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Trends in Infant Bed Sharing in the United States, 1993-2000
The National Infant Sleep Position Study
Marian Willinger, PhD;
Chia-Wen Ko, PhD;
Howard J. Hoffman, MA;
Ronald C. Kessler, PhD;
Michael J. Corwin, MD
Arch Pediatr Adolesc Med. 2003;157:43-49.
Background Bed sharing with parents has been described as both beneficial to infant well-being and as a potentially lethal situation.
Objective To examine trends in bed sharing between infants and caregivers, and the factors that influence this behavior.
Design Annual nationally representative telephone surveys conducted between 1993 and 2000.
Setting The 48 contiguous United States.
Participants Nighttime caregivers of infants born within 7 months prior to interview between 1993 and 2000. Approximately 1000 interviews were conducted each year for a total sample of 8453 nighttime caregivers.
Main Outcome Measures Where and with whom the infant usually slept at night in the preceding 2 weeks.
Results Forty-five percent of infants spent at least some time at night on an adult bed in the last 2 weeks. Between 1993 and 2000, the proportion of infants usually sharing an adult bed at night increased from 5.5% to 12.8%. More than 90% of infants who "usually" slept on an adult bed shared it with their parents. In a multivariate analysis, factors associated with increased probability of routine bed sharing included: maternal age less than 18 years (odds ratio [OR] = 2.26; 95% confidence interval [CI], 1.22-4.21), maternal race or ethnicity reported as black (OR = 4.04; 95% CI, 3.04-5.36) or as Asian or "other" (OR = 2.72; 95% CI, 1.74-4.22), household income less than $20 000 (OR = 1.49; 95% CI, 1.15 = 1.92), living in the Southern states compared with living in the Midwest (OR, 1.59; 95% CI = 1.23, 2.06), and infant age less than 8 weeks (OR = 1.60; 95% CI, 1.10-2.33). Living in the Mid-Atlantic compared with the Midwest (OR = 0.63; 95% CI, 0.44-0.90), and being born with low birthweight and preterm (OR = 0.32; 95% CI, 0.14-0.74) were associated with decreased probability of routine bed sharing.
Conclusions Bed sharing as a routine practice is growing in the United States. Given that this practice seems to be widespread and strongly influenced by cultural factors, more studies of the consequences of bed sharing are needed to inform health care providers and parents on the risks and benefits.
From the Pregnancy and Perinatology Branch, Center for Research for Mothers and Children, National Institute of Child Health and Human Development, National Institutes of Health (Dr Willinger), and the Epidemiology and Biostatistics Program, National Institute on Deafness and Other Communication Disorders, National Institutes of Health (Dr Ko and Mr Hoffman), Bethesda, Md; and the Department of Health Care Policy, Harvard School of Medicine (Dr Kessler), and Department of Pediatrics, Boston Medical Center, Boston University School of Medicine (Dr Corwin), Boston, Mass.
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