Article Text

Download PDFPDF
Randomised trial of infant sleep location on the postnatal ward
  1. H L Ball1,
  2. M P Ward-Platt2,
  3. E Heslop3,
  4. S J Leech3,
  5. K A Brown4
  1. 1Parent–Infant Sleep Laboratory & Medical Anthropology Research Group, Department of Anthropology, Durham University, Durham, UK
  2. 2Newcastle Neonatal Service, Royal Victoria Infirmary, Newcastle upon Tyne, UK
  3. 3Parent–Infant Sleep Laboratory, Department of Anthropology, Durham University
  4. 4Midwifery Services, Royal Victoria Infirmary, Newcastle upon Tyne
  1. Correspondence to:
    H Ball
    Department of Anthropology, Durham University, 43 Old Elvet, Durham DH1 3HN, UK;H.L.Ball{at}


Objective: To determine whether postnatal mother–infant sleep proximity affects breastfeeding initiation and infant safety.

Design: Randomised non-blinded trial analysed by intention to treat.

Setting: Postnatal wards of the Royal Victoria Hospital (RVI), Newcastle upon Tyne, UK.

Participants: 64 newly delivered mother–infant dyads with a prenatal intention to breastfeed (vaginal deliveries, no intramuscular or intravenous opiate analgesics taken in the preceding 24 h).

Intervention: Infants were randomly allocated to one of three sleep conditions: baby in mother’s bed with cot-side; baby in side-car crib attached to mother’s bed; and baby in stand-alone cot adjacent to mother’s bed.

Main outcome measures: Breastfeeding frequency and infant safety observed via night-time video recordings.

Results: During standardised 4-h observation periods, bed and side-car crib infants breastfed more frequently than stand-alone cot infants (mean difference (95% confidence interval (CI)): bed v stand-alone cot = 2.56 (0.72 to 4.41); side-car crib v stand-alone cot = 2.52 (0.87 to 4.17); bed v side-car crib = 0.04 (−2.10 to 2.18)). No infant experienced adverse events; however, bed infants were more frequently considered to be in potentially adverse situations (mean difference (95% CI): bed v stand-alone cot = 0.13 (0.03 to 0.23); side-car crib v stand-alone cot = 0.04 (−0.03 to 0.12); bed v side-car crib = 0.09 (−0.03–0.21)). No differences were observed in duration of maternal or infant sleep, frequency or duration of assistance provided by staff, or maternal rating of postnatal satisfaction.

Conclusion: Suckling frequency in the early postpartum period is a well-known predictor of successful breastfeeding initiation. Newborn babies sleeping in close proximity to their mothers (bedding-in) facilitates frequent feeding in comparison with rooming-in. None of the three sleep conditions was associated with adverse events, although infrequent, potential risks may have occurred in the bed group. Side-car cribs are effective in enhancing breastfeeding initiation and preserving infant safety in the postnatal ward.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Published Online First 18 July 2006

  • Funding: This study was funded by Babes-in-Arms ( The funders had no involvement in the conduct of the trial or in the writing of this paper.

  • Competing interests: None.

Linked Articles

  • Précis
    BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health