COMMENTARY

Bedsharing, Breastfeeding, and Safe Infant Sleep Advice: The Caregiver's Dilemma

Laura A. Stokowski, RN, MS 

Disclosures

March 08, 2016

Bed-sharing by Breastfeeding Mothers: Who Bed-shares and What Is the Relationship With Breastfeeding Duration?

Ball HL, Howel D, Bryant A, Best E, Russell C, Ward-Platt M
Acta Paediatr. 2016 Feb 5. [Epub ahead of print]

Bedsharing and Breastfeeding

To reduce the risk for sleep-related infant death, mothers in some countries, including the United States, are advised to avoid bedsharing with their infants.[1] However, many mothers in other parts of the world routinely share a sleeping surface with their infants to facilitate breastfeeding. The practice has even coined a term—breastsleeping,[2] and is popular because of the belief that bedsharing leads to more successful breastfeeding.[3] [Note: "co-sleeping" is a term often used interchangeably with "bedsharing." Co-sleeping refers to sleeping in proximity of another person, whereas bedsharing refers to sharing the same sleeping surface and is the preferred term].

To learn more about which mothers elect to bedshare and how bedsharing affects breastfeeding outcomes, Ball and colleagues analyzed follow-up data from 870 mothers in the United Kingdom who participated in a hospital-based breastfeeding trial. For 26 weeks following discharge, the mothers reported weekly data on feeding (whether infants were breastfed or received expressed breast milk) and sleeping (whether and how often the infants slept in bed with the mother for at least an hour).

Of the women who provided sufficient data, 44% rarely or never bedshared, 28% sometimes or occasionally bedshared, and 28% often bedshared. A greater proportion of women continued breastfeeding longer in the subgroups where bedsharing was more common (P < .0001). The median time to cessation of breastfeeding was 14 weeks for mothers who rarely bedshared, 24 weeks for intermediate bedsharers, and more than 26 weeks for mothers who bedshared often. Exclusive breastfeeding also continued longer in bedsharing dyads (3 weeks for rare, 5 weeks for intermediate, and 10 weeks for frequent bedsharers; P < .0001).

Ball and colleagues concluded that women with a strong motivation to breastfeed frequently bedshare, commenting that their study results "raise the question of whether recommendations to avoid bed-sharing impede some women from the achievement of their breastfeeding goals, and thereby cause unintended harm to infant and maternal well-being, and even to lifetime health."

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