, next to your bed, for at least the first 6 months. If you bring your baby into bed to feed or comfort them, put them back in their own space before you go to sleep.
When to talk to your pediatrician. Ask at a checkup if night feeds leave you nodding off, if your baby only settles in your bed, or if your family already bed-shares and you want to talk through the risks for your own situation.
Good to Know
The AAP's 2022 policy statement is the source for these figures, and HealthyChildren.org, the AAP's site for parents, explains them in plain language. Those four rows are some of the situations the AAP names, not its whole list, so read the policy or HealthyChildren.org for the rest. None of them marks out conditions under which bed-sharing becomes safe. A sofa or armchair is the riskiest place of all to doze off with a baby, so if you feel sleepy while feeding there, put the baby down in their own space first. If your baby isn't breathing or can't be woken, call 911.
FAQ
Is co-sleeping safe?
It depends which kind. The AAP recommends room-sharing on separate surfaces, and it says it can't recommend bed-sharing under any circumstances.
What if I fall asleep while feeding my baby in bed?
The AAP's advice is to return your baby to their own crib or bassinet as soon as you wake. If you feel yourself getting drowsy, put the baby down in their own space before you sleep.
Why is falling asleep on the couch with a baby so risky?
HealthyChildren.org says the risk of a sleep-related death is up to 67 times higher when a baby sleeps with someone on a couch, soft armchair or cushion. It's the highest of the bed-sharing figures on that page.
Do It in Buhata
Handoff Card
Put the AAP's no bed-sharing rule and the couch warning on a Handoff Card (Premium) in Buhata so every caregiver who does a night feed sees them.
Open BuhataRelated Terms and Categories
- Room sharing
Having a baby sleep in the parents' room in their own crib, bassinet or play yard. The AAP advises it for at least the first 6 months, without bed-sharing.
- Safe sleep
The AAP's rules for lowering the risk of SIDS and suffocation: baby on the back, alone, on a firm flat surface in their own sleep space, every sleep.
- Bassinet
A small bed made for a young baby, often kept beside the parents' bed. CPSC says it's for babies up to about 5 months or until they can push up on hands and knees.
- Newborn
A baby in the first 28 days of life, the stage doctors also call the neonatal period.
- Attachment parenting
A parenting approach from Dr. William and Martha Sears built on closeness and quick response to a baby's cues. The AAP advises room-sharing without bed-sharing.
Sources
American Academy of Pediatrics, "Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment," Pediatrics, 2022; HealthyChildren.org (AAP), "How to Keep Your Sleeping Baby Safe: AAP Policy Explained"; HealthyChildren.org (AAP), "Safe Sleep: Back is Best, Avoid Soft Bedding, Inclined Surfaces & Bed Sharing"; American Academy of Pediatrics, "Safe Sleep and Your Baby: How Parents Can Reduce the Risk of SIDS and Suffocation" (patient education); NICHD Safe to Sleep, "Safe Sleep Environment for Baby"
- publications.aap.org/pediatrics/article/150/1/e2022057990/188304/Sleep-Related-Infant-Deaths-Updated-2022
- www.healthychildren.org/English/ages-stages/baby/sleep/Pages/a-parents-guide-to-safe-sleep.aspx
- www.healthychildren.org/English/news/Pages/safe-sleep-back-is-best-avoid-soft-bedding-inclined-surfaces-and-bedsharing.aspx
- publications.aap.org/patiented/article/doi/10.1542/peo_document088/79989/Safe-Sleep-and-Your-Baby-How-Parents-Can-Reduce
- safetosleep.nichd.nih.gov/reduce-risk/safe-sleep-environment
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