Mother–Infant Sleep Locations and Nighttime Feeding Behavior

Kathleen Kendall–Tackett, Zhen Cong, Thomas W. Hale
Clinical Lactation, Volume 1, Fall 2010


The controversy around mother–infant bedsharing continues to grow. In order to make sound policy recommendations, policy makers need current data on where infants sleep and how families handle nighttime feedings. The present study is a survey of 4,789 mothers of infants 0–12 months of age in the U.S. The findings indicate that almost 60% of mothers bedshare and that this occurs throughout the first year. These findings also indicate that 25% of mothers are falling asleep with their infants in dangerous sleep locations, such as chairs, sofas or recliners. Recommendations for promoting safe infant sleep are made.

In 2005, the American Academy of Pediatrics (AAP) Task Force on SIDS3 issued a statement on safe sleeping practices for infants, recommending that infants “should not bedshare during sleep” (p. 1252). Subsequent to the AAP Statement, some local municipalities have attempted to make this point more strongly by telling parents to never bedshare, with public–service advertising designed to shock parents into compliance (see Figure 1).

In an attempt to present a simple “single message” to parents, these campaigns have, unfortunately, mischaracterized research findings regarding SIDS and infant sleep by indicating that “safe” sleep occurs in a crib and “unsafe” sleep occurs anywhere else. But the SIDS studies themselves indicate risk factors for infant death are not quite so simple. For example, a study of 325 SIDS cases from the UK found no excess risk of SIDS for term infants (>2,500 g at birth) who bedshared with non–smoking parents (Blair et al., 2006a). In a study of 238 SIDS cases in New Jersey, only 39% (N=93) were “bedsharing.” Of these, only 21 were breastfeeding, and most of these had other SIDS risk factors, such as non–supine position; pillows or fluffy blankets in the sleep area; substance abuse; couch/recliner sharing; or maternal smoking (Ostfeld et al., 2006). In 78% of these cases, families had anywhere from two to seven risk factors (Ostfeld et al., 2010).

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