1. Fern R. Hauck,1 Caroline Signore,2 Sara Fein,3 Tonse N. K. Raju2
Infant Feeding Practices and Mother-Infant Bed Sharing: Is There an Association? Results from the Infant Feeding Practices Study II
Fern R. Hauck,1 Caroline Signore,2 Sara Fein,3 Tonse N. K. Raju2
1 University of Virginia Health System
2 National Institute of Child Health and
Human Development Food and Drug Administration

2. Introduction
Bed sharing (mother-infant sleeping together in the same bed at night) has become more popular in the U.S.
Some experts encourage this practice to facilitate breastfeeding.
Others discourage it as a potential risk factor for infant suffocation and SIDS.
Thus, an optimum strategy to maximize breastfeeding, while minimizing SIDS risk is unclear.

3. Infant Feeding and Bed Sharing Study
Using data for 6-month-old infants from the IFPS-II, we carried out this study with the following objectives:
Characterize the ethnic and demographic differences in infant feeding and bed sharing practices.
Characterize the association between breastfeeding and bed sharing.
Assess the reasons why mothers did or did not choose to bed share with their infant.

4. Sample Demographics (N=2078)
Maternal age: yr (+/-5.4)
Education: (%)
<12 yr
12 yr 17
>12 yr 81
Race/ethnicity:
White 87
Black 3
Hispanic 6
Asian or Pacific
Islander 3
Other 2

5. Breastfeeding Demographics
50% of the cohort was breastfeeding at 6 months (compared with 60% at 3 months)
Breastfeeding was positively associated with:
Older maternal age
Race/ethnicity: Whites, Hispanics, and Asian/ Pacific Islanders more than Blacks
> 12 years of education
Income >$50,000 per year

6. Breastfeeding Patterns at 6 Months*
* Survey asked about feeds during prior week

7. Bed Sharing Definitions
Bed sharing = mother slept for any part of the night with her infant in the past 4 weeks
Exclusive bed sharing = slept with infant every night, all night

8. Bed Sharing Demographics
32% of the cohort was bed sharing at 6 months of infant age (compared with 44% at 3 months)
Lower income mothers had significantly higher rates of bed sharing
Race/ethnicity was associated with bed sharing, but some numbers too small for stable estimates: Whites (n=524, 30%), Blacks (n=36, 54%), Hispanics (n=41, 37%), Asians/PI (n=29, 50%),
Maternal age and education were not associated with bed sharing

9. Bed Sharing and Breastfeeding Associations
Bed sharing by feeding type:
41% of breastfed infants bed shared
23% of formula-fed infants bed shared (P<.001)
Feeding type by bed sharing:
64% of bed sharing infants breastfed
44% of non-bed sharing infants breastfed (P<.001)

10. Breastfeeding by Bed Sharing Pattern
X2=86.8, df=4, P<0.001

11. Bed Sharing by Feeding Pattern
X2=86.8, df=4, P<0.001

12. Reasons for Bed Sharing at 6 Months
P<0.0001
P<0.001
P<0.05
P<0.05
P<0.0001
P=0.05

13. Reasons for Not Bed Sharing at 6 Months
P<0.0001
P<0.05
P=0.05
P<0.0001

14. Summary of Results for 6-Month-Old Infants
Bed sharing more common among mothers who breastfed than among those who formula-fed (41% vs. 23%). However, 59% of breastfeeding infants did not bed share.
Among bed sharers, breastfeeding more common than formula-feeding (64% vs. 36%); among non-bed sharers, breastfeeding less common (44% vs. 56%).
Exclusive bed sharing associated with higher exclusive breastfeeding rates than partial bed sharing or no bed sharing (51% vs. 38% vs. 27%).

15. Summary (Continued)
The reasons given for bed sharing by mothers who breastfed or formula-fed were similar, with the primary exception of breastfeeding being the #1 reason among the breastfeeding mothers.
Reasons for not bed sharing were similar between groups: leading reasons were safety concerns and difficulty getting the baby to sleep in a crib when older. Waking each other up an issue more for breastfeeding mothers.

16. Conclusions
The results of this study lend further support to the facilitative role of bed sharing for breastfeeding.
However, bed sharing is not required for breastfeeding.
This benefit needs to be weighed against the potential risk of SIDS and suffocation deaths associated with bed sharing.
This risk is the crux of the ongoing debate about recommendations regarding mother-infant bed sharing.

17. Thank you!