Is co-sleeping ever safe? US experts update advice for first time in six years

The American Academy of Pediatrics has issued new guidelines on safe sleeping for infants and toddlers, just one week after a reported 13 deaths occurred from infants placed in inclined rockers. Now, doctors warn parents from co-sleeping with babies as it could increase the risk of suffocation.

On 21 June, the American Academy of Pediatrics (AAP) revised its safe sleep policy for the first time in five years to include new recommendations for reducing the risk of sudden infant death syndrome (SIDS).

The updated policy emphasises a number of safe-sleep recommendations from the previous version – including that babies should sleep on a firm, flat non-inclined surface. For the first time, the updated report also issued a new recommendation on co-sleeping.

“The AAP understands and respects that many parents choose to routinely bed share for a variety of reasons, including facilitation of breastfeeding, cultural preferences, and a belief that it is better and safer for their infant,” they said in the report. “However, on the basis of the evidence, the AAP is unable to recommend bed sharing under any circumstances.”

Doctors recommended placing the infant’s crib or bassinet in the parents’ bedroom, at least for the first six months. According to the AAP, evidence shows that avoiding co-sleeping will decrease the risk of SIDS by as much as 50 per cent.

“This arrangement also reduces SIDS risk and removes the possibility of suffocation, strangulation, and entrapment that may occur when the infant is sleeping in the adult bed,” they added.

Each year in the United States, an estimated 3,500 infants die of sleep-related infant deaths, including sudden infant death syndrome.

“We’ve made great strides in learning what keeps infants safe during sleep but much work still needs to be done,” Dr Rachel Moon, lead author of the safe sleep report, said in a statement. “A baby’s death is tragic, heartbreaking and often preventable. If we’ve learned anything, it’s that simple is best: babies should always sleep in a crib or bassinet, on their back, without soft toys, pillows, blankets or other bedding.”

Among the new recommendations to reduce the risk of SIDS also included short periods of supervised tummy time, feeding infants human milk, and avoiding the use of weighted blankets or swaddles.

“There is a high risk for death if a swaddled infant is placed in or rolls to the prone position,” the AAP said, adding that there is “no evidence” to suggest swaddling helps reduce the risk of SIDS. “If infants are swaddled, always place them on the back.”

Doctors also explained that proper swaddling should be snug around the chest but allow for ample room at the hips and knees. Parents can also decide whether to swaddle their child with their arms in or out of the blanket.

The new recommendations come after President Biden signed the Safe Sleep Act for Babies into law last March. The new legislation bans the manufacture, sale, or distribution of inclined sleep products and crib bumper pads, which have been linked to more than 200 reported deaths in the US.

Last week, the US Consumer Product Safety Commission (CPSC) and Fisher-Price issued an alert for the company’s Infant-to-Toddler Rockers and Newborn-to-Toddler Rockers after “at least 13 reported deaths” occurred between 2009 and 2021.

According to the CPSC, the deaths happened when the babies fell asleep in the rockers. The company advised parents and caregivers that rockers “should never be used for sleep and infants should never be unsupervised or unrestrained in the Rockers.”

As a result, the CPSC finalised a rule that requires infant sleep products to have a sleep surface angle of 10 degrees or less, which goes into effect on 23 June 2022.

The Independent contacted Fisher-Price for comment.