Source:

Huang
Y
,
Hauck
FR
,
Signore
C
, et al
.
Influence of bedsharing activity on breastfeeding duration among US mothers
.
JAMA Pediatr
.
2013
;
167
(
11
):
1038
1044
; doi:
https://doi.org/10.1001/jamapediatrics.2013.2632

Researchers from multiple institutions studied the influence of bedsharing on breastfeeding duration. Data for the study were obtained from mothers who were enrolled during pregnancy in the Infant Feeding Practices Study II (IFPS II) and who were breastfeeding at 2 weeks postpartum. Participants were asked to complete questionnaires mailed to them at 10 postpartum time points: 1 through 7 months as well as at 9, 10, and 12 months postpartum. Each questionnaire included questions about breastfeeding behaviors. Participants were also asked about their infants’ sleeping arrangements over 7 distinct time points: 2 weeks and 1, 2, 3, 6, 9, and 12 months. Bedsharing was defined as the mother lying down and sleeping with her infant in the same bed or other sleeping surfaces for nighttime sleep or during the major sleep period.

The main outcomes were duration of any breastfeeding within the first year of infancy and duration of exclusive breastfeeding within the first 6 months, obtained by compiling questionnaire responses. The main exposure was bedsharing, which was categorized as a categorical and continuous variable based on a combination of responses on the questionnaires. In the analysis, investigators controlled for 10 covariates to assess the association of bedsharing with breastfeeding exclusivity and duration: maternal age, education, race, marital status, income, smoking, return to work, breastfed other children, plan to exclusively breastfeed, and breastfeeding problems in the first 2 weeks.

A total of 1,846 mothers met criteria for the study. The mean age of study mothers was 29 years, 85% were white, 83% were married, and 83% had at least some college education. The mean duration of any breastfeeding was 30.7 weeks and the mean duration of exclusive breastfeeding was 9.7 weeks. Sixty-eight percent of mothers reported they had shared a bed with their infants during the first year of life. Bedsharing started at a mean infant age of 8.3 weeks. After adjusting for covariates, a longer duration of any breastfeeding was significantly associated with a longer duration of bedsharing, but not exclusive breastfeeding.

Despite the strong association in this study of bedsharing and breastfeeding, the investigators hesitated to recommend bedsharing due to the association of bedsharing with sudden infant death syndrome (SIDS).

Dr Noble has disclosed no financial relationship relevant to this commentary. The commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.

One of the major public health successes of the past 20 years has been the reduction of SIDS from 120 to 56 deaths per 100,000 live births with the Back to Sleep Campaign, now called Safe to Sleep. However, as SIDS remains the third leading cause of infant mortality and the leading cause of postneonatal mortality, the AAP published several recommendations in 2011 to decrease SIDS further, including eliminating bedsharing,...

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