The Atlantic Divide: Contrasting U.K. and U.S. Recommendations on Cosleeping and Bed-Sharing

This 'Insight into practice' explores the current state of guidance regarding SIDS and co-sleeping/bed-sharing in the UK and US (co-sleeping and bed-sharing have been used interchangeably to describe an infant and one or more parents/adults/others sharing a sleep surface, with some variations as discussed below).The goal is to help lactation professionals and allied staff become aware of the larger contextual picture on this topic, and to encourage reflection on how we educate new parents around infant sleep location.There is no doubt that the issue of babies sleeping with their parents has been a polarizing topic; previously I have likened it to a tug of war between different theoretical and ideological perspectives, with health professionals and parents caught in the middle of an academic debate about contradictory evidence and appropriate advice.But over the past 2-3 years the nature and content of discussions on this topic have begun to shift, and agreements are emerging.As will be discussed later, the 'tug of war' is no longer an appropriate metaphor to represent the clarifying picture of bed-sharing and co-sleeping.The literature cited here includes examples of key (well known) papers in the chronology of the debate about SIDS and sleep location; and papers providing specific evidence supporting a point.The bed-sharing / co-sleeping debate ignited in the nineties during a period of intense research and public health activity around unexplained infant deaths that occurred during sleep, and peaked during the 3 rd month of life (SIDS or Sudden Infant Death Syndrome).Epidemiological studies conducted in the eighties had identified that infant sleep position was strongly linked with SIDS (Gilbert, Salanti, Harden, & See 2005) and high profile 'risk reduction' campaigns in many countries informed parents to sleep babies on their backs.Why the supine sleep position was protective was unclear (and still is), but central apnea (involving sudden cessation of breathing) was a key hypothesis at the time.SIDS rates were high in many Western countries, and as well as sleeping prone most babies slept in cribs in a separate room from their parents.