Cosleeping &SIDS Fact Sheet

The Crib Industry wants you to know that 60 “accidental” infant deaths have occurred in the United States per year, in adult beds, for age birth to 2 years. The implication is that these are co-sleeping deaths,

but many of these infants are sleeping alone in adult beds. Why did they forget to mention that safe cosleeping actually reduces bed deaths? … especially after the first several weeks.

Linda Folden Palmer, DC


In 2005, the crib industry (JPMA) provided a large forum for the Consumer Product Safety Commission (CPSC) to announce this report. Unfortunately, no comparative statistics are provided in their announcements, and even the statistics they report are admittedly anecdotal and irregular. While the report supposedly left out the adult bed deaths that were diagnosed as SIDS (versus accidents), the determination between suffocation and SIDS is often a judgment call. Suffocation in a crib is more often reported as SIDS, while suffocation in an adult bed is reported as “death by adult bed.” Whether suffocation or other undetermined cause, all parents want to know is what is safe and what is not. Today, studies are not complicating this issue as much.

The actual SIDS statistics were not measured. Why? Several well-designed research studies demonstrate that SIDS is actually reduced in babies cosleeping along with an aware, protective (non-smoking, non-drug-impaired) mother in a safe bed. Such an announcement would not sell cribs. The numbers in the largest study on cosleeping around the world suggest that safe cosleeping reduces SIDS!  (See graph at bottom)International Child Care Practices Study  

Another large study on SIDS shows 1/5th the risk of death for sleeping infants simply sharing the room with non-smoking adults. This includes many sleep variations. The rate for sharing bed was not measured directly. New Zealand Cot Death Study.

While SIDS can be greatly reduced by breastfeeding, no one ever mentions this.

The Chicago Infant Mortality Study reveals that Breastfeeding Infants have 1/5th the Rate of SIDS. They report a nearly doubled SIDS rate for cosleeping, but this study does not remove the powerful effect of smoking parents from their statistic. When other studies remove this behavior, they find the remaining infants enjoy a greatly lower rate of SIDS for cosleeping versus isolated crib sleeping.There are two kinds of cosleeping, that conscious decision made by highly attentive parents, and that coming from factors such as fatigue from partying or drinking. When sofa sleeping and wedging dangers are also removed, the family bed shines as safest.

Some numbers:

Number of U.S. births year 2000: 4,058,814

Total infant deaths year 2000: 28,411 – age birth to 1 year (6.9 per thousand)

Number SIDS deaths year 2000: 2,523  Defined as death with unexplained cause, birth to 1 year.

Total suffocation deaths year 2000: 1,000

Number of crib-related “accidents”/yr: 50

Number of playpen-related deaths/yr: 16

Number deaths/yr attributed to overlying: 19 Most are only “suspected.”

Number of babies (0-2) dying in night fires/yr: 230 Many of which may have been retrievable if next to parent, not in another room of home. This is true for abductions and other night dangers as well.

Number of deaths/yr in adult beds reported as entrapment/suffocation between bed and wall, headboard, or other furniture, on waterbed, in headboard railings, or tangled in bedding18    

With side-rail: 1 That’s 19 of the 60.

Number of deaths/yr reported as suffocation of unknown cause in adult bed: 13 These would be SIDS if in a crib. Remember, these do not necessarily involve cosleeping.

Number of deaths/yr in adult beds from prone sleeping: Again, these are considered SIDS in cribs, and they are preventable in adult beds, as in cribs.

4/yr died not from falling out of adult bed, but from suffocating (pile of clothes, plastic bag) or other danger (such as drowning) after falling out.

13% of U.S. infants are routinely cosleeping with nearly 50% sharing bed for part of the nights. National Institute of Child Health and Human Development 2000 Survey,

Number of U.S. infant lives that could be saved per year by exclusive/extended breastfeeding: Thousands  Exclusive/extended breastfeeding cuts SIDS risk and may cut overall infant death risk in half.

Why does our nation rank only 36th in infant survival?* in the industrialized world (some non-reporting nations are thought to rank better than us as well)? Our difference from the best-ranking nations is a high predominance of formula feeding, isolated sleep, and medical intervention.   *(The ranking number is lowered by 6 by statisticians to adjust for an assumption that the U.S. has more live premature births, leading to more infant deaths. The statistical impact factor is only slight.)

The highest cosleeping/ breastfeeding nations rank with half or LESS of our overall infant death rate (and with negligable SIDS rates).

Remember we rank #1 in medical intervention.

The SIDS/Suffocation Risk Factors for Co-Sleeping:

Bed sharing not being the accustomed sleep arrangement

Sofa sleeping

Smoking parent

Unsafe space between mattress and headboard or wall # Prone sleeping

# Parent compromised by drugs or alcohol  # Overly heavy or fluffy bedding

# Sleeping with sibling (for tiny infants) or non-interested adult

and additionally for parental bed sleeping: 

                      # Sleeping without protective parent in room

Clearly cosleeping and adult beds can be made to be safer. This would be a much more appropriate service for the Consumer Product Safety Commission to provide, rather than their thoughtless suggestion against cosleeping. Also, clearly, responsible parents consciously creating a safe cosleeping environment are safely providing the best of all worlds for their baby.

When crib deaths were much higher than they are now, the decision was to make the crib safer, not to throw out the baby. Most of the improvement in the crib death rate occurred from the “Back to Sleep” campaign. Babies can sleep supine in adult beds as well, although there’s no evidence that side sleeping with mother, as may occur after nursing, is a risk.

Co-sleepers and side-beds that attach firmly to the mattress are good options for preventing falling out, suffocation, and entrapment, whether baby is in the co-sleeper or in the adult bed. Adjustments should be considered for the space between headboard and mattress, especially for “creepers.” Some just put mattresses on the floor, eliminating entrapment concerns.


I have taken numbers from the “International Child Care Practices Study,” Nelson, et al. to create the above graph. The Sudden Infant Death rates for each studied area are plotted against the percent of infants in that area who are cosleeping for over 5 hours per night (percent bed sharing X percent over 5 hours). One more point could be placed at 88% cosleeping for Chongqing, China, with negligible (<.1) SIDS. I have not plotted this point in the graph, as the study authors did not assign an exact SIDS value, and I do not wish to be distorting the graph in favor of conclusions. The report supplies 1995 statistics. The U.S. was not included. In 1995, the U.S. SIDS rate was 1.0 per thousand. Cosleeping was a little lower than today’s estimated “20% for half the time or more.” The authors of the study did not propose any graphs. They did not wish to weigh too much conclusion on their study findings as there were many variables, such as fashion of bedsharing and diagnostic criteria for SIDS.

The material in this website is provided for information purposes only. No part of this text should be taken as, or considered a substitute for, medical diagnosis, medical advice, or medical treatment prescription.


  • Dr Sarah December 17, 2013 at 1:30 pm

    Dr Palmer, unfortunately your claim simply isn’t true. The ‘[s]everal well-designed research studies’ that you are claiming ‘demonstrate that SIDS is actually reduced in babies cosleeping along with an aware, protective (non-smoking, non-drug-impaired) mother in a safe bed’ do not actually exist. Why are you claiming they do?

    *No* studies have shown SIDS to be reduced by bedsharing when other factors are adjusted for. In fact, studies have consistently shown that in the early months bedsharing slightly increases the risk. I’ve discussed this in detail at

    • Lauren Smith April 8, 2015 at 1:27 pm

      All the studies referenced are hyperlinked. How exactly are you claiming that none exist?

    • Linda F. Palmer April 17, 2015 at 9:37 am

      “…when other factors are adjusted for,” as described in studies. When not practicing all the safety measures and especially when not breastfeeding, there IS a statistical increase in risk showing for first several weeks (up to a few months). Maybe even in any parental behavior. Mostly this is for the tiniest. Cautious parents may want very small babies in a side co-sleeper until they’re a little bigger.

      Of course, I find it highly interesting that this slight increase in risk for first weeks, over having a baby next to parental bed, is turned into a huge scare campaign when no one ever mentions the greatly increased SIDS risk of having baby sleeping alone in a crib in another room of the house.

    • Roland September 18, 2015 at 5:58 pm

      I am curious as well how you can claim a study that is clearly hyperlinked to does not exist… And your discussion on your shamelessly promoted page completely ignored these studies, it seems.

  • Thao April 25, 2015 at 4:48 pm

    Dr Palmer, am I reading this right? Are u saying of the 3500 or so SIDS and suffocation deaths in 2000 only around 60 are related to the adult bed? What about the rest? How many SIDS babies were found in cribs – 2523? How many suffocation deaths were in cribs?

    • Linda F. Palmer May 7, 2015 at 7:44 pm

      There are some 2500 SIDS per year. Now days they are trying to separate the suspected suffocation causes from the entirely unknown causes but anyway, the 60 in adult beds are ones that were considered some kind of accident pertaining to the adult. Most SIDS are in cribs, yes, but there would have been more in adult beds, I think, than just the ones reported as a suffocation accident. Then there are SIDS in playpens, carseats, swings, lots occur on sofas (so now they don’t call those SIDS, rather suffocations) and other unsafe sleeping surfaces, some even in parental arms, and anywhere else babies are.

  • Perspectives in Parenting: We Bed Share (and get a lot more sleep than if we didn’t) | Cincinnati Moms Blog June 30, 2015 at 2:01 am

    […] To learn more about SIDS rates, check out these articles: Co-Sleeping Around the World By: James McKenna, PHD BeBedsharing and SIDS: The Whole Truth Co-sleeping and SIDS Factsheet […]

  • Zajedničko spavanje | Tatine mudrolije October 29, 2015 at 7:35 am

    […] Otprilike baš u vrijeme kada smo počeli razmišljati o tome susreo sam se s pojmom zajedničkog spavanja, te sam proučio koje su prednosti i koji rizici. Mnogi izvori govore o tome kako roditelji tokom zajedničkog spavanja mogu slučajno ugušiti bebu. No, činjenice pokazuju suprotno. Od preko 28000 novorođenčadi koje je umrlo u prvoj godini života u SADu 2000-te godine, 60 njih umrlo je u krevetu roditelja zbog različitih razloga, uključujući SIDS, zapetljavanje i gušenje posteljinom, plastičnim vrećicama, zapinjanjem između kreveta i zida ili namještaja, na vodenim krevetima, između stupića ograde na uzglavlju, itd. To su razlozi koji nisu nužno vezani uz zajedničko spavanje. Za usporedbu, njih 2523 umrlo je zbog neutvrđenih razloga koji se pripisuju (isključivo!) SIDSu u zasebnoj koljevci. 230 djece do 2. godine života je poginulo u požarima noću, između ostaloga i zato što roditelji nisu mogli doći do njih nakon izbijanja požara (nešto što ne bi bio problem da dijete spava odmah kraj roditelja). Podaci su iz ove studije, tj. sa ove stranice. […]

    GOOGLE Translation:
    About the very time when we started to think about it, I met with the concept of co-sleeping, and I studied the advantages and the risks. Many sources say how parents during co-sleeping can accidentally choke the baby. But the facts show otherwise. Of the more than 28,000 infants who died in the first year of life in the United States in the year 2000, 60 of them died in the parents’ bed for various reasons, including SIDS, tangling and choking bedding, plastic bags, jammed between the bed and the wall or furniture, on the water beds, between guiding rails at the head, and so on. These are the reasons that are not necessarily associated with co-sleeping. For comparison, in 2523 they died due to unknown reasons attributable to the (only!) SIDS in a separate crib. 230 children up to age 2, died in the fire at night, among other things, because parents could not reach them after the fire (something that would not be a problem if the child is sleeping next to their parents). The data from this study, that is, from this site.

  • 4 Common Concerns about Co-Sleeping {and how to address them} – Modern Alternative Pregnancy January 6, 2016 at 12:09 pm

    […] When co-sleeping is done carefully there is virtually no danger for the baby. Furthermore, the original SIDS researcher has explained why bed-sharing per se isn’t dangerous. (Read more facts about co-sleeping safety.) […]

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