As a doctor who breastfed her child, I believe that bed-sharing can be safely practised by breastfeeding mothers, provided certain precautions are observed ("Open verdict on death of baby girl who slept with parents"; last Friday).
I disagree that there is no advantage to the baby in bed-sharing.
The baby has ready access to the breast, and mother-infant bonding is also promoted.
Sleep studies conducted by Dr James McKenna suggest that when breastfeeding mothers sleep with their babies, both are in a heightened state of awareness of each other.
Dr William Sears, writing for breastfeeding support organisation La Leche League International, proposes the theory that bed-sharing may have a protective effect against apnoea and sudden infant death syndrome.
Of course, unsafe practices must not be downplayed.
Parent-infant bed-sharing is hazardous under certain conditions, such as when the infant is subjected to overheating, rebreathing, airway obstruction, head covering, and exposure to tobacco smoke.
Sharing an adult bed also exposes the infant to the risk of falls and getting trapped.
Precautions to take when bed-sharing include putting infants to sleep on their backs and on firm surfaces with no pillows, cot bumpers or loose bedding, which could cover or trap their heads.
Bed-sharing should not be done with adults who smoke or who are sedated with medication or alcohol.
It can be argued that many instances of infant deaths while bed-sharing may occur because these precautions are not followed, not because of bed-sharing itself.
Many breastfeeding mothers fall asleep while feeding their infants during the night.
There is a much higher risk to the baby if this occurs in an unsafe environment, such as on chairs or sofas, rather than in a safe environment intentionally created for bed-sharing.
Many Asian caregivers also persist in far more unsafe practices, such as placing the baby on his tummy to sleep, putting pillows around him.
Rather than put undue blame on bed-sharing, let us continue to educate the public about the basics of safe infant sleep.
Joanna Chan Shi-En (Dr)