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‘We can’t just teach abstinence’: How advice on bed-sharing with a baby is evolving

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‘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)

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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.”

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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.

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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.

A woman with blond hair, in a gray plaid shirt, smiles while seated on a sofa

Little touts the positive aspects of bed-sharing and helps families mitigate the risks.

(Tanya Goehring / For The Times)

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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.

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A man with a dark beard and a smiling woman with blond hair are seated on a sofa with a blond-haired baby

“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.

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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.

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Video: NASA’s Mission Back to the Moon

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Video: NASA’s Mission Back to the Moon
Artemis II, which would be the first time anyone would travel this far from Earth since 1972, launches on April 1. Kenneth Chang, a reporter for The New York Times, describes how the mission is key to a U.S. goal.

By Kenneth Chang, Marco Hernandez, Melanie Bencosme, Jon Miller, Gabriel Blanco, Joey Sendaydiego and Luke Piotrowski

April 1, 2026

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MAHA says red meat and beef tallow will make you healthy. The American Heart Assn. isn’t buying it

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MAHA says red meat and beef tallow will make you healthy. The American Heart Assn. isn’t buying it

In an earlier era, the American Heart Assn. and the U.S. federal government were very closely aligned on what the American public should eat and why.

Dietary guidelines from the cardiovascular research nonprofit largely mirrored those published by the U.S. Department of Health and Human Services. American Heart Assn. representatives advised the government on the science behind its dietary advice.

But as is the case with many public health issues these days, the distance between the policies recommended by established medical groups and those endorsed by Department of Health and Human Services Secretary Robert F. Kennedy Jr. appears to be growing wider.

On Tuesday, American Heart Assn. released its updated guidelines for a heart-healthy diet. Like the new federal dietary guidelines released back in January, the document cautions against processed foods and refined sugars.

But the group pressed back on some nutrition claims that Kennedy and Make America Healthy Again influencers have touted in public statements and written into federal policy.

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Unlike the new federally authorized inverted food pyramid, which gives top billing to an enormous cut of steak, a tray of ground meat, a hunk of cheese and carton of whole milk, the American Heart Assn. urges plant-based proteins over red meat, and low- or nonfat dairy products over whole-fat options.

In contrast to Kennedy’s declaration in January that the U.S. was “ending the war on saturated fat,” the heart association continues to recommend unsaturated fat sources over saturated ones for the sake of cardiovascular health.

The heart association also pushes back on Kennedy’s well-publicized passion for beef tallow as a replacement for seed oils, which he has accused (despite shaky evidence) of “poisoning” Americans.

“Animal fats (eg, beef tallow and butter) and tropical oils (eg, coconut oil, cocoa butter, and palm oil) are relatively high in saturated fat, whereas nontropical plant oils (eg, soybean, canola, and olive oils) are relatively high in unsaturated fat,” the American Heart Assn. paper reads. “In summary, as part of heart-healthy dietary patterns, nontropical plant sources of fat should be used as part of food preparation in place of animal fats and tropical oils.”

In response to questions, both the American Heart Assn. and Department of Health and Human Services emphasized their shared objectives over any differences.

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“The American Heart Association’s [paper] is aligned with the Dietary Guidelines on the major issues: eat real food, avoid highly processed food, and limit refined grains and added sugar,” said Andrew Nixon, a health department spokesman. “We look forward to working collaboratively with the [American Heart Assn.] to evangelize these core principles and reverse the diet-related chronic disease epidemic.”

The heart association and the federal government have different purposes when drafting their recommendations, said Dr. Simin Liu, director of UC Irvine’s Center for Global Cardiometabolic Health & Nutrition and a professor at the UC Irvine School of Medicine.

The heart association’s guidelines are intended to reflect the best available evidence on nutrition and cardiovascular health outcomes, whereas federal nutrition standards inform the content of federally funded meals served in schools, hospitals and military dining facilities, and help determine foods included under assistance plans like the Supplemental Nutrition Assistance Program.

The two sets of guidelines aren’t totally at odds. The heart association applauded the government’s warnings against added sugars, refined grains and processed foods in January, noting that the advice aligns with the organization’s long-standing recommendations.

“Those of us in the field have been pushing for food-based dietary recommendations, like advocating people eat actual foods instead of [processed] food products,” Liu said, but “the focus on animal product consumption is a bit off the mark.”

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The administration’s hearty endorsement of animal protein sources surprised many health groups, as a diet rich in red meat is strongly associated with poorer cardiovascular health.

A supplemental report published alongside the federal guidelines noted that several members of the government’s advisory panel had financial ties to meat and dairy industry groups, including the National Cattlemen’s Beef Assn., the National Pork Board and the California Dairy Research Foundation.

The heart association’s guidelines better reflect the current scientific consensus on the relationship between food and cardiovascular health, said a spokesperson for the nonprofit Center for Science in the Public Interest, and “will be a valuable resource for anyone who was confused by the mixed messages” in the government’s earlier advice.

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How NASA plans to keep Artemis astronauts alive if disaster strikes

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How NASA plans to keep Artemis astronauts alive if disaster strikes

If NASA’s colossal new moon rocket, slated to launch with astronauts for the first time as soon as tomorrow, explodes on the pad or breaks up as it accelerates through the atmosphere, the space agency has a plan:

Fire a powerful motor affixed to the top of the crew capsule that is literally designed to outrun debris from an exploding rocket, flip the capsule around as it soars through the air, then deploy parachutes to bring the astronauts back to safety.

Reliably pulling off this high-energy yet delicate dance isn’t easy. Engineers and scientists across the country spent years developing and testing this Launch Abort System, including many at the Armstrong Flight Research Center, which has spent decades pushing the limits of human flight in Southern California’s Mojave Desert.

For the Artemis program, aiming to bring humans back to the moon for the first time in a half-century and prepare for eventually landing people on Mars, NASA tapped the center to help execute two critical tests of the abort system in the 2010s.

In the first, NASA engineers attached the system to a dummy test capsule packed with hundreds of sensors, placed it alongside the glimmering white sand dunes of New Mexico and fired it off to simulate an abort from the launch pad.

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In the second, crews headed to the Florida space coast, where they placed the abort system and test capsule on a modified missile. To mimic the conditions of a rocket ascent, they launched the missile and, after it broke the sound barrier, triggered the abort system.

It’s these kinds of extreme flight conditions that the Armstrong Flight Research Center specializes in.

Brad Flick, who retired as director of the center on March 20, recalled a poster outside his office depicting the Apollo moon landings: “The poster says, ‘Before we did it there, we practiced it here.’ And that’s what we do.”

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Southern California’s pioneers in human flight

Even before NASA was called NASA, its engineers, scientists and test pilots were pushing the limits of flight in the Mojave Desert.

Out in the middle of current-day Edwards Air Force Base — one of the largest airfields in the world, at some 480 square miles — a small team began the X-plane program, a series of experimental aircraft designed to travel faster, higher and (purposefully) more awkwardly than ever before.

In 1947, with its X-1 plane, the team became the first in the history of human flight to break the sound barrier.

By the early 1960s, the full-fledged flight research center had become a hub of cutting-edge aviation research, thrown into high gear by NASA’s “brightest and boldest”:

A young pilot by the name of Neil Armstrong was guiding the rocket-powered X-15 on a number of test flights. On one where Armstrong flew above Earth’s atmosphere, he struggled to trigger a safety system designed to limit the intense forces pilots experience and overshot his runway by about 45 miles, ending up over Pasadena.

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This NASA Armstrong Flight Research Center (AFRC) hangar

This NASA Armstrong Flight Research Center hangar houses a Gulfstream III airplane that the center will use during the Artemis II mission to track the capsule as it reenters the atmosphere.

(Genaro Molina/Los Angeles Times)

The center was also designing and testing mock-ups of a lunar lander, which Armstrong — now the center’s namesake — later used to practice landing on the moon while still here on Earth.

Meanwhile, another plane dubbed the “flying bathtub” was also taking shape at the center. The odd-looking craft essentially aimed to test whether they could fly with no wings, instead generating lift from the body of the plane. To launch it, they attached the plane to a Pontiac convertible and ripped across the nearby lake bed at 120 mph.

The data they got from the experiment informed the design of the Space Shuttle. Instead of relying solely on large wings — which would have needed to be heavy and bulky to survive the extreme conditions of reentry — the shuttle generated a fair amount of lift with its body so it could get by with stubbier, lighter wings. The necessary but perhaps inelegant design earned the Space Shuttle its own nickname: the “flying brick.”

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Flick didn’t indulge in telling any of the “cowboys-in-airplanes stories” he’d heard during his nearly 40 years at the center. However, he noted that it’s a special breed that can handle the extremes of the test pilot job — and that it requires some serious risk management across the whole team.

“The safest thing to ever do with an airplane is to never fly it,” Flick said. “That’s not the business we’re in. … The people in that airplane — be they pilots, or in the cabin — they rely on us to do our jobs well, to keep them safe and alive. That’s a responsibility we take very seriously.”

Armstrong Flight Research Center Director Brad Flick stands next to a Gulfstream III airplane

Armstrong Flight Research Center Director Brad Flick stands next to a Gulfstream III airplane on March 18, 2026.

(Genaro Molina / Los Angeles Times)

Testing astronauts’ last resort

The center’s experience not only pushing far past the frontiers of flight, but also turning its experimental aircraft into “flying labs” with dozens or hundreds of sensors, has made it key to the success of NASA’s space missions over the years.

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For the first of the two Artemis abort tests, called Pad Abort-1, the Armstrong Flight Research Center team painted the test capsule; installed the sensors, flight computers, wires and parachutes; and then put the whole system through a series of tests and measurements to make sure it was ready for launch.

Throughout the complex aerial gymnastics of an abort, the distribution of weight matters immensely: A top-heavy capsule performs differently than a bottom-heavy capsule. Unaccounted weight on one side can also set the capsule off-kilter. So the Armstrong team employed a series of tests involving fancy scales and gently tipping the capsule.

Aborts are also intense. The motors that pull the capsule away from the doomed rocket are designed to accelerate from 0 to 500 mph — well over half the speed of sound — in just two seconds. In the process, the capsule shakes pretty aggressively. So the team subjected the capsule to vibrations in the lab to ensure everything would still work after that kind of extreme shaking. It’s better to break stuff on the ground than in the air.

The Armstrong team ultimately selected White Sands Missile Range in New Mexico for the pad-abort test. It also oversaw the construction of the launch pad and coordinated operations for the test, which NASA successfully completed in 2010.

Years later, NASA launched its Ascent Abort-2 test atop a modified missile in preparation for the Artemis launches. For that, the Armstrong team had a more focused role designing and testing the network of hundreds of sensors that would be the agency’s eyes and ears for the test. This included strapping the sensors to a vibration table and giving them a solid shake to make sure they could handle the G-forces.

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Environmental Test Technician Cryss Punteney places her hands on the Unholtz Dickie vibration table

Environmental test technician Cryss Punteney places her hands on the Unholtz Dickie vibration table where components for Ascent Abort-2 were tested inside at the NASA Armstrong Flight Research Center.

(Genaro Molina / Los Angeles Times)

“If the tree falls in the forest, and no one was around to hear, did it actually make a sound?” said Laurie Grindle, Armstrong deputy center director who served as the project manager for the first abort test. “If we didn’t have any instrumentation, we could have launched something great that showed up wonderful on video, but we wouldn’t know if it performed well.”

The second test went off without a hitch in 2019. The teams got invaluable data — and some wonderful video too.

In 2022, NASA’s uncrewed Artemis I test mission with the abort system successfully reach the moon — no abort needed. When the crewed Artemis II mission launches to the moon as soon as tomorrow, the abort system will, for the first time, be responsible for keeping astronauts alive.

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