What is co-sleeping: Positions for co-sleeping

Pregnancy can be an exciting time, but it can also be filled with many decisions — and a topic that has long divided opinions is co-sleeping or sharing the same bed as your baby.

Sleeping arrangements are deeply personal, and your decisions may be swayed by the size of your home and how you feel in the first few weeks of parenthood. Having your baby close to you may make night feeds feel more manageable or give you the peace of mind that you can soothe them immediately when they wake up. It’s widely recommended that the safest way for your baby to sleep is in their own space, on their back, without any additional blankets, pillows, or bumpers. However, if you decide to co-sleep, then here are some tips to make it as safe as possible.

If you have considered co-sleeping at any point, then you’re not alone. A study published in the Handbook of Cross-Cultural Human Development estimated that 44% of US infants between the ages of 2 to 9 months “always,” “almost always,” or “sometimes” co-slept with their parents or guardians. Similarly, the charity, The Lullaby Trust, found that 76% of the 8,500 British parents they surveyed had co-slept with their baby at some point. 

Making decisions about sleeping following the birth of your baby can feel daunting, and putting your baby’s safety first is key. Online guidance can be inconsistent or even contradictory, which can make the whole thing seem even more confusing. That’s why we’ve broken down everything you need to know about co-sleeping below, including some of the things you should consider so it’s as safe as possible.

What is co-sleeping?

Co-sleeping is when you choose to sleep in the same bed, on the same surface, or close by in the same room as your child. Some parents choose to attach their baby’s bassinet directly to their bed or switch between sleeping in the bed together and putting their baby in their crib. According to the US Centers for Disease Control and Prevention, it’s a sleeping arrangement that 61% of families sometimes or often use. 

While it isn’t uncommon, co-sleeping has long divided opinions between parents and experts. For people who breastfeed, studies have suggested that co-sleeping can be beneficial. An Academy of Breastfeeding Medicine study found that it “promotes breastfeeding initiation.” Similarly, research published in the Journal of Human Lactation supported the idea that there are links between co-sleeping (or room sharing) and longer breastfeeding durations. 

Aside from co-sleeping being convenient for night feeds, there may be some psychological benefits to sleeping close to your child. One study concluded that infants who were breastfed and co-slept with their parents at six months old were better at managing stress than one-year-olds who didn’t sleep with their parents. Your baby may also be able to feel your heartbeat and breathing pattern, which mimics their experience in the uterus. However, research into this is limited. 

The main argument against co-sleeping hinges on safety and the correlation between bed-sharing and sudden infant death syndrome (SIDS), which we discuss in more detail below. Another point that’s often raised is that co-sleeping may discourage your child from being more independent. It’s totally normal to want to protect your baby, but learning to sleep alone may help them feel more secure when they’re not in your presence. Similarly, both you and your baby may get a better night’s sleep if you sleep in different rooms. A study published in Pediatrics found that infants over the age of four months who slept in their own room slept for longer. 

Ultimately, your child’s safety is your top priority. 

Is co-sleeping safe?

Until recently, co-sleeping has generally been discouraged by health care professionals due to perceived links to sudden infant death syndrome (SIDS) or cot death. The NHS describes SIDS as “the sudden, unexpected, and unexplained death of an apparently healthy baby” under the age of one. Tragically, there are an estimated 3,400 sudden unexpected infant deaths in the United States each year, according to the CDC.

SIDS may be something you’re incredibly anxious about. It can be something that’s too horrible to even think about. So what do the experts suggest? Well, the American Academy of Pediatrics recommends that “infants sleep in the parents’ room, close to the parent’s bed, but on a separate surface designed for infants, ideally for the first year of life, but at least for the first 6 months.” This is because “there is evidence that sleeping in the parents’ room but on a separate surface decreases the risk of SIDS by as much as 50%.” This may mean having your baby in a bassinet next to your bed but not on the bed with you.

However, the Royal College of Midwives’ recent Safer Sleep Guidance for Maternity Healthcare Professionals states that “none of the studies conducted to date provide evidence that co-sleeping causes SIDS, but that the two are linked through mediating factors.” 

Those factors that can increase the risk of SIDS include:

• Co-sleeping while parents or caregivers are under the influence of drugs and alcohol
• Smoking around your baby
• Co-sleeping on couches or sofas with babies

The American Academy of Pediatrics has also added the following factors that are linked to an increased risk of SIDs:

• Babies born prematurely or with a low birth weight
• Babies younger than four months old
• Soft bedding in a space where the baby is sleeping 

New research published in The Lancet’s eBioMedicine highlighted that there might be another reason why some babies are at a greater risk of SIDS. Researchers at the Children’s Hospital at Westmead in Australia analyzed an enzyme called butyrylcholinesterase (BChE) that’s found in your blood. They drew a sample from babies at birth and compared the samples of babies who died of SIDS with those who went on to be healthy. They found that the BChE levels of the babies who died of SIDS were significantly lower at birth. This is the first piece of research of its kind. 

So, information can be pretty conflicting, and you may just want a straight answer so you can make a decision for you and your baby. We put the safety question to Deborah Friedman, professor emeritus of pediatrics at New York Medical College. Her advice? “Bed-sharing is unsafe in the first year of life, but afterward, it’s felt to be safe and is a cultural and a personal choice.” As an alternative, she suggests that “room sharing can be very helpful in the first few months of life, especially for a breastfeeding mother.”

How to make co-sleeping safer

Because co-sleeping isn’t something that is widely encouraged by health care professionals, you’ll be hard-pressed to find a co-sleeping “yes” list from any organizations in the medical field, but there are some reliable sources that you can refer to for advice. The Lullaby Trust aims to reduce the number of SIDS deaths and support bereaved families. 

To help parents co-sleep more safely, they suggest removing any adult bedding from the space where your baby will be sleeping, ensuring your baby sleeps on their back, and not leaving them alone in the adult bed. You should make sure that the bed or surface your baby is sleeping on is firm and flat.

Positions for co-sleeping: The “C” co-sleeping position

In terms of the safest positioning for co-sleeping, the “C” position is a popular choice. This is where you lie on your side facing your baby with your lower arm above their head so that your body curls around them. Your knees should be positioned under your baby’s feet. 

This position is especially convenient for those who are breastfeeding as it gives your baby easy access to your breast without you having to repeatedly change your position.

Comfortable co-sleeping positions

Alongside the safety concerns surrounding co-sleeping, you may also wonder how you can co-sleep comfortably. We wanted to hear first-hand from parents to find out how they slept with their babies while bed-sharing. 

Alexandria co-slept with both of her children, now aged two and three. Describing how she would position her little ones in bed, she explains: “My partner is the big spoon, I’m the middle spoon, and the baby is the itty bitty spoon in front of me. I liked to cup around that little baby in a protective ball with their back to my chest.” 

Co-sleeping for Michelle, another parent of two, looked a little bit different. “I put my baby in between us but closer to me because my partner moves around a lot,” she says. “So I put the baby closer to me, and I put my arm around him, so he was kind of under my armpit area. So if my partner moved his elbow or something, he’d hit my hand and not the baby.”

For those who like the idea of maintaining close contact with your baby but aren’t quite sold on the traditional idea of co-sleeping, there are lots of bedside cribs on the market that you can attach to the side of your bed. This allows you to sleep right next to your baby. You can stroke them during the night or comfort them quickly when they wake up. However, your baby isn’t on the same surface as you.

How to transition from co-sleeping to a crib

You might decide co-sleeping works for you and your family for a period of time, but now that you’ve started, you don’t know how to stop. If your quality of sleep or the quality of sleep of your baby starts to be impacted, then it might be time to begin transitioning them into a crib in their own room. And, as a general rule, younger babies are more flexible, so this may be easier than with toddlers. While this might seem like a daunting task, it isn’t impossible. 

• Avoid letting your baby nap or feed in your bed. Babies don’t understand the difference between sleeping at night and napping during the day. If you let them sleep in your bed some of the time but not all of the time, this will confuse them. It isn’t the treat you might think it is. 
• Make your baby’s room an ideal environment for sleep. You can invest in blackout blinds, avoid putting lots of items around the baby’s crib, and keep their crib safe by avoiding extra blankets or pillows.
• Invest in a baby monitor. This way, you can still see and hear your baby even if they’re in another room. 
• If your child is a toddler or older, then explain to them why you’re making the change. Tell them that their space is their own and that it’s special. Develop a bedtime routine that’s calming and encourages them to be in their bed or crib. It won’t be easy right away, but they will get used to sleeping on their own. 

What is co-sleeping: The takeaway

Advice on co-sleeping has certainly shifted in recent years, as has the stigma attached to parents who choose to do it. Thankfully conversations have become more nuanced, and the emphasis has shifted from co-sleeping being a total no-no to some health care professionals advising on the best ways to do it as safely as possible. 

There’s a lot to consider, along with a huge amount of information (and in some cases, misinformation) around co-sleeping which could easily have you second-guessing your decisions. Try not to get overwhelmed, and take your time making sense of all there is to learn. Ultimately, it’s about doing what makes you comfortable and what you feel is best for yourself and your child.