Intended for healthcare professionals


Making informed choices on co-sleeping with your baby

BMJ 2015; 350 doi: (Published 02 February 2015) Cite this as: BMJ 2015;350:h563
  1. Peter J Fleming, professor of infant health and developmental physiology ,
  2. Peter S Blair, reader in medical statistics
  1. 1Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, St Michael’s Hospital, Bristol BS2 8EG, UK.
  1. Correspondence to: P Fleming peter.fleming{at}

Avoid smoking, alcohol, recreational drugs, and co-sleeping on the sofa

For most of human history, and in most parts of the world today, sharing a sleep surface (“co-sleeping”) with the primary caregiver—almost always the mother—has been the normal experience of most human infants. Such close contact has benefits for the baby, including facilitating breast feeding, and even in modern Western societies infant mortality is significantly lower among breast fed infants.1 Routine co-sleeping is common in Western societies and is thought to be increasing with increased breast feeding; studies have shown a close bidirectional relation between breast feeding and co-sleeping.2 On any given night in the UK, around one quarter of infants under 6 months of age spend part or all of the night sharing a sleep surface with a sleeping parent.3

Against this background is the recognition that, since the large fall in the number of sudden infant deaths that followed the “Back to Sleep” campaign, the proportion of such deaths occurring while co-sleeping has risen.4 In some countries, notably the United States, many professionals have accepted that co-sleeping substantially contributes to unexpected infant deaths and should be discouraged.5

For parents who smoke, …

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