Bedsharing Studies – With Quotes

As of May 2013

1.    “Co-sleeping should be avoided in infants who are <20 weeks of age.”

McGarvey C, McDonnell M, Chong A, O’Regan M, Matthews T. National Sudden Infant Death Register, The Children’s Hospital, Temple Street, Dublin 1, Republic of Ireland  Factors relating to the infant’s last sleep environment in sudden infant death syndrome in the Republic of Ireland. Arch Dis Child. 2003Dec;88(12):1058-64.

2.    Sharing a sleep surface was associated with SIDS. The association remained if mother did not smoke or the infant was breastfed … Bedsharing is associated with an increased risk of SIDS for infants <11 weeks of age.”

Tappin D, Ecob R, Brooke H. Paediatric Epidemiology and Community Health (PEACH) Unit, Department of Child Health, University of Glasgow, Yorkhill, Scotland, UK  Bedsharing, roomsharing, and sudden infant death syndrome in Scotland: a case-control study. J Pediatr. 2005 Jul;147(1):32-7.

3.    “For mothers who did not smoke during pregnancy, OR for bed-sharing was very small… and only significant during the first 8 weeks of life.” [One way to phrase this in a one sentence headline is: Co-sleeping with children under 2 months old was a significant risk factor for SIDS.]

R G Carpenter, L M Irgens, P S Blair, P D England, P Fleming, J Huber, G Jorch, P Schreuder  Sudden unexplained infant death in 20 regions in Europe: case control study.  Lancet 2004; 363: 185-91

4.    “Epidemiologic evidence shows that there is little or no increased risk for SIDS among infants of nonsmoking mothers but increased risk among infants of smoking mothers and younger infants [<8-11 weeks of age] of nonsmoking mothers. It seems prudent to discourage bedsharing among all infants <3 months old. Young infants brought to bed to be breastfed should be returned to a crib when finished…[P]utting an infant of a nonsmoking mother to sleep in an adult bed should be delayed until 3 months of age.”

Lahr MB, Rosenberg KD, Lapidus JA.  Bedsharing and maternal smoking in a population-based survey of new mothers. Pediatrics. 2005 Oct; 116(4):e530-42.
5.    “Infants aged <12weeks born of nonsmokers are at increased risk of SIDS with bed sharing compared with infants of nonsmoking mothers not bed sharing.”

E A Mitchell Department of Paediatrics, University of Auckland, Private Bag 92019, Auckland, New Zealand.  Recommendations for sudden infant death syndrome prevention: a discussion document. Arch Dis Child. 2007 February; 92(2): 155–159.

6.    Bed-sharing is a serious risk factor for sudden infant death for all babies of less than 4 months of age.”

Ruys JH, de Jonge GA, Brand R, Engelberts AC, Semmekrot BA., Leiden University Medical Center, Reviuslaan 38, 2343 JR Oegstgeest, The Netherlands. Bed-sharing in the first four months of life: a risk factor for sudden infant death. Acta Paediatr. 2007 Oct;96(10):1399-403.

7.    “Bed sharing (especially for infants younger than 13 weeks… increased the risk for sudden infant death syndrome.”

Vennemann MM, Bajanowski T, Brinkmann B, Jorch G, Sauerland C, Mitchell EA; GeSID Study Group.  Sleep environment risk factors for sudden infant death syndrome: the German Sudden Infant Death Syndrome Study. Pediatrics. 2009 Apr;123(4):1162-70.

8.    “By demonstrating that among an urban population at high risk for SIDS, bedsharing is strongly associated with a younger age at death, independent of any other factors.”

Cindie Carroll-Pankhurst and Edward A. Mortimer Jr   Sudden Infant Death Syndrome, Bedsharing, Parental Weight, and Age at Death  PEDIATRICS Vol. 107 No. 3 March 2001, pp. 530-536

9.    “[Y]ounger infants are at highest risk when faced with the environmental challenges of bedsharing….There was no evidence of diagnostic shift and the prevalence of bedsharing did not change over the decade. Conclusions: Bedsharing was associated with a high proportion of SUDI cases, especially in the youngest infants.”

Lynne Hutchison B, Rea C, Stewart AW, Koelmeyer TD, Tipene-Leach DC, Mitchell EA.  Sudden unexpected infant death in Auckland: a retrospective case review.  Acta Paediatr. 2011 Aug;100(8):1108-12. doi: 10.1111/j.1651-2227.2011.02221.x. Epub 2011 Mar 22.

10.  “During 2000-2002, 1,064 infants died from [Accidental Suffocation and Strangulation in Bed], resulting in an ASSB mortality rate of 9.2 per 100,000 live births. Most ASSB deaths (71%) occurred before an infant reached 4 months old.”

Carlberg MM, Shapiro-Mendoza CK, Goodman M. Matern  Maternal and Infant Characteristics Associated With Accidental Suffocation and Strangulation in Bed in US Infants. Child Health J. 2011 Jul 17. [Epub ahead of print] PMID: 21769585 [PubMed – as supplied by publisher]

11.  “Reported deaths of infants who suffocated on sleep surfaces other than those designed for infants are increasing. The most conservative estimate showed that the risk of suffocation increased by 20-fold when infants were placed to sleep in adult beds rather than in cribs.  The public should be clearly informed of the attendant risks.”

N. J. Scheers, PhD, George W. Rutherford, MS and James S. Kemp, MD   Where Should Infants Sleep? A Comparison of Risk for Suffocation of Infants Sleeping in Cribs, Adult Beds, and Other Sleeping Locations  PEDIATRICS Vol. 112 No. 4 October 2003, pp. 883-889

12.  “Infant mortality rates attributable to accidental suffocation and strangulation in bed have quadrupled since 1984.”

Carrie K. Shapiro-Mendoza, PhD, MPHa, Melissa Kimball, MPHa, Kay M. Tomashek, MD, MPHa, Robert N. Anderson, PhDb, Sarah Blanding, MPHa Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland.  US Infant Mortality Trends Attributable to Accidental Suffocation and Strangulation in Bed From 1984 Through 2004: Are Rates Increasing? Pediatrics Vol. 123 No. 2 February 1, 2009 pp. 533 -539 (doi: 10.1542/peds.2007-3746)

13.  “The Office of the Chief Medical Examiner (OCME) has recorded a significant increase of accidental asphyxia deaths in infancy associated with cosleeping in the state of Maryland in 2003. A total of 102 infants died suddenly and unexpectedly during 2003… Ten of the 46 cosleeping infant deaths (20%) were determined to be the result of accidental asphyxia, and 28 cosleeping infant deaths (59%) were classified as “undetermined” because the possibility of asphyxia due to overlay while cosleeping could not be ruled out.”

Li L, Zhang Y, Zielke RH, Ping Y, Fowler DR.  Observations on increased accidental asphyxia deaths in infancy while cosleeping in the state of Maryland. Am J Forensic Med Pathol.  2009 Dec;30(4):318-21. PMID: 19901821 [PubMed – indexed for MEDLINE]

14.  “Bed sharing showed an increased risk of dying accidentally, when compared with infants sleeping in designated infant containers.”

Beal SM, Byard RW  Sudden infant death syndrome in South Australia 1968-97. Part 3: is bed sharing safe for infants? J Paediatr Child Health 2000 Dec 36:552-4

15.  “Several factors related to the sleep environment during last sleep were associated with higher risk of SIDS: … bed sharing overall, bed sharing with parent(s) alone, and bed sharing in other combinations.”

Fern R. Hauck, Stanislaw M. Herman, Mark Donovan, Solomon Iyasu, Cathryn Merrick Moore, Edmund Donoghue, Robert H. Kirschner, and Marian Willinger  Sleep Environment and the Risk of Sudden Infant Death Syndrome in an Urban Population: The Chicago Infant Mortality Study  Pediatrics 2003; 111: 1207-1214

16.  “[C]osleeping or placing an infant in an adult bed is a potentially dangerous practice. The frequency of cosleeping among cases diagnosed as SIDS in our study suggests that some of these deaths may actually be caused by mechanical asphyxia due to unintentional suffocation by the cosleeping adult and/or compressible bedding materials.

Person TL, Lavezzi WA, Wolf BC. State University of New York at Plattsburgh. Cosleeping and sudden unexpected death in infancy. Arch Pathol Lab Med. 2002 Mar;126(3):343-5.

17.  “[A]sphyxia plays a greater role in many sudden infant deaths than has been historically attributed to it.”

Pasquale-Styles MA, Tackitt PL, Schmidt CJ   Infant death scene investigation and the assessment of potential risk factors for asphyxia: a review of 209 sudden unexpected infant deaths.  .  J Forensic Sci. 2007 Jul;52(4):924-9. Epub 2007 Jun 6.

18.  “Bed-sharing was involved in most of the unintentional suffocation deaths (90.9%) and the SIDS deaths (70.0%). All unintentional suffocation deaths (100%) and the majority of SIDS deaths (77.5%) took place in a non-crib sleeping environment….The study demonstrates how CDR provides enhanced documentation of risk factors to help steer prevention efforts regarding SUID deaths in a community and reaffirms infants in an unsafe sleep environment have an increased risk of death.”

Brixey SN, Kopp BC, Schlotthauer AE, Collier A, Corden TE. Department of Pediatrics, Policy Core, Injury Research Center, Medical College of Wisconsin, Downtown Health Center Pediatric Clinic, Milwaukee, Wisconsin, USA.  Use of child death review to inform sudden unexplained infant deaths occurring in a large urban setting. Inj Prev. 2011 Feb;17 Suppl 1:i23-7.

19.  “Bed-sharing appears to increase the proportion of unexplained deaths, regardless of the position of the infant.”

Thogmartin JR, Siebert CF Jr, Pellan WA. Palm Beach County Medical Examiner Office, West Palm Beach, Florida  Sleep position and bed-sharing in sudden infant deaths: an examination of autopsy findings. J Pediatr. 2001 Feb;138(2):212-7.

20.  “Bed sharing was associated with 2 times greater risk of SIDS compared with not bed sharing. .. bed sharing was still associated with an increased risk of SIDS, even when the infant was not using a pillow or sleeping on a firm surface…Bed sharing is a common practice among black infants. It is associated with a clear and strong increased risk of SIDS…This practice likely contributes to the excess incidence of SIDS among blacks.”.

Fu LY, Moon RY, Hauck FR.  Bed sharing among black infants and sudden infant death syndrome: interactions with other known risk factors. Acad Pediatr. 2010 Nov-Dec;10(6):376-82.

21.  “Babies were found on a sleep surface that was not designed for infants (adult bed, sofa, or chair) in more than 75% of the deaths.  Bedding covered the baby’s head or face in nearly 30% of the cases. A shared sleep surface was the site of death in almost half the cases.”

Kemp, J. S., Unger, B., Wilkins, D., Psara, R. M., Ledbetter, T. L., Graham, A.{p. M. A., Case, M., Thach, B. T.  Unsafe Sleep Practices and an Analysis of Bedsharing Among Infants Dying Suddenly and Unexpectedly: Results of a Four-Year, Population-Based, Death-Scene Investigation Study of Sudden Infant Death Syndrome and Related Deaths. Pediatrics Vol. 106 No. 3 September 1, 2000 pp. e41

22.  “In addition, the co-sleeping habit, which was not uncommon in Japan, seems to contribute to certain deaths of infants whose causes of death were controversial. In the investigation of SIDS, therefore, the sleeping environments, such as bedclothes and the co-sleeping habit, as well as the sleeping position should be taken into consideration as risk factors.”  

Mukai T, Tamaki N, Sato Y, Ohno Y, Miyazaki T, Nagamori H, Hara S, Endo T. Department of Forensic Medicine, Tokyo Medical University, 160-8402, Tokyo, Japan  Sleeping environments as risk factors of sudden infant death syndrome in Japan. Leg Med (Tokyo). 1999 Sep;1(1):18-24.

23.  “Asian v. Western Countries – These comparisons are grossly misleading and often used by those who may lack detailed knowledge on SIDS research. Unfortunately, the ways infant deaths are investigated and diagnosed vary from country to country and even state to state in the US. For example, up until 1995, Japan held two definitions of SIDS. Researchers that compared Asian and western countries found that ‘Suffocation’ as cause of death is rarely recorded in western countries. The situation in Asia is essentially different. Taiwan and Japan both record suffocation rates that are higher than SIDS rates, and together these two causes of death sum up to values similar to those for SIDS in western countries. Additional research in Japan has found bed sharing to be a risk factor for SIDS.”

Cindie Carroll-Pankhurst* and Edward A. Mortimer Jr.)  Sudden Infant Death Syndrome, Bedsharing, Parental Weight, and Age at Death. PEDIATRICS Vol. 107 No. 3 March 2001, pp. 530-536

24.  “Almost all SIDS deaths in Alaska occurred in association with prone sleeping, bed sharing, or sleeping outside a crib.”

Gessner BD, Ives GC, Perham-Hester KA.  Association between sudden infant death syndrome and prone sleep position, bed sharing,  and sleeping outside an infant crib in Alaska. Pediatrics Vol. 108 No. 4 October 1, 2001 pp. 923 -927 (doi: 10.1542/peds.108.4.923)

25.  “It might be prudent to inform parents that co-sleeping is a risk factor for SIDS and that it should therefore be avoided.” [Note:  this study focuses on deaths over 100 years ago.]

Williams FL, Lang GA, Mage DT.  Sudden unexpected infant deaths in Dundee, 1882-1891: overlying or SIDS? Scott Med J. 2001 Apr;46(2):43-7.

 26. “Bed sharing is a risk factor for SIDS and is especially enhanced in smoking parents and in very young infants.”

Mechtild M. Vennemann MD, MPHa, Hans-Werner HenseMDb, Thomas Bajanowski MD, PhDc, P.S. Blair PhDd, Christina Complojera, Rachel Y. Moon. Bed Sharing and the Risk of Sudden Infant Death Syndrome: Can We Resolve the Debate? The Journal of Pediatrics doi:10.1016/j.jpeds.2011.06.052 28 June 2011

 27“Asphyxia as a potential contributor to, or  as the specific cause of death, appears to exist in a large percentage of cases designated as SIDS using other classification schemes. When certifiers use a  classification system that focuses upon potential asphyxia in determining the  cause of death the incidence of SIDS dramatically declines.”

Randall B,  Donelan K, Koponen M, Sens MA, Krous HF., Application of a classification  system focusing on potential asphyxia for cases of sudden unexpected infant  death. Department of Pathology, University of South Dakota Sanford School of  Medicine, 2441 Stanton Dr, Sioux Falls, SD, 57103, Forensic  Sci Med Pathol. 2011 Nov 11

28.  “[C]urrently no reliable marker exists at  autopsy to distinguish a suffocation death from SIDS.”

Shapiro-Mendoza CK, Camperlengo LT, Kim SY,  Covington T., The Sudden Unexpected Infant Death Case Registry: A Method to
Improve Surveillance. Pediatrics. 2012 Jan 9

29.  “88% of the deaths that occurred while bed sharing would probably not have occurred had the baby been placed on its back in a [crib] by the parents’ bed. Even for the very low-risk breastfed babies under 3 months of age, with no risk factors other than that they slept in their parents’ bed, the model predicts that 81% of the deaths could have been readily prevented in this way. One has to ask whether it is worth taking the risk.”

Carpenter R, McGarvey C, Mitchell EA, et al. Bed sharing when parents do not smoke: is there a risk of SIDS? An individual level analysis of five major case–control studies. BMJ Open 2013;3:e002299.doi:10.1136/



















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