Is It Safe To Sleep While Breastfeeding?

Posted by Megan Petchel & Julie Monson on Jul 06, 2021

Not only does breastfeeding provide all the nutrients your baby needs as they grow, it has also shown to decrease the risk of SIDS.

As incredible as it is, the exhaustion and sleep deprivation that comes along with breastfeeding around the clock can make it difficult for you to stay awake while feeding them.

A study has shown that 72% of moms consulted had fallen asleep with their baby while still nursing. This may seem natural, but is it safe to fall asleep while breastfeeding your baby?

It is not encouraged to fall asleep while breastfeeding your baby. There are various unintentional accidents which could occur. These include your baby falling out of your arms or off the bed, their mouth or nose becoming covered by your body or bedding, and possibly becoming wedged between your body and the furniture resulting in suffocation.

While you may not intentionally fall asleep while nursing, knowing how to breastfeed safely is vital.

It is not safe to sleep while breastfeeding your baby

IS IT SAFE TO SLEEP WHILE BREASTFEEDING?

It is very challenging to keep yourself awake especially in the early morning hours when your sleep hormones are at their highest.

This is often aggravated by the fact that it is not only the reduced amount of sleep affecting you but also the lack of quality sleep.

With regards to the safety of sleeping while breastfeeding, there are two main schools of thought and, they directly contradict each other.

La Leche League

One of the approaches to sleeping while breastfeeding was developed by the International La Leche League, who are experts in breastfeeding.

They indicate that although most breastfeeding moms do not plan on sharing their bed with their baby, ultimately 60-75% will at some stage do so. While they acknowledge that this is not in line with most safe sleep practices, they also recognise the benefits that are associated with sharing a bed. Those who do so report that they get more sleep and experience positive benefits on their milk supply.  

They suggest that a mother’s instincts kick in to prevent her from rolling onto or accidentally suffocating her baby as she automatically lies on her side, with her knees bent and arm under the pillow to provide a cocoon-like environment protecting her baby.

To make sleeping while breastfeeding as safe as possible, the International La Leche League developed the Safe 7:

You should be a non-smoker.
Your should be sober and not impaired by any type of medication or drugs
You should be breastfeeding (as apposed to formula feeding)
Your baby should be healthy and full-term
Your baby should be on their back
Your baby should be lightly dressed
Both you and your baby should be on a safe surface

It must be noted that we can find no evidence or research to support that the Safe 7 is indeed safe.

In fact, a study performed in Japan investigated factors and frequency of infant suffocation incidents associated with co-sleeping and breastfeeding in the side-lying position using a self-administered questionnaire survey of 895 mothers during their babies' 1-, 4-, or 10-month health check-ups.

They concluded that, “As deaths caused by co-sleeping/breastfeeding in the side-lying position are preventable, we believe they should not occur. While the incidence of ASSB (Accidental suffocation or strangulation in bed) is low in Japan, complete awareness of factors that lead to infant suffocation incidents associated with co-sleeping/breastfeeding in the side-lying position and increasing attention for the prevention of infant suffocation among mothers are crucial for preventing infant deaths as mothers customarily co-sleep/breastfeed in the side-lying position.”

breastfeeding baby while sleeping

American Association of Paediatrics

The American Academy of Paediatrics (AAP) findings differ from the opinion of the La Leche League. In their most recent publication (2016), updated recommendations were made regarding sleeping while breastfeeding.

The AAP strongly discourages bedsharing as their research has found that this increases the risk of SIDS and sleep-related accidents. While it is still their standpoint that your baby should share your room and not your bed for the first 6 months, they do acknowledge that parents frequently fall asleep while feeding their baby.

To minimise any increased risk of SIDS they suggest that if you do bring your baby to your bed for feeding, that they are placed in their own cot or bassinet when you are ready to sleep.

Should you unintentionally fall asleep while feeding your baby, they point out that it is less hazardous to fall asleep if you were on an adult bed rather than a couch or chair, where babies are more likely to fall or become entrapped if you were to fall asleep.

Removing loose blankets, pillows and duvets is also important as a large percentage of babies who have died from SIDS were found with their head covered by bedding. Taking away bedding also reduces the risk of your baby overheating.

The AAP also indicates, based on evidence, that the risks associated with bed-sharing are higher the longer it goes on for. Based on this they recommend placing your baby in their cot or bassinet as soon as you wake up should you have accidentally fallen asleep with your baby.

These recommendations put forward by the AAP are echoed by both the Lullaby Trust and UNICEF. They all agree that bedsharing and falling asleep with your baby in your bed is not safest.

If there is a chance that you may fall asleep while breastfeeding, it is best to do so in a bed which is clear of blankets, pillows and sheets as they could cover your baby’s mouth and nose or contribute to overheating.

Falling asleep while breastfeeding should be avoided should either parent be under the influence of sedating medication or alcohol. They also include that other safe sleep advice such as placing your baby on their back should be followed.

WHY DO YOU GET SLEEPY WHILE BREASTFEEDING?

In addition to being sleep deprived from the frequent feeds, there are two key hormones which are released whilst feeding and add to the feeling of tiredness.

The first hormone is Prolactin which is responsible for milk production. Interestingly, more Prolactin is produced at night which intensifies the feeling of sleepiness.

The second hormone is Oxytocin which prompts milk let down. It is also known as the “love hormone” which initiates positive emotions and reinforces the bond between you and your baby.

Whilst they both hormones have important roles to play and help keep you calm and relaxed so you are able to take care of your baby, they also make staying awake while breastfeeding at night more difficult.

mom sleeping with baby

HOW SHOULD I SLEEP WHILE BREASTFEEDING?

No matter how hard you try to stay awake while breastfeeding at night, falling asleep when you are exhausted is sometimes inevitable.

Based on this, the AAP has compiled the following suggestions to curb any chance of an increased risk to your baby:

1. Create a less hazardous environment to sleep in while feeding:

This means that there should be no pillows, sheets, blankets or items in your baby’s sleep area which could could cover their mouth or nose or cause them to overheat.
Do not have things such as hot beverages, medications or sharp objects near you while sleeping.
The bed should also be moved away from the wall to avoid the risk of entrapment (getting stuck).
Try to identify a safe night time feeding space taking into account the above recommendations before going to bed.

2. Avoid falling asleep on couches or chairs as these positions increase the risk of falling or suffocation by becoming stuck or wedged between the chair and cushions.

3. Place your baby on their back on a flat and firm surface in a separate area (such as their cot) as soon as you wake up.

4. Babies who are brought into bed to feed or comforted should be taken back to their own cot once the parent needs to sleep.

how to sleep safely if you fall asleep breastfeeding

CAN YOU PLACE YOUR BABY IN A CO-SLEEPER IN BETWEEN BREASTFEEDING sessions?

There are two types of co-sleepers; bedside co-sleepers that attach to the side of your bed and in-bed co-sleepers that you place in your bed.

The idea behind co-sleepers is that they allow you to keep your baby close to you at night to keep an eye on them and to promote bonding, as well as make it easier for you to reach your baby for night feeds.

The AAP guidelines suggest sharing a room and not a bed with your baby for the first 6 months as this reduces the risk of SIDS. In order to do this, they recommend using a cot, Moses basket, or bassinet alongside your bed. They do not however, provide any guidelines around the use of a co-sleeper in your bed or baby nest as they acknowledge that there is not enough evidence to support safe use.

While some in-bed-sleepers which are marketed as making bed-sharing safer, the research results are not yet available and there is no indication if they reduce the risk of SIDS and suffocation.

There are safety standards for bedside sleepers which could be used as an option in guiding your decision. While they provide specific criteria which bedside sleepers need to meet to ensure your infant’s safety, there have been no studies to examine the association of these products with SIDS, unintentional death or suffocation.

safe co sleeping with baby

WHAT FACTORS MAKE SLEEPING WHILE FEEDING YOUR BABY MORE DANGEROUS?

The following factors can increase your baby’s risk of SIDS if you sleep while feeding them:

Babies who were born prematurely or with a low birth weight
Mothers who smoked during the pregnancy (a SIDS related death is 3 times more likely to occur)
Mothers who were exposed to secondary smoking from other members in the same house
Mothers who had little or no prenatal care during their pregnancy
Babies who had a sibling that passed away from SIDS

HOW DO I STOP myself from FALLING ASLEEP WHILE BREASTFEEDING?

Keeping yourself from falling asleep is challenging. The following are some things to consider to help keep yourself awake and keep your little one safe:

Getting out of bed and walking to fetch your baby assists in waking you up for a longer period of time.
Drinking water and having a snack to eat can help wake you up as well as maintain your hydration and nutrition to effectively produce milk.
Avoid feeding on a comfortable and snug surface like a couch or rocking chair as this can add to your sleepiness (and risk to your baby).
Set an alarm on your phone before you start feeding to make sure you wake up (remember to keep the phone at a safe distance if you do fall asleep)
Ask your partner or family member to wake you up if they find you sleeping whilst feeding.

It is not ideal to use a phone close to your baby due to possible concerns regarding the Microwave Radiation (MWR) given off by wireless devices, particularly for children and unborn babies.

If possible, try to put your phone on airplane mode while breastfeeding.