Peer-reviewed article

Association of co-sleeping and bed sharing practices with early childhood caries in children: a systematic review and meta-analysis.

Yadiki JV, Sharma A, Aileni KR, K K, J SR et al. · 27 Jul 2026

Abstract

Purpose Co-sleeping or bed sharing is a common practice that is believed to offer convenient and longer breastfeeding time, although it may contribute to the development of early childhood caries (ECC). This study aimed to explore the association between co-sleeping or bed sharing practices and ECC. Methods A search was conducted across electronic databases, journals, and National repositories from their inception to December 2025. The Newcastle-Ottawa scale for cohort studies and a modified version was used for cross-sectional studies to assess the risk of bias. The random effects model was used for meta-analysis and the certainty of evidence was evaluated using 'Grading of Recommendations, Assessment, Development and Evaluations' criteria. Results A total of 10,635 articles were identified, and the full-text review led to the inclusion of six articles with 2587 participants. A total of 267 children reported co-sleeping, 1193 practiced bed sharing, 1023 engaged in night-time breastfeeding, and 849 were diagnosed with ECC. One study revealed moderate risk, while five studies demonstrated low risk of bias. Statistics Substantial heterogeneity was observed across the studies (I2 = 90%). The meta-analysis revealed a statistically significant association between bed sharing and ECC (OR =  2.77, 95% CI 1.36-5.64, p = 0.005). The certainty of evidence was found to be moderate. Conclusions This review shows a positive correlation between co-sleeping or bed sharing practices and ECC which is a significant concern worldwide.