Prevalence of Bed-Sharing

Parent-infant bed-sharing is a fairly common sleeping arrangement employed by parents of young infants.

Over the past 15 or so years, research into parent-infant sleep in the UK, and around the world, has demonstrated that parent-infant bed-sharing is a common behaviour. Ball (2002, 2003) reported that bed-sharing prevalence (ever sleeping with baby in the same bed) in the north-east of England was 47% among a sample of 253 families with 1 month old infants, dropping to 29% when the same babies were 3 months old.

These figures were confirmed when Blair and Ball (2004) compared the above study with data from the 1095 UK national CESDI study control families. Using the same definitions of bed-sharing at identical time-points 48% of CESDI control families had slept with their infant during the 1st month, falling to 24% at 3 months.

This base-line bed-sharing prevalence of 47-48% among neonates has now been replicated by epidemiological studies around the world (see Table 1) and further confirmed for the UK by the 2005 infant feeding survey (Bolling et al 2007). Both McCoy et al (2004) and Blair and Ball (2004) also calculated that 22% of infants were likely to bed-share on any given night in their 1st month of life.

In one of the first studies examining bed-sharing in the UK Ball et al (1999) discovered that although expectant first-time parents did not anticipate sleeping with their baby, by 3 months after birth, the majority of parents had done so. Mothers were more likely to have slept with their babies than fathers, and breastfeeding mothers particularly so. This has now been confirmd in multiple subsequent studies.

Table 1: Prevalence of Bed-Sharing

Study

%

Sample

Method

Tuohy et al 1998

43

6,268 NZ families

Interviewed at clinics

Gibson et al 2000

46

410 Philadelphia families

Questionnaires

Rigda et al 2000

46

44 Australian families

Questionnaires

Ball 2002

47

253 NE UK families

Interviews / diaries

Brenner et al 2003

48

394 Inner City (DoC) families

Interviews

Willinger et al 2003

47

8453 US caregivers

NISPS telephone survey

Van Sleuwen et al 2003

40

210 Dutch families

Questionnaires

Blair & Ball 2004

48

1095 UK CESDI control families

HV interview

Lahr et al 2005

77

1867 US families

Oregon PRAMS surveys

Bolling et al 2007

49

12,290 UK mothers

Postal survey

Hauck et al 2008

42

2300 Infant Feeding Practices Study II respondents

Questionnaires

Ateah & Hamelin 2008

72

293 Canadian families

Questionnaires

Santos et al 2009

48

2636 Brazilian families

Home interview

Kendall-Tackett et al 2010

59

4789 (mainly breastfeeding) US mothers

Internet survey

Ehnicity and bed-sharing prevalence

Parents from particular ethnic groups are much more likely to share a sleep surface with their babies than others (Salm Ward & Doering, 2014; Ball et al 2013). The association between SIDS and bed-haring is very low for South Asian families in the UK; the UK South Asian community has a 4-times lower SIDS-rate than the White British community (Ball et al 2013). In the US, however, minorities are at the highest risk from SIDS and accidental infant death, with black infants being at two to three times greater risk than white infants. A review of literature by Salm-Ward & Doering (2014) found that the most significant evidence was the impact of maternal-level factors in the black community, such as tending to use softer bedding and more layers when bed-sharing. These sorts of ethnically distinct factors are most influenced by beliefs and practices surrounding infant-sleep and bed-sharing behaviour, not bed-sharing itself. This supports the idea that whilst bed-sharing can in itself pose a risk, the most significant risks are when it is not practiced safely.