Safe Sleep

Safe Sleep Statement

BreastfeedLA is dedicated to improving the health and well-being of infants and families through education, outreach and advocacy to protect, promote and support breastfeeding. This statement affirms the importance of creating a safe sleep environment while also supporting a healthy breastfeeding relationship.[1] [2] [3] [4] [5]

BreastfeedLA acknowledges that it is normal, healthy human behavior for infants to sleep in close proximity to their mother. Studies have shown that infants who sleep in close proximity to their mother breastfeed longer and enjoy better bonding. BreastfeedLA encourages families and health care providers to educate themselves on both the known risk factors and known benefits for infants and mothers sleeping in close proximity. BreastfeedLA wishes to provide families and professionals with the resources they need to minimize risk if a nursing mother wishes to sleep with her infant in close proximity.

Neither a nursing mother nor any other caregiver should bed-share with an infant if their ability to rouse and respond to infant’s needs is compromised. This may occur if the caregiver is impaired by drug (both prescribed and illicit) or alcohol use. Parental smoking is also a strong independent risk factor compromising infant safety during sleep. Additional factors contributing to suffocation risk include bed sharing when an adult is obese, when adults other than the nursing mother, when siblings are sharing the bed, or on a surface with soft pillows and bedding. Pets should never share a bed with an infant. Caregivers should be warned about these risks and cautioned to never sleep with their babies when risk factors are present.

BreastfeedLA affirms that there are numerous benefits to infants sleeping near their mothers. Babies sleep more peacefully, have more physiological stability and enjoy long term emotional health benefits that are not realized when babies sleep in a separate room. In addition, forbidding a caregiver to ever sleep with an infant may result in unintended negative consequences.Caregivers who are trying to feed or soothe their baby when they are exhausted may find themselves falling asleep in chairs and sofas that could cause harm if the baby is dropped or becomes trapped between the armrest and the sleeping adult.[5]  Helping families to identify safe sleep options that fit their needs is crucial to encouraging the development of a healthy relationship between the baby and the family.

BreastfeedLA supports programs that identify at-risk families and provide education for families regarding sleep safety.  Programs such as the Welcome Baby Program, the Nurse-Family Partnership, and the California Baby Behavior Campaign provide families with the tools and the support they need to help raise healthier children and communities.

BreastfeedLA encourages families and health care professionals to become familiar with the California Department of Public Health Guidance for Local Health Jurisdictions and Communities Addressing Infant Safe Sleep Environments, which includes recommendations and cautions regarding infant sleep.

Professional Resources

AAP Policy statement on Safe Infant Sleeping Environment 

California Department of Public Health (CDPH) Guidance for Local Health Jurisdictions and Communities Addressing Infant Safe Sleep Environments

Parental Resources Caring for your baby at night: A guide for parents, UNICEF UK Baby-Friendly Initiative  

Safe Co-sleeping Guidelines, University of Notre Dame 

[1] Breastfeeding Medicine.  ABM Clinical Protocol #6:  Guideline on Co-Sleeping and Breastfeeding.  3(1). 2008
[2] Hauck F, Signore C, Fein S, et al. Factors associated with the duration of breastfeeding. Acta Paediatr. 1999;88(12):1320–1326
[3] Horsley T, Clifford T, Barrowman N, et al. Benefits and harms associated with the practice of bed sharing: a systematic review. ArchPediatr Adolesc Med. 2007;161(3):237–245
[4] Moon RY, Darnall RA, Goodstein MH, Hauk FR. Technical Report:American Academy of Pediatrics Task Force on Sudden Infant Death Syndrome: SIDS and other sleep-related infant deaths: expansion of recommendations for a safe infant sleeping environment. Pediatrics, 128: e000,
[5] Blair PS, Sidebotham P, Evason-Coombe C, et al. Hazardous cosleeping environments and risk factors amenable to change: case-control study of SIDS in south west England. BMJ. 2009;339:b3666.