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Trends in infant bed sharing in the United States, 1993-2000: the National Infant Sleep Position study
Marian Willinger1, Chia-Wen Ko, Howard J Hoffman
1Pregnancy and Perinatology Branch, Center for Research on Mothers and Children, National Institute of Child Health and Human Development, National Institutes of Health, 6100 Executive Blvd, Room 4B03, MSC 7510, Bethesda, MD 20892-7510, USA. mw75q@nih.gov
Insights
Routine bed sharing among infants and caregivers is increasing in the U.S. This practice is influenced by cultural factors, necessitating further research into its risks and benefits for infant well-being.
Area of Science:
- Pediatrics
- Public Health
- Sociology
Background:
- Bed sharing with parents is a practice with debated implications for infant well-being, cited as both beneficial and potentially hazardous.
- Understanding the prevalence and influencing factors of bed sharing is crucial for public health initiatives.
Purpose of the Study:
- To examine trends in infant bed sharing with caregivers in the United States.
- To identify demographic and socioeconomic factors associated with bed sharing behavior.
Main Methods:
- Nationally representative telephone surveys were conducted annually from 1993 to 2000 in the contiguous United States.
- Data were collected from 8453 nighttime caregivers of infants born within 7 months prior to interview.
- The primary outcome measure was where and with whom the infant usually slept at night.
Main Results:
- The proportion of infants routinely sharing an adult bed increased from 5.5% in 1993 to 12.8% in 2000.
- Factors associated with increased bed sharing included younger maternal age, Black or Asian/other maternal race/ethnicity, lower household income, Southern U.S. residence, and younger infant age.
- Low birthweight, preterm birth, and living in the Mid-Atlantic region were associated with decreased bed sharing.
Conclusions:
- Routine bed sharing is a growing practice in the United States.
- Cultural factors significantly influence bed sharing prevalence.
- Further research is needed to fully understand and inform about the risks and benefits of bed sharing for infant health.
Background:
Bed sharing with parents has been described as both beneficial to infant well-being and as a potentially lethal situation.
Objective:
To examine trends in bed sharing between infants and caregivers, and the factors that influence this behavior.
Design:
Annual nationally representative telephone surveys conducted between 1993 and 2000.
Setting:
The 48 contiguous United States.
Participants:
Nighttime caregivers of infants born within 7 months prior to interview between 1993 and 2000. Approximately 1000 interviews were conducted each year for a total sample of 8453 nighttime caregivers.
Main Outcome Measures:
Where and with whom the infant usually slept at night in the preceding 2 weeks.
Results:
Forty-five percent of infants spent at least some time at night on an adult bed in the last 2 weeks. Between 1993 and 2000, the proportion of infants usually sharing an adult bed at night increased from 5.5% to 12.8%. More than 90% of infants who "usually" slept on an adult bed shared it with their parents. In a multivariate analysis, factors associated with increased probability of routine bed sharing included: maternal age less than 18 years (odds ratio [OR] = 2.26; 95% confidence interval [CI], 1.22-4.21), maternal race or ethnicity reported as black (OR = 4.04; 95% CI, 3.04-5.36) or as Asian or "other" (OR = 2.72; 95% CI, 1.74-4.22), household income less than $20,000 (OR = 1.49; 95% CI, 1.15 = 1.92), living in the Southern states compared with living in the Midwest (OR, 1.59; 95% CI = 1.23, 2.06), and infant age less than 8 weeks (OR = 1.60; 95% CI, 1.10-2.33). Living in the Mid-Atlantic compared with the Midwest (OR = 0.63; 95% CI, 0.44-0.90), and being born with low birthweight and preterm (OR = 0.32; 95% CI, 0.14-0.74) were associated with decreased probability of routine bed sharing.
Conclusions:
Bed sharing as a routine practice is growing in the United States. Given that this practice seems to be widespread and strongly influenced by cultural factors, more studies of the consequences of bed sharing are needed to inform health care providers and parents on the risks and benefits.
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