Is co-sleeping (co-sleeping) with a baby recommended beyond one year of age?

Co-sleeping with Babies Beyond One Year of Age

Room-sharing without bed-sharing is recommended for infants, and there is no evidence supporting the safety of bed-sharing with babies at any age, including beyond one year. 1

Safe Sleep Recommendations

The American Academy of Pediatrics (AAP) provides clear guidelines regarding infant sleeping arrangements:

• Room-sharing without bed-sharing is the safest arrangement for infants, reducing SIDS risk by up to 50% 1
• The infant should sleep on a separate sleep surface designed specifically for infants, placed close to the parents' bed 1
• While the guidelines focus primarily on infants under one year (when SIDS risk is highest), there is no evidence suggesting that bed-sharing becomes safe after one year of age

Why Bed-Sharing Is Not Recommended

The AAP guidelines strongly advise against bed-sharing due to significant risks:

1. Suffocation risk - Adult beds contain soft surfaces, pillows, and bedding that pose suffocation hazards
2. Entrapment risk - Infants can become trapped between the mattress and wall, headboard, or other furniture
3. Strangulation risk - Bedding can wrap around an infant's neck
4. Overlay risk - Adults may roll onto the infant during sleep

Particularly Dangerous Bed-Sharing Situations

The following bed-sharing situations are especially hazardous and should be avoided at all times 1:

• Bed-sharing with someone who smokes
• Bed-sharing with someone who is excessively tired
• Bed-sharing with someone using medications or substances that impair alertness
• Bed-sharing with non-parents, including other children
• Bed-sharing with multiple people
• Bed-sharing on soft surfaces (waterbeds, old mattresses, sofas, couches)
• Bed-sharing with soft bedding (pillows, heavy blankets, quilts)

Recommended Sleep Arrangements

The safest sleep arrangement involves:

• Room-sharing - Placing the infant's crib, bassinet, or play yard in the parents' bedroom
• Separate sleep surface - Using a firm, flat surface designed for infant sleep
• No soft objects or loose bedding in the infant's sleep area
• Supine position (on back) for all sleep

Common Challenges and Pitfalls

Recent research indicates that despite awareness of safe sleep guidelines, many parents struggle with implementation 2:

• 80% of mothers report holding or rocking their infant to sleep
• 76% feed their infant to sleep
• Many parents find the guidelines difficult to follow when balancing infant comfort and parental sleep needs

Addressing Common Concerns

While some parents may choose co-sleeping to facilitate breastfeeding or to soothe a fussy baby 3, the AAP recommends:

• Bringing the infant into bed for feeding or comforting, but returning them to their separate sleep surface when the parent is ready to sleep 1
• Using a pacifier at nap time and bedtime, which has been shown to have a protective effect against SIDS 1
• Ensuring the infant's separate sleep surface is placed close to the parents' bed for easy access during nighttime feedings

Conclusion on Co-Sleeping Beyond One Year

While SIDS risk decreases after the first year of life, the physical risks of suffocation, entrapment, and strangulation remain present when bed-sharing at any age. The AAP guidelines focus on infants under one year because this is when SIDS risk is highest, but the safety concerns of bed-sharing continue beyond this age.