Doctors debate safety of older babies sharing parents’ bedroom

At four months of age, nighttime and total sleep duration didn’t appear different based on whether babies slept in their own room or their parents’ bedroom, the survey of 230 mothers found. But babies who did sleep in their own room at this age got an average of 40 minutes more sleep a night by nine months of age than infants who were room-sharing this entire time.

“We know from prior research that babies experience brief awakenings overnight regardless of where they sleep,” said lead study author Dr. Ian Paul, chief of academic general pediatrics at Pennsylvania State College of Medicine in Hershey.

“Our research suggests that parents respond to these brief awakenings, which interrupts both parent and child sleep when they are room-sharing, but not as much when the baby is sleeping in a separate room,” Paul said by email. “This could set up a cycle where parents respond to the infant and then the infant grows to expect a parent response in order to get back to sleep.”

The American Academy of Pediatrics (AAP) recommends that babies sleep in the same room as their parents for at least the first six months of their lives, and ideally up to one year, to reduce the risk of SIDS. The safest place for infant sleep is on a firm surface such as a crib or bassinet without any soft bedding, bumpers or pillows – and not in their parents’ bed, the AAP guidelines stress.

Babies rooming with their parents at four months of age were more than twice as likely to have unsafe objects around them like blankets or pillows that increase the risk of sleep-related deaths, the study found. Infants in their parents’ rooms also had more than four times the odds of sleeping in their parents’ beds, another practice associated with an increased risk of SIDS.

These findings suggest AAP should reconsider its recommendation of continued room sharing up to one year of age, the authors conclude in Pediatrics.

The majority of the babies in the study – 62 percent – were already sleeping in their own room by four months of age, and another 27 percent of them made this transition by the time they were nine months old. About 11 percent of babies, however, were still room-sharing at nine months.

Babies were more likely to sleep in parents’ rooms when the mothers were single or not living with a partner, had less income or education, or had less space in their home to give the baby a separate room.

The study wasn’t a controlled experiment designed to prove how babies’ sleep location influences safety or the duration or quality of sleep.

Beyond its small size, another limitation of the study is that some mothers were given information on reducing the risk of SIDS and recommendations on where babies should sleep, the authors note, though this didn’t appear to influence whether room-sharing occurred.

Previous studies have linked room-sharing to a reduced risk of SIDS, which may have to do with babies sleeping more lightly and being more arousable or waking more easily when their parents are nearby, said Dr. Rachel Moon, a SIDS researcher at the University of Virginia and an author of the AAP’s infant sleep recommendations.

“A leading hypothesis in SIDS causation is that failure to arouse makes the infant more vulnerable to dying from SIDS,” Moon, author of an editorial accompanying the current study, said by email.

Still, it’s concerning the study found room sharing linked to unsafe infant sleep practices like bed-sharing and using pillows and blankets, Moon added.

“Bed-sharing is strongly recommended against and therefore it is important that a recommended practice (i.e., room-sharing) not lead to a practice that is associated with greater potential harm (i.e., bed-sharing),” Moon said.

SOURCE: bit.ly/2qQMnWd Pediatrics, online June 5, 2017.