UNICEF statement on mother-infant bed sharing.

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Following the publication of a European study in the Lancet (1) on sudden infant death among bed-sharing babies, the UNICEF UK Baby Friendly Initiative issued the following statement on February 16, 2004.

'In recognition of the fact that mother-infant bed-sharing appears to be associated with longer and more successful breastfeeding, the UNICEF UK Baby Friendly Initiative has been working to help health professionals enable breastfeeding mothers to share a bed with their baby whilst maintaining the safest possible environment.

'The Lancet paper suggested a slight increase in the risk of sudden infant death among babies of non-smoking mothers who bed-shared all night in the first eight weeks of life.

'At present, the UNICEF UK Baby Friendly Initiative is unable to support recommendations against bed sharing in the early weeks for the following reasons:

* There is some controversy as to whether the results of the study clearly ... indicate an increased risk of bed sharing with non-smoking parents in the absence of other known risk factors ... Until these issues are resolved, it remains inappropriate to give advice to parents based on the results of this study.

* There is concern that simply, advising parents against bed sharing without giving practical information about how to cope with a very young baby at night may increase risk. Bottle fed babies are significantly, more likely to suffer infections and respiratory illness both of which put young babies at risk (2). There is evidence that bottle-fed babies are not as easily roused from sleep as those who are breastfed which again could put babies at risk (3).

* There is anecdotal evidence that health professionals may simply advise parents against bed sharing if they perceive it to be discouraged at ... national level. This means that parents are denied a full discussion about important topics such as the benefits, contraindications and safety issues. It is ... essential that ... parents be given full information appropriate to their needs in order to encourage safe practice and to protect breastfeeding (4).

UNICEF recommends that discussions with parents about bed sharing should address the following factors:

* the circumstances under which co-sleeping should be discouraged (parental...