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.

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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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)

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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.

“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.

During the government shutdown, the U.S. Forest Service completed prescribed burns on more than 127,000 acres, Forest Service Chief Tom Schultz announced in an internal memo welcoming back furloughed employees. During the same time frame in 2023 and 2024, the Forest Service completed a comparable amount of work, indicating the agency managed to take advantage of prime weather for burns even with a reduced workforce.

“Despite the disruption, we accomplished a great deal together,” the memo, first reported by the Hotshot Wake Up and verified by The Times, said. “We advanced timber sales that strengthen local economies, kept recreation sites open and safe for public enjoyment, and carried out critical wildfire response and active management work.”

By comparison, the Forest Service completed about 200,000 acres of prescribed burns in 2023 from Oct. 1 through Nov. 12 — the same span as the 2025 shutdown — and in 2024, it burned roughly 90,000 acres during that time frame, according to a Forest Service database that tracks hazardous fuel treatment work.

The latest contingency plan for the Forest Service — the largest federal firefighting entity in the country — called for continuing essential work during a shutdown, including responding to and suppressing wildfires.

The plan also involves furloughing roughly 30% of the service’s workforce, including those who oversee forest-use permit processing and public recreation, as well as researchers studying forest health and the timber market. Yet fuel treatment work, such as prescribed burning and mechanically thinning forests, is conducted by many of the same personnel responsible for putting out fires — the part of the workforce that avoided the furloughs.

That was important, given that significant fire activity across the West in 2024 inhibited the Forest Service from reducing wildfire risk on as many acres. So, this year, the Forest Service has been playing catch-up.

However, Grassroots Wildland Firefighters, a nonprofit representing current and former federal firefighters, found in October that Forest Service fuel management work in 2025 was down by 38% compared with recent years. The organization said that downturn was largely due to staff and resource cuts championed by President Trump’s cost-cutting team at the start of his second administration.

The Forest Service did not immediately respond to a request for comment.

California Gov. Gavin Newsom has challenged the federal government to match state investments in wildfire risk reduction work, and in July even sent the White House a draft executive order that Newsom said would accomplish exactly that.

In 2021, the state and U.S. Forest Service agreed to ramp up their yearly fuel treatment work in California to 500,000 acres each by 2025.

In 2023, the most recent year both state and federal data are available, the state reached 415,000 acres, and the Forest Service reached 311,000, according to a state dashboard. From 2021 to 2024, the state invested $4.3 billion to complete that work, whereas the Forest Service invested $3.1 billion.

This past weekend’s rain could mark an early start to prescribed-burn season in Southern California — home to a handful of national forests, including the Los Angeles and San Bernardino forests — as federal employees return to work until at least the end of January, when the agreed-upon funding is set to expire.

“I’m profoundly grateful to welcome our furloughed employees back as the government reopens,” Schultz said in the memo. “I look forward to getting the entire team back together to continue and build upon the work that we’ve begun this new fiscal year.”

Infection rates are soaring in the United States due to a menacing bacteria that are resistant “to some of the strongest antibiotics available,” prompting infectious-disease experts to warn about the difficulty of responding to the surge.

The Centers for Disease Control and Prevention warned in a report this week that between 2019 and 2023, bacterial infections caused by a “super bug” bacteria dubbed NDM-producing carbapenem-resistant Enterobacterales (NDM-CRE) surged by more than 460% in the U.S.

The NDM-CRE is a type of bacteria with a special gene that can break down powerful antibiotics rendering most drug treatments ineffective, said Shruti Gohil, associate professor of infectious diseases at UC Irvine School of Medicine.

“This makes these ‘superbug’ bacteria very hard to treat because they’re resistant to some of the strongest antibiotics we have,” Gohil said.

The CDC’s findings, originally published in a 2022 report, noted that there were approximately 12,700 infections and 1,100 deaths in the U.S. in 2020 due to this drug-resistant bacteria.

The public health agency did not determine the exact reason for the surge; however, there is an association involving the use of antibiotics to treat COVID-19 patients in the beginning of the pandemic, said Neha Nanda, medical director of antimicrobial stewardship with USC’s Keck Medicine.

Public health officials warn that NDM-CRE has not historically been common in the U.S., so healthcare providers might not suspect it when treating patients with bacteria-related infections.

The rise of the bacteria also “threatens to increase NDM-CRE-related infections and deaths,” according to the CDC.

This is the second report the CDC released that highlighted a rise in bacteria-related cases, the most recent was published in June and focused on cases in New York City between 2019 and 2024.

Available treatment for NDM-CRE?

Experts say people with NDM-CRE bacteria won’t have any symptoms unless they develop an infection. Once they develop an infection, the symptoms will vary. NDM-CRE can cause such ailments as pneumonia, bloodstream infections, urinary tract infections and wound infections.

Some symptoms can include fever, chills with cough, shortness of breath if the bacteria infect the lung, and pain or blood when urinating if the bladder/kidneys are infected.

Since the bacteria are resistant to most antibiotics, treatment options are severely limited, leading to slower recovery and higher risk of serious complications or death, Gohil said.

Another reason health officials are concerned is because the bacteria can spread to others and survive on contaminated surfaces.

Doctors can test for NDM-CRE, but most people do not need to be tested unless they are at higher risk for having it, according to experts.

Those at risk are people who have been “in a hospital (especially in another country), had repeated antibiotics, hospital stays, or invasive medical procedures, or if you’re sick and been in contact with someone known to have NDM-CRE,” Gohil said.

Testing for the bacteria is also difficult because many hospitals and clinics do not have the tools to rapidly detect it in patients even when the patient is not sick.

How to protect yourself against NDM-CRE

NDM-CRE is caused by overuse of powerful antibiotics.

“I think this may be an opportunity for us to change the narrative where all patients typically want antibiotics,” Nanda said.

Nanda advises patients who are being prescribed with antibiotics to ask their healthcare provider:

• Why they’re getting prescribed the antibiotics? Why is it necessary?
• Ask about your options. Make sure you’ve exhausted all other treatments options before going straight to antibiotics.

“If you need it, you need it, but then be judicious about it,” she said.

Because NDM-CRE infections happen to people who are very sick, patients in hospitals or in long-term care, experts recommend that patients, healthcare staff and visitors in these settings wash their hands and avoid contact with dirty surfaces.