Inner-city caregivers' perspectives on bed sharing with their infants

To understand parents' motivations for bed sharing with their infants aged 1-6 months, their beliefs about safety concerns, and their attitudes about bed-sharing advice.

We conducted 4 focus groups with primary caregivers of infants ages 1-6 months who regularly shared beds with their infants. We recruited participants from an inner-city primary care center in Pittsburgh, serving primarily African American families who received medical assistance. Discussions were audiotaped and transcribed. Two investigators coded the transcripts and identified themes in an iterative process to achieve agreement between coders.

A total of 28 caregivers aged 17-50 participated. The majority were African American (86%), female (93%), single (50%), and high school graduates (71%). Eleven percent of participants breast-fed their infants. We identified 5 themes, common to all groups, to explain parents' motivations for bed sharing: 1) better caregiver and infant sleep, 2) convenience, 3) tradition, 4) child safety, and 5) parent and child emotional needs. Parents expressed divergent views about the safety of bed sharing: 1) ambivalence regarding balancing risks of overlaying and suffocation with benefits of bed sharing, or 2) assertion that bed sharing poses no risks for their child. Common to all groups was the finding that clinicians' advice against bed sharing did not influence parents' decision, but advice to increase safety when bed sharing would be appreciated.

Parents' motivation to bed share outweighed the concerns and the warnings of others. An understanding of parents' perspectives on bed sharing should inform counseling to promote safe sleeping practices.