Science
‘We can’t just teach abstinence’: How advice on bed-sharing with a baby is evolving
When Emily Little gave birth to her first child, sleeping together with her baby in bed was a given — despite all the public health messages telling her not to.
“I knew it was something that I wanted to do,” said Little, a perinatal health researcher and science communications consultant who has studied cultures around the world that bed-share. Little was drawn to the skin-to-skin closeness she could maintain with her baby throughout the night, and the ease of breastfeeding him without getting up. It felt natural to sleep the way mothers and babies had slept “since the beginning of human history,” she said.
So she began to research ways to reduce the risk to her baby. Bed-sharing has been found to be less risky for full-term infants in nonsmoking, sober homes who are exclusively breastfed: Check. Only the breastfeeding parent should sleep next to the baby: Check. Since babies are less likely to suffocate on firm mattresses and without loose bedding, Little replaced her pillow-top mattress and got rid of all of her blankets and extra pillows. Because babies could fall off the bed or into a gap between the bed and the wall, Little pushed the bed up against the wall, and filled in the gap with foam.
Emily Little shares her bed with her baby after breastfeeding. Little is a perinatal health researcher who created a discussion guide for parents and healthcare providers to address the nuances of bed-sharing.
(Tanya Goehring / For The Times)
Still, Little’s decision conflicts with advice from pediatricians and public health advocates, who warn that bed-sharing increases the risk that a baby will die during the night. For decades, U.S. pediatricians and public health officials have been warning that the only way to avoid sudden unexplained infant death (SUID) is to stick to the “ABCs of safe sleep” — always have the baby sleep Alone, on their Back, in a separate Crib empty of any pillows, blankets, stuffed animals and crib bumpers. One controversial campaign even depicted a baby lying next to a meat cleaver, sending the message that parents could be deadly weapons when sleeping next to a baby.
And it worked: The rate of sleep-related infant death declined significantly after the safe sleep campaigns began in the 1990s. But in recent decades, the rate has plateaued and even started to tick upward again, at the same time that bed-sharing has become more popular among parents. So some advocates are instead shifting to a “harm reduction” approach that acknowledges parents want to sleep with their infants and offers tips on how to make it as safe as possible.
“Abstinence-only messaging hasn’t worked, and parents often aren’t honest with their pediatricians when they’re asked. We all need to acknowledge that it’s practically inevitable,” said Susan Altfeld, a retired University of Illinois- Chicago professor who studied bed-sharing. “Developing new messages to educate parents on what specific behaviors are especially risky and what they can do to reduce those risks have the potential to effect change.”
Engage with our community-funded journalism as we delve into child care, transitional kindergarten, health and other issues affecting children from birth through age 5.
A shifting message on infant bed-sharing
About 3,700 infants die suddenly and unexpectedly each year in the U.S, a number that has remained stubbornly high for decades, according to data from the U.S. Centers for Disease Control and Prevention. The risk of sharing sleep surface is real: Infants who sleep with adults are two to 10 times more likely to die than those who sleep alone in a crib, depending on their specific risk factors, the American Academy of Pediatrics, or AAP, wrote in its most recent safe sleep guidelines.
Nonetheless, the percentage of parents in the U.S. who said they usually bed-share has grown, from about 6% in 1993 to 24% in 2015. And in 2015, 61.4 of respondents reported bed-sharing with their infant at least occasionally. Although more recent national data are not available, more than a quarter of mothers in California said they “always or often” bed-shared in 2020-22.
Little touts the positive aspects of bed-sharing and helps families mitigate the risks.
(Tanya Goehring / For The Times)
La Leche League International, a breastfeeding advocacy organization, offers the “Safe Sleep 7” on their website to help parents bed-share more safely. Little codified her own “harm reduction” advice for safer bed-sharing in an online discussion guide for other parents to help encourage nuanced conversation between parents and healthcare providers to help mitigate the risks of what is at least an occasional practice for most parents. She also touts the positive aspects of bed-sharing and helps families mitigate the risks.
Babies who share a bed with their mothers, for example, have been shown to breastfeed longer. Parents who plan ahead and bed-share more safely may avoid falling asleep accidentally with a baby in the most unsafe of situations — a reclining chair or sofa. And many parents feel it strengthens their bond with their baby, she said.
“Infants have the biological expectation to be in close contact with their caregivers all the time, especially in the early months,” Little said. “Denying that because we as a society are unable to have a conversation about risk mitigation and harm reduction is really doing a disservice to infant well-being and mental health.”
Pushback from safe sleep advocates
The pediatrics academy, in its 2022 guidelines, acknowledges that parents may “choose to routinely bed share for a variety of reasons,” and offers a few safety suggestions if a parent “unintentionally” falls asleep with their baby. “However, on the basis of the evidence, the AAP is unable to recommend bed sharing under any circumstances,” the guidelines state.
It’s almost impossible to assess whether a family is truly a low risk when it comes to bed-sharing, especially as many are not forthcoming with their physician about drinking, smoking and drug use, said Dr. Rachel Moon, a pediatrician and researcher at the University of Virginia medical school, and lead author of the AAP report. Even if a parent is a low risk some nights, when they have a glass of wine one evening, they suddenly tip into a high-risk category, she said.
“I knew it was something that I wanted to do,” Little, shown with her family, said about bed-sharing with her baby.
(Tanya Goehring / For The Times)
Moon said bed-sharing advice has been a topic of conversation for years in the academy, but given the evidence of risk, the group decided to warn against the practice in all situations.
“It’s not responsible for us to give [parents] permission,” said Moon, who deals with sleep-related deaths in her role as a researcher. “Every day I deal with babies who have died, and if it happened in a bed-sharing situation, [parents] regret it. I deal with this enough that I don’t want anybody to have that regret.”
Changing the messaging on safe sleep would be a “slippery slope,” said Deanne Tilton Durfee, executive director of the Inter-Agency Council on Child Abuse and Neglect, which runs L.A. County’s safe sleep campaign. “You have to be extremely clear with messaging” because many parents may not pay attention to the details, she said.
In 2024, 46 infants in Los Angeles County died as they slept, and almost all of them involved bed-sharing, Durfee said.
The reality in parents’ homes
Pachet Bryant, a mother in Mission Viejo, felt deeply committed to sleeping with her new baby from the moment she gave birth. “You’re growing a baby for nine to 10 months, and all of a sudden for them to be separated from your heart, from your presence, from your smell, can be traumatic,” she said.
But she wanted to do it as safely as possible. So when lactation consultant Asaiah Harville began to work with her, the consultant offered tailored advice to the new mother’s situation, which Bryant took “very, very seriously.” Bryant had already been doing some research of her own and was able to modify her space accordingly. She also reevaluated every night whether she felt it was safe for her baby to sleep in the bed; on nights when she was too exhausted, she put her daughter to sleep in a bassinet instead.
“We know that parents are either intentionally or unintentionally at some point going to wind up falling asleep with their baby, and we have to think about creating the safest possible environment for that,” Harville said. In the lived reality of an individual family’s home, she said, “we can’t just teach abstinence.”
This article is part of The Times’ early childhood education initiative, focusing on the learning and development of California children, from birth to age 5. For more information about the initiative and its philanthropic funders, go to latimes.com/earlyed.
Science
A push to end a fractured approach to post-fire contamination removal
The patchwork efforts to identify and safely remove contamination left by the 2025 Eaton and Palisades fires has been akin to the Wild West.
Experts have given conflicting guidance on best practices. Shortly after the fires, the federal government suddenly refused to adhere to California’s decades-old post-fire soil-testing policy; California later considered following suit.
Meanwhile, insurance companies have resisted remediation practices widely recommended by scientists for still-standing homes.
A new bill introduced this week by state Assemblymember John Harabedian (D-Pasadena) aims to change that by creating statewide science-based standards for the testing and removal of contamination deposited by wildfires — specifically within still-standing homes, workplaces and schools, and in the soil around those structures.
“In a state where we’ve had a number of different wildfires that have happened in urban and suburban areas, I was shocked that we didn’t have a black-and-white standard and protocol that would lay out a uniform post-fire safety standard for when a home is habitable again,” Harabedian said.
The bill, AB 1642, would task the state’s Department of Toxic Substances Control with creating standards by July 1, 2027. The standards would only serve as guidance — not requirements — but even that would be helpful, advocates say.
“Guidance, advisories — those are extremely helpful for families that are trying to return home safely,” said Nicole Maccalla, who leads data science efforts with Eaton Fire Residents United, a grassroots organization addressing contamination in still-standing homes. “Right now, there’s nothing … which means that insurance companies are the decision-makers. And they don’t necessarily prioritize human health. They’re running a business.”
Maccalla supports tasking DTSC with determining what levels of contamination pose an unacceptable health risk, though she does want the state to convene independent experts including physicians, exposure scientists and remediation professionals to address the best testing procedures and cleanup techniques.
Harabedian said the details are still being worked out.
“What’s clear from my standpoint, is, let’s let the public health experts and the science and the scientists actually dictate what the proper standards and protocol is,” Harabedian said. “Not bureaucrats and definitely not insurance companies.”
For many residents with still-standing homes that were blanketed in toxic soot and ash, clear guidance on how to restore their homes to safe conditions would be a much welcome relief.
Insurance companies, environmental health academics, and professionals focused on addressing indoor environmental hazards have all disagreed on the necessary steps to restore homes, creating confusion for survivors.
Insurance companies and survivors have routinely fought over who is responsible for the costs of contamination testing. Residents have also said their insurers have pushed back on paying for the replacement of assets like mattresses that can absorb contamination, and any restoration work beyond a deep clean, such as replacing contaminated wall insulation.
Scientists and remediation professionals have clashed over which contaminants homeowners ought to test for after a fire. Just last week, researchers hotly debated the thoroughness of the contamination testing at Palisades Charter High School’s campus. The school district decided it was safe for students to return; in-person classes began Tuesday.
Harabedian hopes the new guidelines could solidify the state’s long-standing policy to conduct comprehensive, post-fire soil testing.
Not long after the federal government refused to adhere to the state’s soil testing policy, Nancy Ward, the former director of the California Governor’s Office of Emergency Services, had privately contemplated ending state funding for post-fire soil testing as well, according to an internal memo obtained by The Times.
“That debate, internally, should have never happened,” Harabedian said. “Obviously, if we have statewide standards that say, ‘This is what you do in this situation,’ then there is no debate.”
Science
Expiration of federal health insurance subsidies: What to know in California
Thousands of middle-class Californians who depend on the state-run health insurance marketplace face premiums that are thousands of dollars higher than last year because enhanced federal subsidies that began during the COVID-19 pandemic have expired.
Despite fears that more people would go without coverage with the end of the extra benefits, the number enrolling in Covered California has held steady so far, according to state data.
But that may change.
Jessica Altman, executive director of Covered California, said that she believes the number of people dropping their coverage could increase as they receive bills with their new higher premiums in the mail this month. She said better data on enrollment will be available in the spring.
Altman said that even though the extra benefits ended Dec. 31, 92% of enrollees continue to receive government subsidies to help pay for their health insurance. Nearly half qualify for health insurance that costs $10 or less per month. And 17% of Californians renewing their Covered California policies will pay nothing for premiums if they keep their current plan.
The deadline to sign up for 2026 benefits is Saturday.
Here’s help in sorting out what the expiration of the enhanced subsidies for insurance provided under the Affordable Care Act, often called Obamacare, means in the Golden State.
What expired?
In 2021, Congress voted to temporarily to boost the amount of subsidies Americans could receive for an ACA plan. The law also expanded the program to families who had more money. Before the vote, only Americans with incomes below 400% of the federal poverty level — currently $62,600 a year for a single person or $128,600 for a family of four — were eligible for ACA subsidies. The 2021 vote eliminated the income cap and limited the cost of premiums for those higher-earning families to no more than 8.5% of their income.
How could costs change this year for those enrolled in Covered California?
Anyone with income above 400% of the federal poverty level no longer receives subsidies. And many below that level won’t receive as much assistance as they had been receiving since 2021. At the same time, fast-rising health costs boosted the average Covered California premium this year by more than 10.3%, deepening the burden on families.
How much would the net monthly premium for a Los Angeles couple with two children and a household income of $90,000 rise?
The family’s net premium for the benchmark Silver plan would jump to $699 a month this year from $414 a month last year, according to Covered California. That’s an increase of 69%, costing the family an additional $3,420 this year.
Who else could face substantially higher health bills?
People who retired before the Medicare-qualifying age of 65, believing that the enhanced subsidies were permanent, will be especially hit hard. Those with incomes above 400% of the federal poverty level could now be facing thousands of dollars in additional health insurance costs.
How did enrollment in Covered California change after the enhanced subsidies expired on Dec. 31?
As of Jan. 17, 1,906,033 Californians had enrolled for 2026 insurance. That’s less than 1% lower than the 1,921,840 who had enrolled by this time last year.
Who depends on Covered California?
Enrollees are mostly those who don’t have access to an employer’s health insurance plan and don’t qualify for Medi-Cal, the government-paid insurance for lower-income people and those who are disabled.
An analysis by KFF, a nonprofit that provides health policy information, found that nearly half the adults enrolled in an ACA plan are small-business owners or their employees, or are self-employed. Occupations using the health insurance exchanges where they can buy an ACA plan include realtors, farmers, chiropractors and musicians, the analysis found.
What is the underlying problem?
Healthcare spending has been increasing faster than overall inflation for years. The nation now spends more than $15,000 per person on healthcare each year. Medical spending today represents about 18% of the U.S. economy, which means that almost one out of every five dollars spent in the U.S. goes toward healthcare. In 1960, health spending was just 5% of the economy.
What has California done to help people who are paying more?
The state government allocated $190 million this year to provide subsidies for those earning up to 165% of the federal poverty level. This money will help keep monthly premiums consistent with 2025 levels for those with an annual income of up to $23,475 for an individual or $48,225 for a family of four, according to Covered California.
Where can I sign up?
People can find out whether they qualify for financial help and see their coverage options at the website CoveredCA.com.
What if I decide to go without health insurance?
People without insurance could face medical bills of tens of thousands of dollars if they become sick or get injured. And under California state law, those without coverage face an annual penalty of at least $900 for each adult and $450 for each child.
Science
Department of Education finds San Jose State violated Title IX regarding transgender volleyball player
The U.S. Department of Education has given San José State 10 days to comply with a list of demands after finding that the university violated Title IX concerning a transgender volleyball player in 2024.
A federal investigation was launched into San José State a year ago after controversy over a transgender player marred the 2024 volleyball season. Four Mountain West Conference teams — Boise State, Wyoming, Utah State and Nevada-Reno — each chose to forfeit or cancel two conference matches to San José State. Boise State also forfeited its conference tournament semifinal match to the Spartans.
The transgender player, Blaire Fleming, was on the San José State roster for three seasons after transferring from Coastal Carolina, although opponents protested the player’s participation only in 2024.
In a news release Wednesday, the Education Department warned that San José State risks “imminent enforcement action” if it doesn’t voluntarily resolve the violations by taking the following actions, not all of which pertain solely to sports:
1) Issue a public statement that SJSU will adopt biology-based definitions of the words “male” and “female” and acknowledge that the sex of a human — male or female — is unchangeable.
2) Specify that SJSU will follow Title IX by separating sports and intimate facilities based on biological sex.
3) State that SJSU will not delegate its obligation to comply with Title IX to any external association or entity and will not contract with any entity that discriminates on the basis of sex.
4) Restore to female athletes all individual athletic records and titles misappropriated by male athletes competing in women’s categories, and issue a personalized letter of apology on behalf of SJSU to each female athlete for allowing her participation in athletics to be marred by sex discrimination.
5) Send a personalized apology to every woman who played in SJSU’s women’s indoor volleyball from 2022 to 2024, beach volleyball in 2023, and to any woman on a team that forfeited rather than compete against SJSU while a male student was on the roster — expressing sincere regret for placing female athletes in that position.
“SJSU caused significant harm to female athletes by allowing a male to compete on the women’s volleyball team — creating unfairness in competition, compromising safety, and denying women equal opportunities in athletics, including scholarships and playing time,” Kimberly Richey, Education Department assistant secretary for civil rights, said.
“Even worse, when female athletes spoke out, SJSU retaliated — ignoring sex-discrimination claims while subjecting one female SJSU athlete to a Title IX complaint for allegedly ‘misgendering’ the male athlete competing on a women’s team. This is unacceptable.”
San José State responded with a statement acknowledging that the Education Department had informed the university of its investigation and findings.
“The University is in the process of reviewing the Department’s findings and proposed resolution agreement,” the statement said. “We remain committed to providing a safe, respectful, and inclusive educational environment for all students while complying with applicable laws and regulations.”
In a New York Times profile, Fleming said she learned about transgender identity when she was in eighth grade. “It was a lightbulb moment,” she said. “I felt this huge relief and a weight off my shoulders. It made so much sense.”
With the support of her mother and stepfather, Fleming worked with a therapist and a doctor and started to socially and medically transition, according to the Times. When she joined the high school girls’ volleyball team, her coaches and teammates knew she was transgender and accepted her.
Fleming’s first two years at San José State were uneventful, but in 2024 co-captain Brooke Slusser joined lawsuits against the NCAA, the Mountain West Conference and representatives of San José State after alleging she shared hotel rooms and locker rooms with Fleming without being told she is transgender.
The Education Department also determined that Fleming and a Colorado State player conspired to spike Slusser in the face, although a Mountain West investigation found “insufficient evidence to corroborate the allegations of misconduct.” Slusser was not spiked in the face during the match.
President Trump signed an executive order a year ago designed to ban transgender athletes from competing on girls’ and women’s sports teams. The order stated that educational institutions and athletic associations may not ignore “fundamental biological truths between the two sexes.” The NCAA responded by banning transgender athletes.
The order, titled “Keeping Men Out of Women’s Sports,” gives federal agencies, including the Justice and Education departments, wide latitude to ensure entities that receive federal funding abide by Title IX in alignment with the Trump administration’s view, which interprets a person’s sex as the gender they were assigned at birth.
San José State has been in the federal government’s crosshairs ever since. If the university does not comply voluntarily to the actions listed by the government, it could face a Justice Department lawsuit and risk losing federal funding.
“We will not relent until SJSU is held to account for these abuses and commits to upholding Title IX to protect future athletes from the same indignities,” Richey said.
San José State was found in violation of Title IX in an unrelated case in 2021 and paid $1.6 million to more than a dozen female athletes after the Department of Justice found that the university failed to properly handle the students’ allegations of sexual abuse by a former athletic trainer.
The federal investigation found that San José State did not take adequate action in response to the athletes’ reports and retaliated against two employees who raised repeated concerns about Scott Shaw, the former director of sports medicine. Shaw was sentenced to 24 months in prison for unlawfully touching female student-athletes under the guise of providing medical treatment.
The current findings against San José State came two weeks after federal investigators announced that the California Community College Athletic Assn. and four other state colleges and school districts are the targets of a probe over whether their transgender participation policies violate Title IX.
The investigation targets a California Community College Athletic Assn. rule that allows transgender and nonbinary students to participate on women’s sports teams if the students have completed “at least one calendar year of testosterone suppression.”
Also, the Education Department’s Office of Civil Rights has launched 18 Title IX investigations into school districts across the United States on the heels of the Supreme Court hearing oral arguments on efforts to protect women’s and girls’ sports.
-
Illinois1 week agoIllinois school closings tomorrow: How to check if your school is closed due to extreme cold
-
Pennsylvania5 days agoRare ‘avalanche’ blocks Pennsylvania road during major snowstorm
-
Science1 week agoContributor: New food pyramid is a recipe for health disasters
-
Technology1 week agoRing claims it’s not giving ICE access to its cameras
-
Movie Reviews1 week ago
Movie Review: In ‘Mercy,’ Chris Pratt is on trial with an artificial intelligence judge
-
News1 week agoVideo: Jack Smith Defends His Trump Indictments During House Hearing
-
Politics1 week agoSupreme Court appears ready to keep Lisa Cook on Federal Reserve board despite Trump efforts to fire her
-
Politics5 days agoTrump’s playbook falters in crisis response to Minneapolis shooting