Greetings, all!

This was on Medscape today.  Enjoy!

Pamela Morrison IBCLC
Rustington, England
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Breast-Feeding Link Should Figure Into Bed-Sharing Advice
Nancy Fowler Larson

October 19, 2010 — The value of breast-feeding 
should be considered before advising mothers not 
to share their beds with their infants, according 
to a British study published online October 18 
and in the November issue of Pediatrics.

Nearly half of all English infants sleep in a 
parent's bed at times; one fifth does so 
regularly during their first year. The practice 
has been linked to sudden infant death syndrome, 
and many professionals and organizations, 
including the American Pediatric Society, advise against it.

However, bed sharing is also known to support breast-feeding.

"Both cross-sectional epidemiological and sleep 
laboratory studies showed close links between the 
frequency and duration of breastfeeding and the 
practice of bed sharing," write Peter Blair, PhD, 
Community-Based Medicine and Social Medicine, 
University of Bristol, United Kingdom, and colleagues.

The researchers sought to further the knowledge 
about bed sharing and breast-feeding through a 
longitudinal, population-based study using data 
gathered in 1991 and 1992 for the Avon 
Longitudinal Study of Parents and Children. To 
that end, they examined bed-sharing and 
breast-feeding habits during 5 periods (0 - 2 
months, 6 - 8 months, 17 - 20 months, 30 - 33 
months, and 42 - 45 months) in 7447 children.

Patterns of bed sharing were broken down into 4 
unique groups: parents who never shared their 
beds with infants (66%), those whose babies slept 
with them in their beds only in infancy (13%), 
those who shared their bed with a child only 
after the first year (15%), and parents who 
shared their beds consistently for 4 years (6%).

Bed-Sharing Associated With Breast-Feeding

The results showed that mothers who shared a bed 
with their newborns were better educated and of a 
higher socioeconomic status, and that those whose 
children routinely slept in their beds during the 
first 15 months of life reported a significantly 
greater incidence of breast-feeding, among other findings:
all 3 categories of bed sharing had an important 
relationship with breast-feeding at 12 months (P 
< .001), whether the bed sharing occurred late 
(odds ratio [OR], 1.72; 95% confidence interval 
[CI], 1.36 - 2.18), early (OR, 2.36; 95% CI, 1.87 
- 2.97), or during the entire 4 years (OR, 5.29; 95% CI, 4.05 - 6.91);
29% of the mothers who slept with their infants 
at 0 to 2 months (251/872 mothers) had university 
degrees compared with 14% of mothers (888/6464) 
whose babies slept separately during that period (P < .0001); and
the finding for education lessened for those who 
shared a bed with their 6- to 8-month-old-infants 
(17% vs 15%; P = .17) and there was a negative 
relationship with education for those sleeping 
with their 17- to 20-month-olds (11% vs 16%; P < .0001).

Because bed-sharing mothers of newborns were 
found to be better educated and more 
socioeconomically advantaged, their babies are at 
lower risk for sudden infant death syndrome 
because they will likely follow other infant 
safety guidelines, the researchers reasoned. 
Therefore, more lives could be saved if 
preventive messages focused on behaviors other than sharing a bed.

"Given the likely beneficial effects of bed 
sharing on breastfeeding rates and duration, risk 
reduction messages to prevent sudden infant 
deaths would be targeted more appropriately to 
unsafe infant care practices such as sleeping on 
sofas, bed sharing after the use of alcohol or 
drugs, or bed sharing by parents who smoke," the authors write.

Limitations to the study include the fact that 
using 5 time periods reduced the number of 
infants who could be studied (of the 14,062 
mother–infant pairs on whom data was collected, 
only 53% [7447] provided information for all time 
points). In addition, most longitudinal studies 
have a larger dropout rate for socioeconomically 
disadvantaged participants — a situation that 
could skew the results toward those of higher socioeconomic status.

Regardless, the bottom line of the study results 
is a simple one: "Advice on whether bed sharing 
should be discouraged needs to take into account 
the important relationship with breastfeeding," the authors write.

The UK Medical Research Council, The Wellcome 
Trust, and the University of Bristol provided 
core support for the Avon Longitudinal Study of 
Parents and Children. The Foundation for the 
Study of Infant Deaths supported this specific 
study. The study authors have disclosed no relevant financial relationships.

Pediatrics. Published online October 18, 2010.
  

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