The influence of bed-sharing on infant physiology, breastfeeding and behaviour: A systematic review

Area of Science:

• Physiology
• Infant Sleep Science
• Behavioral Science

Background:

• Bed-sharing (co-sleeping) is a common infant care practice with debated risks and benefits.
• Understanding the physiological and behavioral implications of bed-sharing is crucial for infant safety and well-being.
• Existing research presents varied findings due to differing methodologies and definitions of bed-sharing.

Purpose of the Study:

• To review and synthesize the existing literature on the physiological and behavioral aspects of bed-sharing.
• To identify the potential risks and benefits associated with adult-infant bed-sharing.
• To explore how environmental factors and parental behaviors influence infant outcomes during bed-sharing.

Main Methods:

• Systematic literature review of eight databases.
• Keywords included adult-infant/baby, bed-sharing/co-sleeping, and physiological/behavioral outcomes.
• Inclusion criteria focused on studies reporting objective or subjective data on infant physiology, sleep, cardiovascular, respiratory, temperature, and behavior during bed-sharing.

Main Results:

• 59 papers from 48 cohorts met inclusion criteria, with 27 providing objective data and 32 subjective data.
• Bed-sharing infants exhibited increased behavioral arousals, warmer in-bed temperatures, and longer breastfeeding duration.
• Differences were observed in infant sleep architecture, cardiorespiratory control, and cortisol responses to stress compared to cot-sleeping.

Conclusions:

• Physiological and behavioral differences between bed-sharing and cot-sleeping are context-specific and influenced by parental perceptions and cultural values.
• Objective risk is present when an infant cannot appropriately respond physiologically or behaviorally to their micro-environment.
• Further research is needed to fully elucidate infant risks, potential benefits, and the interaction of bed-sharing with other infant care practices.