Bartick & Tomori (2019): Sofa-Sleeping vs Bed-Sharing
Sofa-sleeping is the real high-risk configuration, not safe bed-sharing
Sofa-sleeping with an infant is among the highest-risk sleep arrangements. Bed-sharing under safe conditions is much lower risk. The AAP conflates the two, which can drive mothers to fall asleep nursing on the couch, the most dangerous configuration.
Melissa Bartick is a US researcher who has published extensively on infant feeding and sleep safety. Her work, including a 2019 paper with Cecília Tomori, drew a sharp distinction that the AAP has often blurred. Sofa-sleeping with an infant is among the highest-risk infant sleep arrangements identified in the data, while bed-sharing under safe conditions is much lower risk.
Bartick's argument has been that conflating the two in public health messaging actively drives unsafe outcomes, because mothers who fall asleep nursing on a couch (often because they have been told never to bring the baby into the bed) end up in the most dangerous configuration. The paper called for the AAP to revise its messaging to distinguish bed-sharing from sofa-sleeping. As of 2026, the AAP has not done so.
Among highest
Sofa-sleeping risk
Much lower
Safe bed-sharing risk
2019
Bartick & Tomori publication
Unchanged
AAP messaging since
Why it matters
When public health messaging tells mothers not to bring the baby into the bed without explaining that the couch is the worst alternative, the messaging can drive the outcomes it is trying to prevent.
This is one finding from the research library behind How to Birth a Mother. Everything here traces back to a study, a dataset, or a systematic review.