Cosleeping and Safety

If you choose to cosleep, you are under an obligation to make the experience as safe for your baby as possible. The CPSC has said of infant mortalities associated with adult beds that, “One of the most tragic aspects of these deaths is that they are largely preventable.” Their recommendations are not cosleeping at all or putting an infant to sleep in an adult bed. If you are determined to cosleep, safety must come first.

Beds

The same safety measures and standards that apply to cribs should be used in regard to your bed. First, be sure that your mattress is ultrafirm; if possible, buy a new one. Under no circumstances should a baby sleep on a waterbed. Not only is there a risk of his smothering in the giving mattress, but he also can get wedged between the water mattress and the bed's frame. The rule that a baby should always be put to sleep on his back still applies.

Size Matters

If you're going to have a family bed, make it a king-size one if you have that option. Your bedroom may not be large enough, or you may not have the budget for a whole new bed (though a firm new mattress is important). But if it's at all possible, get a king-size bed, and not only will your baby have farther to roll before getting out of bed, but you and your spouse will also have more room to get comfortable in — especially when Baby decides she wants to lie horizontally between you. Otherwise you may be the one falling off the edge. Keep in mind that your baby will need more room as she grows.

Fact

According to the AAP, the argument that in cultures where cosleeping is prevalent that babies suffer no ill-effects is misleading. The organization points out that in these cultures, families almost never sleep on soft mattresses with bulky covers.

Another hazard that needs to be considered before opting for a family bed is the weight of both parents. Obese parents are not good candidates for cosleeping since they may not be as aware of the extent to which their girth extends over Baby. An obese mom or dad who is lying snuggled next to Baby and rolls over toward him is jeopardizing him greatly.

Some parents try to solve the dilemma of keeping their baby in the bed by putting one side of the bed up against the wall. At first thought, this seems an eminently sensible thing to do — it would be hard for Baby to roll off that way. But in fact, it's a very bad idea, as your baby can easily become trapped in the small space between the mattress and the wall and can even suffocate. The CPSC reports that between January 1970 and December 1997, twenty babies died just that way.

A good alternative plan is to place your bed as close to the floor as possible. Eliminate the frame; eliminate the box spring as well, if you're willing. With the mattress much closer to the floor, even if Baby rolls out of the bed, he hasn't far to fall. A blanket spread out next to the mattress on the floor will help cushion his fall even further.

Alert!

If any member of the family is allergic to dust, be aware that dust is more prevalent down on the floor. By lowering the mattress to just above the floor, you expose that family member to a greater intake of allergy-inducing dust. In this case, be scrupulous about vacuuming the floor often and being extra careful about cleanliness in general and dusting and vacuuming in particular.

While we're talking about eliminating things for safety, how about eliminating your headboard and footboard? They present hazards, too. Your baby can get an arm or leg or her head trapped between any slats or other apertures in your headboard or footboard. Just as the baby's crib slats should be close together, so too should the space between your headboard or footboard slats be narrow enough that there's no chance of Baby's head fitting between them and getting wedged. Other hazards include peeling paint from an old headboard or footboard and wrought iron headboards and footboards, which are harder on Baby's head if she bangs up against them. (Again, there may be a peeling-paint hazard as well.) So if you do have a headboard and/or footboard on your bed, remove them if possible. At minimum, examine them for safety hazards.

Essential

Always have an adult positioned between a baby and an older sibling, if you all share a bed. Though the older sibling will surely be much smaller and weigh much less than either you or your spouse, he will also be much less aware, and so the baby is at greater risk from him rolling over on her than she is from either you or your spouse doing so.

Betwixt and Between?

Should your cosleeping baby sleep between the two of you or on the outside of one of you? Clearly the baby sleeping between you has little chance of rolling out of bed during the night. But he has two parents who need to be wary of rolling over onto him. If he sleeps between you and the edge, only one parent has to be careful not to roll onto him, and only one of you needs to sleep aware of the hazard. On the other hand, he's in more jeopardy of rolling off the bed. If he hasn't rolled over yet, he will one day soon enough. You know how sound a sleeper you are and your spouse is. You need to make the final decision as to whether your baby is safer between you and your spouse or on the outside of one of you.

Bed Coverings and Pillows

If you must sleep on a pillow, please keep your baby's face far away from it. Preferably, don't use a pillow in a family bed until the baby is at least two years old. Keep the room warm enough so that you need only a light blanket. No heavy blankets, quilts, or anything else that might smother your baby if he gets under the covers.

When you get up in the morning, if you manage to exit the bed without awakening your baby, he'll be unprotected. It's best to stay in bed until he wakes up, but if that's simply not possible, you need a baby monitor with which you can listen for sounds indicating he has woken up. While you're starting your morning routine, your baby might be rolling out of bed. If he's already crawling, he might be liberating himself from the confines of the bed and examining his surroundings and getting into potentially harmful situations. If you absolutely must leave Baby alone in the bed, you need a baby monitor, a guard gate, and the precaution of removing all sharp, poisonous, or otherwise dangerous objects from his reach. Check on him often.

The Sidecar Solution

Just as motorcycles can be fitted with sidecars for passengers, beds can be fitted with a type of sidecar for cosleepers. In fact, these devices sometimes are called “cosleepers.” They're an ideal solution when parents want to let Baby sleep with them yet they are fearful of rolling over on him or of his falling out of the bed. If you just don't trust yourself; if you or your spouse regularly take prescription medications that make you groggy; if you have a double bed and no room for a king-size bed; if you have one child in your bed already and no room for a king-size bed; if you have dust allergies and sleeping close to the floor is impractical for you; or if for any other reason you're concerned about letting your baby sleep in your bed, a sidecar may be the ideal solution.

Alert!

Never cosleep when you are under any alcoholic or pharmacologic influence that might make you groggy or alter your responses. This applies not only to drinking alcohol, but also to taking any prescription drugs that might affect your sleep or your response time. If you are under any sort of chemical influence, sleep apart from the baby, whether that means a night on the living room couch or putting Baby in a crib for one night.

What's a sidecar? A sidecar is a modified three-sided crib, whose height is adjusted to match the height of your bed, whose mattress lies firmly flush to the mattress of your larger bed, which has bars on three sides, keeping Baby in. In fact, some particularly handy parents modify regular cribs to turn them into sidecars. But if you're not Mr. or Ms. Fixit, you can buy a sidecar or cosleeper and attach it to your bed.

One other solution is a device called a “snuggle nest,” which sits on your bed, holds your baby, and protects him from accidental rollovers or inadvertent escapes.

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