Quality statement 5: Safer practices for bed sharing
Parents sharing a bed with their baby is common practice but there is often confusion and mixed messages about it. Giving parents advice at each routine postnatal contact about safer practices for bed sharing and when bed sharing is strongly advised against (such as avoiding certain sleeping positions or places, or after consuming drugs or alcohol), will support them to establish safer infant sleeping habits.
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
Proportion of routine postnatal contacts that include advice about safer practices for bed sharing.
Numerator – the number in the denominator that include advice about safer practices for bed sharing.
Denominator – the number of routine postnatal contacts.
Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, from patient records.
a) Incidence of sudden infant death syndrome (SIDS).
b) Proportion of parents who know about safer practices for bed sharing.
Numerator – the number in the denominator who know about safer practices for bed sharing.
Denominator – the number of parents of babies.
Data source: Data could be collected from a local survey of parents of babies.
Service providers (such as NHS hospital trusts and community providers) ensure that healthcare professionals are trained to discuss safer practices for bed sharing with parents. They ensure that processes are in place to discuss safer practices for bed sharing at each routine postnatal contact.
Healthcare professionals (midwives and health visitors) ensure that they can explain safer practices for bed sharing, and that they give parents advice about this at each routine postnatal contact. Healthcare professionals check that parents understand the information they have been given, and how it relates to them.
Commissioners (such as integrated care systems and local authorities) ensure that they commission services that advise parents about safer practices for bed sharing at each routine postnatal contact.
Parents of babies are given advice about safer practices when sharing a bed with their baby when they see health visitors and midwives. This should include how to keep their baby safer when sharing a bed with their baby and when they should not share a bed with their baby.
Postnatal care. NICE guideline NG194 (2021), recommendations 1.3.13 and 1.3.14
Contact from a healthcare professional that is part of the standard pathway of postnatal care. This includes the first contact on the postnatal ward by a midwife, the first home visit by a midwife, and the first home visit by a health visitor. [NICE's guideline on postnatal care, recommendations 1.1.10, 1.1.14 and 1.1.15]
Advice 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
has taken medicine that causes drowsiness
has used recreational drugs.
[NICE's guideline on postnatal care, recommendations 1.3.13 and 1.3.14]
Parents should be given information that they can easily access and understand themselves, or with support, so they can communicate effectively with healthcare services. Clear language should be used, and the content and delivery of information should be tailored to individual needs and preferences. It should be accessible to people who do not speak or read English, and it should be culturally appropriate. People should have access to an interpreter or advocate if needed. The interpreter or advocate should not be a member of the woman's family, her legal guardian or her partner, and they should communicate with the woman in her preferred language. For parents with additional needs related to a disability, impairment or sensory loss, information should be provided as set out in NHS England's Accessible Information Standard or the equivalent standards for the devolved nations.