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Writer's pictureLaura Bottiglieri

Why Is Dream Feeding Considered a Choking Risk When Breastfeeding While Bedsharing Seems Safe as it's practiced across the world?


You’ve likely heard of the concept of dream feeding—where a baby is fed while they’re still asleep, usually from a bottle. And maybe you’ve also seen information warning about the potential choking risk with dream feeding. This can raise questions, especially when we know that around the world, mothers safely breastfeed their babies while bedsharing, often with babies dozing off during feeds. So, why would dream feeding be seen as risky if breastfeeding while bedsharing isn’t? Let’s break it down.


Understanding Breastfeeding and Bedsharing


Breastfeeding is a natural process, and many babies, especially those who bedshare with their mums, nurse throughout the night while they drift in and out of sleep. During breastfeeding, even when a baby is sleepy, they’re typically in a side-lying or upright position. This allows them to use their natural coordination of sucking, swallowing, and breathing. Even in a drowsy state, a baby’s instincts kick in to make sure that the milk flows safely and again to stress the point, they aren't asleep!


Additionally, when babies breastfeed, they control the flow of milk. They can pause to breathe, and their body responds to their needs. Breastfeeding is an intimate, responsive process where both mother and baby are in tune with each other.


How Dream Feeding Differs


Dream feeding, especially with a bottle, is a bit different. The concern arises when a baby is deeply asleep and not fully aware of what’s happening. Bottle feeding requires a different kind of coordination compared to breastfeeding. The flow from a bottle can be faster, and babies have less control over it. If they’re too sleepy, they may not be as able to effectively coordinate sucking, swallowing, and breathing.


In this scenario, the risk of choking or aspiration (milk going into the lungs) can increase. When a baby is fully awake and alert, they’re more equipped to handle the feeding process safely, but in a deep sleep, they might not be able to respond as well if something goes wrong.


Why Nature Isn’t “Wrong”


It’s not that nature has got it wrong! Breastfeeding during bedsharing is part of how nature designed mothers and babies to bond and nourish through the night. The issue is more about how certain feeding methods—like bottle feeding—are introduced in ways that differ from a baby’s natural instincts. Dream feeding with a bottle bypasses the baby’s usual control over the flow of milk, and their reduced alertness makes it harder to manage the feeding process safely.


Why We Don't Advocate for Bedsharing


While many parents around the world successfully breastfeed while bedsharing, it's important to note that most healthcare professionals, including the American Academy of Pediatrics (AAP) and the NHS, do not recommend bedsharing due to the increased risk of Sudden Infant Death Syndrome (SIDS) and accidental suffocation.


Instead, they advise room-sharing without sharing the same sleep surface, as this allows close proximity for breastfeeding and comforting your baby while reducing the associated risks. By offering guidance that prioritises safety, professionals aim to reduce the chance of sleep-related accidents, even though bedsharing can work well for some families. It’s about promoting practices that offer the best protection for every baby.


Why Professionals Recommend the Safest Option


When it comes to feeding advice, professionals always aim to recommend the safest option for every baby. While many parents have safely breastfed while bedsharing or tried dream feeding without issues, it’s important to remember that every baby is different. Some babies may be more vulnerable to choking or aspiration due to factors like their developmental stage, medical conditions, or how deeply they sleep.


Healthcare professionals base their advice on the best evidence available to minimise any potential risks. By recommending that babies be alert during feeds, they’re taking a precautionary approach to ensure that even in those rare cases where things might not go smoothly, parents are guided towards the safest practices. It's not about saying that bedsharing or dream feeding is always dangerous, but rather about erring on the side of caution to protect all babies, regardless of individual circumstances.


That’s why you’ll often hear recommendations that encourage more alert feeds and to avoid bed sharing especially when bottles are involved—it's about ensuring the highest safety standards for every family.


Final Thoughts


In short, while breastfeeding during bedsharing is a natural and usually safe process, dream feeding, especially from a bottle, can carry more risks due to how babies respond when deeply asleep. If you're bottle feeding, it’s safest to make sure your baby is at least partially awake and alert to help them feed safely.


Understanding the differences in feeding methods can help keep your baby safe and give you peace of mind, whether you're breastfeeding, bottle feeding, or doing a mix of both.




References:


1. AAP Guidelines on Bedsharing and Breastfeeding

The American Academy of Pediatrics (AAP) advises against bedsharing due to the risk of sleep-related infant deaths, but they also acknowledge the benefits of breastfeeding during the night. They encourage room-sharing without bedsharing for safer sleep environments. You can find more about their guidelines here.



2. NHS Information on Safe Feeding Practices

The NHS provides comprehensive advice on safe infant feeding, emphasising the importance of ensuring babies are alert while feeding, especially when using bottles, to prevent choking or aspiration. Visit the NHS guidelines for feeding infants here.



3. La Leche League on Breastfeeding While Bedsharing

La Leche League supports bedsharing and breastfeeding when done safely, highlighting that breastfeeding at night is a natural way to nourish and bond with your baby. However, they also emphasise the importance of ensuring the environment is safe. Learn more here.



4. World Health Organization (WHO) Recommendations on Safe Infant Feeding

The WHO stresses the importance of breastfeeding and provides guidelines on how to do it safely, including during nighttime. They recommend responsive feeding, ensuring the baby is actively engaged during feeds.

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