Should I be co-sleeping with my child?

Having your child share your bed is a fairly common situation in which many families find themselves – either by choice or by accident. Elisa Basora-Rovira, M.D., a pediatrician specializing in sleep medicine at Children’s Health℠ and Assistant Professor at UT Southwestern, receives numerous questions about co-sleeping from parents wanting their family to get the best sleep possible.

Understanding common terms

There are a few terms related to what people generally refer to as “co-sleeping,” so first, it is important to understand the nuances between the terms. Dr. Basora-Rovira explains:

• Co-sleeping: This is the practice of sleeping in the same bed with your child or in close proximity.
• Bed-sharing: A sub-type of co-sleeping, this is when the child shares the bed with one or both parents.
• Solitary sleeping: This is the child sleeping in his or her own room, on his or her own sleep surface.
• Reactive co-sleeping: This is when the child goes to bed in his or her own room, but then wakes in the night and ends up in the parents’ bed at some point overnight.

Pros and cons of co-sleeping

Dr. Basora-Rovira points out that co-sleeping is standard practice in many parts of the world and co-sleeping is practiced in many different cultures. However, there is a lot of controversy regarding the physical and psychological effects of having your child share your bed. Some studies indicate that co-sleeping can cause lower sleep quality, which results in more nighttime waking and daytime sleepiness – for both kids and parents.

Research indicates the following benefits for children who sleep on their own:

• Less difficulty falling asleep
• Tend to sleep longer and wake less
• Fewer problems waking up in the morning
• Fewer future sleep problems

Dr. Basora-Rovira says, “The recommendation overall is that kids should sleep on their own, on their own surface, in their own room.” If the family makes the choice of co-sleeping, they should practice safe sleep practices and co-sleep consistently.

Establishing healthy sleep habits

One main drawback to co-sleeping, says Dr. Basora-Rovira, is that young children do not establish healthy sleep habits early on. Healthy sleep habits promote physical and mental well-being for people of all ages. “If we establish good sleep habits at a younger age,” explains Dr. Basora-Rovira, “children will have fewer behavioral sleep problems in the future.” One of the main steps to establishing healthy sleep habits is to implement a consistent bedtime routine, which includes a consistent sleep schedule for bedtime and waking, seven days a week.

Parents also need to make sure their child is getting enough sleep for his or her age and development. Dr. Basora-Rovira recommends consulting the American Academy of Pediatrics (AAP) childhood sleep guidelines to make sure your child is sleeping enough each day.

Following AAP guidelines to reduce SIDS risk

Dr. Basora-Rovira reminds parents that under the age of 12 months, there should be absolutely no bed-sharing. The AAP updated their sudden infant death syndrome (SIDS) guidelines in 2016 to recommend room-sharing for the baby’s first year, but to avoid bed-sharing due to accidental suffocation risks. Learn more about these guidelines and how to reduce your baby’s SIDS risk.

Is my child too old to be co-sleeping?

Dr. Basora-Rovira says there is no specific age that is “too old” for co-sleeping. She encourages parents to not begin practicing co-sleeping in the first place. And, if you are already co-sleeping with your child, to transition him or her out of your bed and into his or her own room as soon as possible. “Doing so will be beneficial for both the child and the parents,” says Dr. Basora-Rovira.

 How to transition your child into his or her own room

If your family has decided the time has come for your child to begin sleeping in his or her own room, there are some ways to make this process as smooth as possible for the entire family.

• Do it gradually: Most kids (and parents) respond best to a more gradual transition, which occurs over days or weeks. With this method, your child gradually learns that he or she can fall asleep without you in the room with him or her. You put the child in his or her bed when drowsy (not asleep), and then gradually increase the time outside the child’s room at bedtime to get them used to going – and staying – asleep on his or her own. Eventually, the child will be able to fall and stay asleep, on his or her own, he or she has learned to fall asleep without you and you will be nearby to check on them, if needed.
• Don’t give up: Transitioning your child to his or her own room certainly isn’t a one-night process. Some children can make the transition in just three or four nights, while other children may take up to weeks or even months.
• Be consistent: Establish the bedtime routine and be consistent about where your child sleeps, the bed he or she goes to bed in and wakes up in, and that he or she must remain in his or her room upon middle-of-the-night waking. Successfully keeping your child in his or her own room for five nights in a row and then giving in to letting the child into your bed in the middle of the night on the sixth night demonstrates to the child that you will give in and that coming back into your bed is an option.
• Use a reward system: Depending on the age of your child, you may consider using a sleep chart or reward system for helping transition your child to his or her room. This system is most appropriate for children over age 3, who can understand the concept and association of the reward system. Dr. Basora-Rovira explains that a reward system can involve giving the child a token or sticker if he or she stays in his or her bed all night. Then, the child can “cash in” a certain number of tokens – such as 3 or 5 – to get a bigger reward. Rewards may include a trip to the park, a little extra TV time or an outing to get ice cream.

Tips for developing a good bedtime routine

Dr. Basora-Rovira shares the following tips for helping parents establish a good bedtime routine, which can last about 30 to 60 minutes:

• Make sure the routine ends in the child’s bedroom
• Begin the routine with a warm bath
• Brush and floss your child’s teeth
• Read a favorite story together
• Sing a relaxing song with your child
• Talk with your child about a favorite, positive event of the day or say prayers, if desired
• No electronics 1-2 hours before bedtime, including TV, cell phones and computers
• Give bottle before teeth brushing and bath, instead of sending child to bed with a bottle (creates a sleep association and contributes to dental health issues)
• Put child in his or her own bed when drowsy but not asleep
• Don’t rock child to sleep (creates a sleep association)

Breaking sleep associations

An important aspect of implementing a good bedtime routine is to help your child break any sleep associations he or she may have, such as falling asleep with a bottle or while breastfeeding, having the parent in the room to fall asleep or being rocked to sleep.

Dr. Basora-Rovira explains: “All of us wake up between 5 and 9 times during the night. If the last thing the child remembers is breastfeeding, having a bottle or being rocked by a parent, that is what they’re going to think of when they wake up in the night. They will then cry because they are lost or confused that that object or activity is gone.” Therefore, a key element of transitioning your child to solitary sleeping is making your child understand that he or she can fall and stay asleep on his or her own without these sleep associations.

Learn more

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