Is “Bed Sharing” Beneficial and Safe during Infancy? A Systematic Review

Table 1

Observational studies on bed share and breastfeeding.

S. no.	Study ID/site or country	Design, setting	Study population	Number of subjects	Intervention/exposure	Outcome (effect size)	Comments
1	Flick et al. 2001/USA [11]	Cross-sectional study (within an interventional study), population based	Pregnant women enrolled at 28 wk, contacted at around 8 weeks after delivery	Questionnaire based survey of 218 consecutive infants	Bed share	Breast feeding rate = 61/133 (bed share),; 30/85 (no bed share); OR (95% CI): 1.55 (0.86, 2.84)	Any breast feeding (not exclusive breast feeding) at 8 weeks of age. Loss to followup was 2.2%.
2	Ball 2003/United Kingdom [12]	Case-control study, population based	Health infants and mothers, delivered at 36+ weeks. Followed uptill 4 months of age	Cases, 112; Controls, 141	Bed share	Breast feeding rate = 81/112 (case),; 54/141 (control); OR (95% CI): 4.2 (2.38, 7.47)	Any breast feeding (not exclusive breast feeding) for ≥1 mo is the definition of the case. Loss to followup was 40%.
3	Blair and Ball 2004/United Kingdom [13]	Data from two studies: one was cross-sectional and the other was longitudinal, population based	Healthy infants and their mothers at home	Data available on 424 subjects	Bed share	Breast feeding rate at 4 weeks = 73/84 (bed share), 113/227 (no bed share); OR (95% CI): 6.66 (3.37, 13.3)	Reported any breast feeding (not exclusive breast feeding rate). Loss to followup was <20%
						Breast feeding rate at 3 months = 58/74 (bed share), 202/350 (no bed share); OR (95% CI): 2.66 (1.43, 5.14)
4	McCoy et al. 2004/USA [14]	Cross-sectional study, community based (followup at home of institutional births)	Data from the Infant Care Practices Study (ICPS) between years 1995 and 1998. Followup of infants born at selected study hospitals	Data available on 10355 subjects	Bed share	Breast feeding rate at 1 month = 1346/2071 (bed share), 4142/8284 (no bed share); Adjusted OR (95% CI): 3.0 (2.6, 3.5)	Reported any BF rate for >4 weeks. Loss to followup was ~30%
						Breast feeding rate at 3 months = 725/1346 (bed share), 3107/9009 (no bed share); Adjusted OR (95% CI): 3.4 (2.9, 4.0)
						Breast feeding rate at 6 months = 518/1243 (bed share), 2071/9112 (no bed share); Adjusted OR (95% CI): 3.6 (3, 4.2)
5	Lahr et al. 2007/USA [15]	Cross-sectional study (random sample survey), population based	Stratified sample of women drawn each month from recently filed birth certificates between years 1998 and 1999	Data available on 1685 subjects	Bed share	Breast feeding rate = 485/584 (bed share),; 770/1101 (no bed share); Adjusted OR (95% CI): 2.65 (1.72 to 4.08)	Any breastfeeding for >4 weeks
6	Blair et al. 2010/United Kingdom [16]	Prospective longitudinal study, population based	Infants of all pregnant women residing in the 3 health districts of Avon; age group: birth to 4 years. Bed share was categorized into the following 3 groups: early, late, and constant	Data available on 7447 subjects	Bed share	Breast feeding rate at 6 months = 733/1415 (constant and early bed share), 2111/6032 (no bed share); OR (95% CI): 2.0 (1.77 to 2.25)	Reported only breast feeding rate (not exclusive breast feeding rate). The adjusted OR for bedsharing in the neonatal age group is not known. Loss to followup was 50% loss.
						Breast feeding rate at 12 months = 322/1415 (constant and early bed share), 549/6032 (no bed share); OR (95% CI): 2.94 (2.52 to 3.44)
7	Tan 2011/Malaysia [17]	Cross-sectional study, facility based	Mother-infant pairs with infants up to 6 months attending health clinics over 4 months in year 2006	Data available on 682 subjects	Bed share	Breast feeding rate = 249/501 (bed share),; 45/181 (no bed share); Adjusted OR (95% CI): 1.50 (1.12 to 2.37)	Exclusive breast feeding rate one month prior to interview. Only 20.3% of study infants were <1 mo of age—data for this subgroup is not known. Loss to followup was <5%
8	Möllborg et al. 2011/Sweden [18]	Cross-sectional study, population based	Randomly selected families with infants who had reached 6 months of age	Questionnaire based survey on 8176 families	Bed share	Breast feeding rate = 544/2035 (bed share),; 159/2167 (no bed share); Adjusted OR (95% CI): 1.94 (1.56 to 2.41)	Any breast feeding (not exclusive breast feeding) at 6 months of age. Loss to followup was 31.5%