There it was loud and clear blasting from my television on an October morning in 2016: “The American Academy of Pediatrics recommends babies should sleep in mom’s room FOR THE ENTIRE FIRST YEAR!” Thank you, Good Morning America.
That morning, when I saw the new guideline of room-sharing for the ENTIRE FIRST YEAR, my heart dropped, because in my experience as a nurse and baby sleep expert, many babies after the ages of 4-6 months do sleep better in a separate room. No, not all, but many.
Why would they make this NEW recommendation of room-sharing until the baby turns ONE?
Well, they want to decrease the risk of Sudden Infant Death Syndrome. (Don’t we all!) So many professionals were declaring that this recommendation was “admittedly cautious,” but even I thought… “If it decreases SIDS, it must be the answer. Right?”
Why would we hesitate to follow these recommendations?
I know as a baby sleep expert that parents and babies often don’t sleep as well while room-sharing after about 4-6 months, and this lack of sleep can have a devastating impact on the entire family.
Here's why: We all have “mini wake-ups” during the night. We simply check in with our surroundings and drift back off to dreamland. Babies do the same. BUT… after about 4-6 months of age, babies are suddenly AWARE of the world around them, and seeing mom or dad (or even just knowing they are there) can cause “mini wake-ups” to turn into full-blown night wakings. This can occur as often as every 45-120 minutes ALL NIGHT LONG.
So...knowing the recommendation for room-sharing AND the reduced quality of sleep that can come from room-sharing beyond 4-6 months, I was torn. My heart broke for new parents who wanted to set their babies up to be great sleepers, but were fearful to put baby into their own room. It’s an awful judgment call to have to make. “Do I help my baby and family get more sleep at the risk of something happening to my baby?” No parent should ever have to make that call.
So, what does the research actually say?
Well, in June of 2017 (less than a year after the initial recommendation), a follow-up study was published in Pediatrics: Official Journal of the American Academy of Pediatrics. This study calls out the recommendation of the AAP: there simply is not any substantial evidence that room sharing prevents SIDS for older babies. (Did you notice who called out the AAP’s recommendation? Yep, that’s the “Official Journal of the AAP.”) This new study also shares very important information about room sharing and baby sleep. The research found that room-sharing beyond 4-9 months actually resulted in LESS NIGHTTIME SLEEP and MORE NIGHT WAKINGS. This is NOT merely an inconvenience, but it actually impacts every facet of our babies’ being! The pediatric experts in the study point out that, for babies “inadequate sleep affects nearly every health domain, including emotional regulation, mood, and behavior in infancy and childhood.” This means that interrupted sleep in infancy should be a major factor in choosing where our babies sleep.
What are the potential concerns with parental sleep deprivation?
Simply put, parents who are sleep deprived are more likely to practice unsafe sleep. Please know, I am all too familiar with pulling my baby into my bed in a sleep deprived moment of desperation. (I would love to share my personal story with you.)
The study went on to find that babies who room-share beyond 4 months of age were also four times more likely to be pulled into their parents’ bed during the night, and two times more likely to have pillows, blankets, and other unsafe sleeping materials close by during sleep. Pulling a baby into bed and sleeping with loose bedding is known to increase the risk of SIDS. So, keeping the baby in the same room beyond 4-6 months actually increased parental behaviors that are known to cause SIDS.
Furthermore, the AAP’s recommendation of room sharing for the entire first year didn’t take into account the WHOLE picture of infant sleep safety. Dr. Ian Paul, the lead author in the 2017 study, says that infant safety is our priority. At the same time, he points out that SIDS is not the only sleep safety issue. There are other FAR MORE COMMON safety risks that put our babies in danger. These safety risks are the ones resulting from sleep deprivation! What are those risks? Poor bonding with baby, marital struggles, Postpartum Depression, anxiety, car accidents, and even Shaken Baby Syndrome. Sometimes we don’t consider how truly DANGEROUS sleep deprivation is. Did you know our brains actually act drunk when we are sleep deprived? It’s true!
Parents, did you catch all of that?
The year-long recommendation for room sharing is admittedly “cautious” and based on evidence that has been called into question.
New studies demonstrate that room-sharing beyond 4-9 months is associated with less sleep and poorer quality sleep for infants as well as tied to a greater use of unsafe sleeping practices.
The risks linked to parental sleep deprivation (accidents, suffering relationships, PPD, and inability to effectively care for baby) occur much more frequently than SIDS.
Should we ever room share?
Please don’t misinterpret my thoughts. I absolutely encourage room sharing in the first several months of life and even longer if that’s best for the family. BUT, what are new parents to do with this recommendation of room sharing for the entire first year if it isn’t working?
Consider it! But take in ALL the information about infant safety. Weigh the risks and benefits and trust your inner voice. Yes, you know that voice. The one that says, “I know what is best for my baby and our family." Move your baby to his or her room when it's best for YOU, YOUR BABY, and YOUR family after taking in all the facts.
Can I room share and take your classes?
If you are struggling with sleep deprivation, please know baby sleep help is available. The Taking Cara Babies classes and resources use evidenced-based research to help families sleep. Yes, room sharing is absolutely acceptable if that’s what parents choose. In fact, it is encouraged in the newborn class. Parents who are utilizing Navigating Months 3 & 4 can choose whether room sharing is right for them. The 5–24 Month Collection: Everything You Need for Great Sleep is a plan to conquer nights, naps, and every bump along the way. You will be encouraged to give your baby his/her own space for the first 14 nights, but please know that we can customize this to your comfort.
What else should I know about safe sleep?
I have a safe sleep checklist for you. Other important sleep recommendations from the American Academy of Pediatrics (AAP):
Place the baby on his or her back on a firm sleep surface such as a crib or bassinet with a tight-fitting sheet.
Avoid use of soft bedding, including crib bumpers, blankets, pillows and soft toys. The crib should be bare.
Share a bedroom with parents, but not the same sleeping surface, preferably until the baby turns 1 but at least for the first six months. Room-sharing decreases the risk of SIDS by as much as 50 percent.
Avoid baby's exposure to smoke, alcohol and illicit drugs
Know that currently (as of 2021) the AAP has been more relaxed with the recommendation stating, "Room share for the first 6 months, or ideally, for the first year." Parents, again- take in all the facts, look at the research, talk with your doctor, use safe sleep guidelines, and make the best decision for you and your family regarding how long to room share.
