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Benefits and harms associated with the practice of bed sharing: a systematic review
Tanya Horsley1, Tammy Clifford, Nicholas Barrowman
1Department of Pediatrics, University of Ottawa, and Department of Pediatrics, the Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, Ontario, Canada. thorsley@rcpsc.edu
Insights
Bed sharing may be linked to sudden infant death syndrome (SIDS), especially for infants of smokers. While benefits like increased breastfeeding exist, more research is needed to understand risks and protective factors.
Area of Science:
- Pediatrics
- Public Health
- Sleep Science
Background:
- Bed sharing, defined as a child sharing a sleep surface with another individual, is a practice with potential benefits and harms.
- Understanding the risks, particularly concerning sudden infant death syndrome (SIDS), is crucial for child safety.
- Factors influencing these risks, such as parental smoking, require careful examination.
Purpose of the Study:
- To review existing evidence on the benefits and harms of bed sharing in children aged 0-2 years.
- To identify factors, like smoking, that modify the risks associated with bed sharing.
- To explore strategies for mitigating potential harms of bed sharing.
Main Methods:
- A comprehensive literature search was conducted across multiple databases (MEDLINE, CINAHL, Healthstar, PsycINFO, Cochrane Library, etc.) from January 1993 to January 2005.
- Included were published, English-language studies investigating bed sharing and its associated outcomes in children up to 2 years of age.
- Data extraction focused on reported benefits, harms, and risk factors related to bed sharing.
Main Results:
- Forty observational studies were included. Evidence suggests a potential association between bed sharing and SIDS in infants of smokers, though less consistently in nonsmokers.
- The association with SIDS may be stronger in younger infants. A positive link between bed sharing and breastfeeding was also observed.
- Causality could not be established; prolonged breastfeeding may be associated with a preference for bed sharing.
Conclusions:
- Further well-designed, prospective cohort studies are necessary to elucidate the mechanisms behind the relationship between bed sharing, its benefits, and its harms.
- Improved understanding is needed to develop effective strategies for safe sleep environments.
- The findings highlight the complexity of bed sharing and its impact on infant well-being.
Objective:
To examine evidence of benefits and harms to children associated with bed sharing, factors (eg, smoking) altering bed sharing risk, and effective strategies for reducing harms associated with bed sharing.
Data Sources:
MEDLINE, CINAHL, Healthstar, PsycINFO, the Cochrane Library, Turning Research Into Practice, and Allied and Alternative Medicine databases between January 1993 and January 2005.
Study Selection:
Published, English-language records investigating the practice of bed sharing (defined as a child sharing a sleep surface with another individual) and associated benefits and harms in children 0 to 2 years of age.
Data Extraction:
Any reported benefits or harms (risk factors) associated with the practice of bed sharing.
Data Synthesis:
Forty observational studies met our inclusion criteria. Evidence consistently suggests that there may be an association between bed sharing and sudden infant death syndrome (SIDS) among smokers (however defined), but the evidence is not as consistent among nonsmokers. This does not mean that no association between bed sharing and SIDS exists among nonsmokers, but that existing data do not convincingly establish such an association. Data also suggest that bed sharing may be more strongly associated with SIDS in younger infants. A positive association between bed sharing and breastfeeding was identified. Current data could not establish causality. It is possible that women who are most likely to practice prolonged breastfeeding also prefer to bed share.
Conclusion:
Well-designed, hypothesis-driven prospective cohort studies are warranted to improve our understanding of the mechanisms underlying the relationship between bed sharing, its benefits, and its harms.
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