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In 2005 the American Academy of Pediatrics published new recommendations on infant sleep environment which advised against infants bed-sharing. A retrospective study was done to determine the prevalence of infant bed-sharing and its associations in a clinical practice. Demographic data were collected from 2,405 infants from a large family practice residency program, which included OB care, in Missouri between March 2002 and February 2008. Data were extracted from electronic medical records at the first four well-child visits: 1 month, 2-3 months, 4-5 months, and 6-8 months of age. Data analysis was performed using SPSS statistical software package, version 12.0 and 15.0 (SPSS, Inc, Chicago, Ill). At the first, second, third, and fourth well-child visit 19, 18, 12, and 11% of infants bed-shared with an adult. Bed-sharing was associated with an infant missing one or more well-child visits (first and third visits only), breastfeeding (first and second well-child visits only), and low SES. Stratified analysis by residence showed that over the 6-year study the decrease in the rate of bed-sharing, in the urban and non-urban areas, was statistically significant (P = 0.005, 0.04, respectively). Infants born 2006-2007 had a decreased rate of bed-sharing compared to infants born 2002-2005 (0.22, 0.30, respectively, P = 0.00). In light of the high rate of bed-sharing recorded at the first well-child visit, the researchers recommend an increased emphasis on safe sleeping education during the third trimester of pregnancy. Keywords Bed-sharing * Infants * Prevalence * Low birth weight * Rural, Introduction In September 1999, the U.S. Consumer Product Safety Commission released a warning concerning the dangers of placing babies to sleep in adult beds. Included in this warning was a [...]