This post is part of our series on infant sleep and its effects on development, published in collaboration with the journal Behavior and Development of Infants. The featured research appeared in a special issue on how infant sleep affects cognitive, social, and physical development, and how parents and doctors can contribute to promoting healthy sleep and development in infancy. Key insights for caregivers
Co-sleeping, typically defined as infants sharing a room or bed with their parents, is a widespread practice worldwide but is culturally accepted to varying degrees. It is less practiced in American culture, and parental views on it are very diverse. Pediatric organizations (such as the American Academy of Pediatrics) do not endorse bed sharing, and while the AAP does not seem averse to room sharing per se, research in Western cultures has linked persistent bed sharing (i.e., bed sharing, room sharing, or a combination of both) beyond six months to parent-child issues. Our research found a correlation between bed sharing and more sleep disruptions for parents, especially for mothers, which can occur in any culture where bed sharing occurs. Bed sharing was also linked to greater stress in co-parenting and poorer quality of parenting before bedtime, more likely in cultures where bed sharing is less accepted. Infant sleep did not appear to be affected by bed sharing. Decisions regarding bed sharing with one’s child are ultimately personal decisions. If practiced, bed sharing should be safe and in accordance with AAP guidelines, and bed sharing parents should take measures to nurture their relationship as a couple. Article content:
Questions regarding parent-child sleep arrangements are complex
Do sleep arrangements for infants relate to the sleep quality of infants and parents or to parenting behavior?
Bed sharing between parents and child was associated with poorer mother sleep and parenting issues
Effects of bed sharing between parents and child are likely culture-specific
Promoting co-parenting as well as safe and healthy sleep may be of utmost importance
1. Questions regarding parent-child sleep arrangements are complex
How parents should shape the sleep of their infants, and whether infants should sleep alone (in a separate room) or together with their parents (i.e., in the same room or same bed as the parents), is a controversial, sensitive, and personal topic. At its core, it involves discussions about what is best for babies, and views on this vary widely. These beliefs are based on cultural norms, medical recommendations against bed sharing for safety reasons, evolutionary biologists advocating for bed sharing for infant protection, personal beliefs of parents, availability of sleeping arrangements, and other practical considerations (e.g., convenience) etc. age of the infant. Additionally, in Western cultures, sleep arrangements for infants in the first year are fluid, with greater likelihood of bed sharing shortly after birth than later. This makes it harder to determine if a family is bed sharing. Photo: Sarah Chai. Pexels.
When deciding where and how long infants should sleep, it may not only be about what is best for the baby, but also what is best for the family. Some studies suggest that parents who bed share with their infants may be at risk for marital and co-parenting issues. Parents, especially mothers, who bed share with their infants also wake up more frequently at night and have more sleep problems than parents and infants sleeping in separate rooms.
2. Do sleep arrangements for infants relate to the sleep quality of infants and parents or to parenting behavior?
The choice of sleeping arrangements for infants can be confusing and influenced by competing needs and requirements. To better understand how parenting and infant and parent sleep affect family life, we examined sleep patterns in the first six months of infants in our current study. We studied 124 families in the USA when the infants were one, three, and six months old. Most mothers and fathers were White (88%), married or cohabiting with a partner (95%), in their thirties; 57% of the infants were girls. 99 percent of the parents had a high school diploma, and about two-thirds had a bachelor’s degree or higher. Most fathers (89%) and mothers (61%) were working full- or part-time when their babies were one month old; the median annual household income was $65,000. To measure participants‘ nightly sleep, we used activity monitors (actigraphs) that parents wore on their wrists and strapped to their infants‘ calves for seven consecutive nights before bedtime. We also measured mothers‘ emotional availability to their infants during infant sleep time (using video recordings of the parents). Mothers also completed questionnaires to assess the quality of positive co-parenting (e.g., support and endorsement of the partner) and negative co-parenting (e.g., extent of conflicts with and undermining by the partner). Sleep arrangements for infants were determined from video recordings of nightly infants. Parent and especially mother sleep may be most affected by bed sharing.
3. Bed sharing between parents and child was associated with poorer mother sleep and parenting issues
Based on video recordings of infants at three and six months of age, we identified three sleep patterns: solitary sleep (infants slept in separate rooms from their parents at both ages), bed sharing (infants slept in the same room or bed as their parents at both ages), and transition from bed sharing to solitary sleep (infants who were bed sharing with a parent in a room or bed at three months and moved to their own room at six months). Infants who slept in the same room as their parents rarely spent their entire time on a separate sleep surface from their parents, even if there was a crib in the room. Videos showed that mothers brought their infants to the parents‘ bed in response to the infants‘ distress, with the infants falling asleep in the parents‘ bed without being returned to the crib immediately. Consistent with other research, families that bed shared were more likely to have lower socioeconomic status than the other two groups, be non-White and unemployed, and have fewer years of schooling.
We also observed patterns related to breastfeeding duration and parental symptoms of depression and anxiety. We used statistical techniques to account for these patterns and examine specific relationships between bed sharing and both sleep quality and co-parenting. Our findings were as follows: mothers had poorer sleep quality when they bed shared. Fathers who bed shared with their infants experienced more varied sleep quality over the week than fathers whose infants slept alone.
Infant sleep quality was not related to the sleep arrangement.
Mothers reported less positive and more negative co-parenting and were observed to be less emotionally available to their infants before bedtime.
Our findings are consistent with other work that shows that persistent bed sharing is associated with poorer parent, especially mother, sleep quality as well as more stress in co-parenting and less emotional availability from parents.
Photo: RDNE Stock Project. Pexels.
Our finding that infant sleep is not related to sleep arrangement suggests that parent, especially mother, sleep may be most affected by bed sharing.
This does not bode well for the long-term well-being of the mother: Chronic sleep problems can increase the risk of depression, which can negatively affect relationships with other family members.
4. The effects of bed sharing between parents and child are likely culture-specific
Our study was conducted in the United States, a culture that generally does not endorse persistent bed sharing. Parents who persistently bed share in a culture that does not endorse it may be criticized for engaging in a practice that some consider harmful to babies — although our study did not find negative associations between bed sharing and infant sleep. Such criticism is based…