The proportion of infants who are sharing a bed with caregivers increased between 1993 and 2010, especially among black and Hispanic families, according to a recent study.
While infant bed sharing is a common practice in many countries, strong associations between the practice and sudden infant death syndrome have been established, the authors wrote in the background for the study, which was published Sept. 30 on the website of JAMA Pediatrics. The American Academy of Pediatrics recommends infants share a room with their parents but not a bed for sleeping to prevent sleep-related infant deaths.
The study by Eve R. Colson, MD, of the Yale University School of Medicine, New Haven, Conn., and colleagues included data on 18,986 participants in the National Infant Sleep Position study, which was conducted through annual telephone surveys in 48 states. More than 84% of the survey respondents were the mothers of infants, while almost half of the caregivers were 30 older, had at least a college education and had a yearly income of at least $50,000. More than 80% of the survey participants were white.
Of survey participants, 11.2% reported infant bed sharing as a usual practice; the proportion of bed sharing increased from 6.5% in 1993 to 13.5% in 2010. Bed sharing increased among black and Hispanic families throughout the study period. Bed sharing increased among white families in the first part of the study period (1993 to 2000), but not more recently (2001 to 2010), according to the results.
The percentage of black infants usually sharing a bed increased from 21.2% in 1993 to 38.7% in 2010; the increase for Hispanic infants was 12.5% in 1993 to 20.5% in 2010. White infants usually sharing a bed increased from 4.9% in 1993 to 9.1% in 2010.
We found that black infants, who are at highest risk of sudden infant death syndrome and accidental suffocation and strangulation in bed, share a bed most often, the authors wrote. Compared with white infants, black infants are 3.5 times more likely to share a bed.
The researchers found several other factors associated with an infant usually sharing a bed, including a household income less than $50,000; living in the West or the South; infants younger than 15 weeks; and being born prematurely.
Almost 46% of survey participants reported speaking with their physician about bed sharing. When compared with those who did not receive advice, those who reported the physician had a negative attitude toward the practice were less likely to bed-share. A neutral attitude on the part of the physician was associated with an increase in bed sharing, the results showed.
The factors associated with infant bed sharing may be useful in evaluating the impact of a broad intervention to change behavior, the authors concluded.
In an accompanying editorial, Abraham B. Bergman, MD, of the Harborview Medical Center, Seattle, argued possible benefits of co-sleeping are being dismissed.
Because of their belief that bed sharing increases infant mortality, the authors call for increased efforts by pediatricians to discourage the practice, Bergman writes. I find the report disquieting because evidence linking bed sharing per se to the increased risk for infant death is lacking.
According to Bergman, the push to discourage bed sharing is based on a recommendation of the American Academy of Pediatrics.
Equal time in counseling should be given to the benefits to bed sharing, such as more sleep for the parent, easier breast-feeding when the infant is nearby, ease of pacifier reinsertion and the intangible satisfaction of skin-to-skin contact, Bergman concluded. In its admonition against bed sharing, the AAP has overreached.
Study abstract: http://archpedi.jamanetwork.com/article.aspx?articleid=1746117
Editorial extract: http://archpedi.jamanetwork.com/article.aspx?articleid=1746115