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
|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.