Copyright © Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. 244 0196-206X/00/2304-0244 Developmental and Behavioral Pediatrics Vol.23,No.4,August2002 Copyright 2002byLippincottWilliams&Wilkins,Inc. Printed in U.S.A. # Outcome Correlates of Parent-Child Bedsharing: An Eighteen-Year Longitudinal Study PAUL OKAMI, PH.D. Department of Psychology, University of California, Los Angeles THOMAS WEISNER, PH.D. Center for Culture and Health, Departments of Anthropology and Psychiatry, University of California, Los Angeles RICHARD OLMSTEAD, PH.D. Neuropsychiatric Institute, Division of Adult Psychiatry, University of California, Los Angeles, California ABSTRACT. We report results of the first longitudinal study of outcome correlates of parent-child bedsharing. Two hundred five families in nonconventional and conventional family lifestyles have been followed since 1975. A target child in each family was followed from the third trimester of mother’s pregnancy through age 18 years. Bedsharing in early childhood was found to be significantly associated with increased cognitive competence measured at age 6 years, but the effect size was small. At age 6 years, bedsharing in infancy and early childhood was not associated with sleep problems, sexual pathology, or any other problematic consequences. At age 18 years, bedsharing in infancy and childhood was unrelated to pathology or problematic consequences, nor was it related to beneficial consequences. We discuss these results in light of widespread fears of harm caused by parent-child bedsharing. We suggest that such fears are without warrant if bedsharing is practiced safely as part of a complex of valued and related family practices. J Dev Behav Pediatr 23:244–253, 2002. Index terms: bedsharing, cosleeping, adolescence, family practices, outcomes. One consequence of the increasing diversity in family andhouseholdarrangementsoverthepasthalf-centuryhas been a lessening of parents’ certainty regarding norms for child-rearing practices. Indeed, the novel question ‘‘How shallwerearourchildren?’’isbeingaskedimplicitlywith eachofmillionsofcopiessoldofthreegenerationsofchild- rearing advice volumes, 1–3 in parent education seminars andself-helpgroups,andintheofficesoftherapists,school counselors, and pediatricians. Aparticularareaofconcernforparentsandprofessionals hasbeeninfantandchildsleepingarrangements.Anumber of clinicians and child-rearing experts have advocated purposefulparent-childbedsharing,or‘‘thefamilybed’’as it has come to be known in the popular literature. 3–5 Adherents of this family practice have claimed a number of long-range benefits to the child, generally stressing psychologicalvariables,suchasattachmentsecurityandthe developmentofacapacityfortrustandintimacy. 5 Parent-infantbedsharingalsohasbeenpromotedinsome ofthebiomedicalliteratureforitspotentialhealthbenefits, for example, increased likelihood and duration of breast- feeding and protectionfromsuddeninfantdeathsyndrome (SIDS). 6,7–10 These commentators observe that the very largemajorityoftheworld’schildrensharearoomand/or bedwiththeirparents,evenwhenspaceconstraintsdonot mandate it. 11–18 Yet many—perhaps most—experts do not advocate bedsharing, and the American Academy of Pediatrics cautions against ‘‘routine’’ bedsharing. 19 In addition to expressedconcernsaboutthepsychosexualimplicationsof bedsharing 20–22 and the physical dangers posed by over- lying (smothering), detractors argue that the practice may occasion sleep disorders, interfere with parents’ conjugal privacy, reflect family pathology, and, in contradiction of the views of family bed advocates, interfere with the processofindividuation. 2,23–28 Review of the Literature on the Outcome of Parent-Child Bedsharing What is the current research status of parent-child bedsharing and other forms of cosleeping relative to outcome? In two qualitative reviews, Medoff and Schae- fer 29 andOkami 11 attemptedtosynthesizefindingsfromthe sporadic empirical and cross-cultural literatures then available. A number of tentative generalizations may be drawnfromtheresultsofthesereviewsandfromthecurrent authors’ updated review of the biomedical literature on infantsleepphysiology,cosleeping,andSIDS. 1. Some form of cosleeping, particularly mother-infant bedsharing,appearstobeahuman‘‘nearuniversal.’’ 12–18,30,31 Thesameistrueinabroaderphyleticcontext,‘‘...direct, continuous mother-infant contact during infant sleep is characteristicofallnon-humanhigherprimates’’(p97). 32 2. Prevalence of bedsharing has not been determined reliably in the United States. However, although routine Address for reprints: Paul Okami, Ph.D., Department of Psychology, UniversityofCalifornia,LosAngeles,California90095-1563.