A study finds found that room-sharing with infants at ages 4 months and 9 months was associated with less nighttime sleep, shorter sleep stretches, and unsafe sleep practices. The study, “Mother-Infant Room Sharing and Sleep Outcomes in the INSIGHTStudy,” published online June 5 and in the July 2017 issue of Pediatrics, emphasizes the need for more research on the effects of room-sharing and its impact on the quality of sleep for infants and parents. The American Academy of Pediatrics (AAP) recommends room-sharing—but not bed-sharing—during infancy because studies have demonstrated a reduced risk of sudden infant death syndrome (SIDS). In October 2016, the AAP updated its policy to recommend room-sharing for at least the baby’s first 6 months, or ideally, 1 year.

The Intervention Nurses Start Infants Growing on Health Trajectories (INSIGHT) study enrolled newborns and mothers from January 2012 to March 2014; data from this obesity-prevention trial were analyzed for this study. A total of 230 mother-infant dyads were divided into three groups: “early independent sleepers,” who slept independently without room-sharing by 4 months (62% of participants); “later independent sleepers,” who began sleeping in a separate room between 4 and 9 months (27% of participants); and those who were room-sharing at 9 months (11% of participants). Researchers observed significant differences in bedtime routines at 4 months, finding that room-sharing babies had lower odds of being put to sleep by 8 pm. At 4 months, room-sharing infants also had greater odds of having an unapproved object in bed with them, such as blankets or pillows, than those who were sleeping independently. Parents of room-sharing infants were 4 times more likely to bring their infant into their bed overnight. Study authors conclude that the poorer sleep-related outcomes and unsafe sleep practices they found in room-sharing infants should lead to a reconsideration of the duration of the room-sharing recommendation.

Published in the same issue of Pediatrics is a commentary, “Are There Long-term Consequences of Room Sharing During Infancy?” authored by two members of the AAP Task Force on SIDS. The commentary authors welcome this additional research on room-sharing and note questions that remain to be explored about the relationships between room-sharing, feeding, bedtime routines, and the physiology of infant sleep. They emphasize the primary objective of the AAP’s safe sleep recommendations is to minimize the risk of SIDS and other sleep-related infant deaths.