Perspectives on Bed-Sharing

The successful and dramatic reduction in cot deaths has come about not so much because of a better understanding of causal mechanisms of sudden death but rather from identifying risk factors in the infant sleeping environment; in particular placing young infants on their front to sleep. More recently bed-sharing has been identified as a potential risk factor and similar efforts are being made in some countries to advise against this care practice. However prone sleeping is not a culturally widespread behaviour; introduced in the 20th century partly based on observations showing how premature infants thrived (and still do) when placed in this position in incubators. If we are going to advise against a behaviour such as bed-sharing that is common to many cultures over many thousands of years we need to address some basic questions. This review asks i) Is there any benefit to bed-sharing? ii) Is bed-sharing in itself a 'risk-factor' for SIDS? and iii) By advising against bed-sharing will we do any harm?