Bed-sharing and unexpected infant deaths: what is the relationship?

For much of human history infant survival has been largely predicated by close and continuous contact between the infant and the primary carer - almost always the mother. Many factors in post-industrial human society - notably tobacco smoking, alcohol intake and the use of recreational drugs- have been associated with increased risk to infants sleeping in close proximity to their mothers. This is particularly true for mothers who choose not to breastfeed. The question of the risks and possible benefits of bed-sharing for mothers who plan to breastfeed, do not smoke, do not drink alcohol or take recreational drugs, and are aware of how to ensure a safe infant sleep environment need to be quantified. In this paper we review the evidence from several epidemiological studies and identify the factors that make bedsharing more or less hazardous for the infant. This analysis is important in allowing us to give parents accurate and unbiased information on which to make their own choices about optimal night time care of their infants without demonising normal parental behaviour or practices.