Quality standard

Quality statement 4: Infant health – bed sharing

Quality statement

Women, their partner or main carers of babies have discussions with their healthcare professional about safer bed-sharing practices.

Rationale

There are risk factors associated with sudden unexpected death in infancy when bed sharing. Discussing safer bed-sharing practices and the circumstances in which bed sharing with a baby is strongly advised against with women, their partner or main carers of babies will support them to establish safer infant sleeping habits.

Quality measures

Structure

Evidence of local arrangements to ensure that women, their partner or main carers of babies have discussions with their healthcare professional about safer bed-sharing practices.

Data source: Local data collection.

Process

Proportion of postnatal contacts in which women, their partner or main carers of babies have discussions with their healthcare professional about safer bed-sharing practices.

Numerator – the number in the denominator in which women, their partner or main carers of babies have discussions with their healthcare professional about safer bed-sharing practices.

Denominator – the number of postnatal contacts.

Data source: Local data collection.

Outcome

a) Incidence of sudden infant death syndrome (SIDS).

Data source: Office for National Statistics' data on unexplained deaths in infancy, England and Wales.

b) Women, their partner and main carers of babies know about safer bed-sharing practices.

Data source: Local data collection.

What the quality statement means for different audiences

Service providers ensure that information about safer bed-sharing practices is available, and that healthcare professionals are trained to discuss safer bed-sharing practices with women, their partner or main carers of babies.

Healthcare practitioners ensure that they understand and can explain safer bed-sharing practices, and that they have discussions about this with women, their partner or the main carers of babies.

Commissioners ensure that they commission services that provide information about safer bed-sharing practices, and that train healthcare professionals to discuss this with women, their partner or main carers of babies.

Women, their partner or main carers of babies have discussions about safer bed-sharing practices with their healthcare professional. This should include how to keep their baby safe if they share a bed with their baby and when they should not share a bed with their baby.

Source guidance

Postnatal care. NICE guideline NG194 (2021), recommendations 1.3.13 and 1.3.14

Definitions of terms used in this quality statement

Main carers of babies

For the majority of babies, the main carer will be the mother. For some babies, the main carer could be a close relative, for example, the baby's father or grandparent, or for looked‑after babies, this could be a foster parent. [Expert opinion]

Safer bed-sharing practices

Discussions about bed sharing should include:

  • safer practices for bed sharing, including:

    • making sure the baby sleeps on a firm, flat mattress, lying face up (rather than face down or on their side)

    • not sleeping on a sofa or chair with the baby

    • not having pillows or duvets near the baby

    • not having other children or pets in the bed when sharing a bed with a baby

  • advice not to share a bed with their baby if their baby was low birth weight or if either parent:

    • has had 2 or more units of alcohol

    • smokes

    • has taken medicine that causes drowsiness

    • has used recreational drugs.

[NICE's guideline on postnatal care, recommendations 1.3.13 and 1.3.14]

Equality and diversity considerations

Communication and information‑giving between women, their partners or main carers of babies (and their families), and members of the maternity team are key aspects of this statement. Relevant adjustments should be in place for people with communication difficulties, and those who do not speak or read English. Verbal and written information should be appropriate for the person's level of literacy, culture, language and family circumstances. Bed sharing can be intentional or a necessity, but all women, their partners or main carers of babies should be given information in a format they can understand, irrespective of their culture.