Is Co-Sleeping Right for You and Your Baby?

Co-sleeping – the practice of parents bringing their baby into bed for the night – is a hotly debated topic.

One side of the debate views co-sleeping as a risky practice, increasing the risk of child death through suffocation or sudden infant death syndrome (SIDS). The other side views it as a convenient way for a mother to nurse and for parents to build a strong bond with their child.

What is Co-Sleeping?
The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHHD) defines co-sleeping as “when a parent and infant sleep in close proximity to one another, either on the same surface or on different surfaces. This is done so that they are able to see, hear, and/or touch each other.”

Crib-sleepers versus Co-Sleepers
A Parenting magazine survey of 6,000 parents shows the stark divide between those who believe in sharing the bed with their child (co-sleepers) and those who believe babies should sleep only in their cribs (crib-sleepers).

Nearly half of all crib-sleepers said they think co-sleepers are “irresponsible” and and are “putting their baby’s life at risk.” Another 39 percent said they think that co-sleeping parents are spoiling their baby, according to the magazine.

On the other side, 20 percent of co-sleeping moms called crib-sleepers “selfish” and said they are “only thinking of their own sleep.” Forty percent of moms said parents who put their baby in a crib do not have as close of a bond with their babies as they do.

Which Way Is Best?
How accurate is each side’s perception of the other? Here are a few comments that parents made to Parenting. You decide:

  • “I had a natural birth, I breastfeed, my husband and I wear our baby, and we co-sleep. Our baby’s needs are met.” (Melissa Armstrong of Costa Mesa, Calif.)
  • “Both of my children sleep in the bed with me. My spouse doesn’t like that it gets in the way of our sex life, but I couldn’t care less about that.” (Lori Anderson of Camden, S.C.)
  • “Our son doesn’t have to hear us roll over, snore, or go to the bathroom in the middle of the night. And my husband and I like having the bedroom to ourselves so we can be husband and wife, not just baby caretakers!” (June Huff of Delaware, Ohio)
  • “My sister’s kids are 7 and 8 [years old] and still sleep with her for half the night. I don’t want that for my family.” (Jenny Wohlrabe of Prescott Valley, Ariz.)

Arguments in Support of Co-Sleeping
The World Health Organization (WHO) and the pediatrician and author, Dr. William Sears, “the father of attachment parenting,” are among supporters of co-sleeping.

For example, the WHO states that co-sleeping facilitates breastfeeding. The WHO cites studies finding that co-sleeping infants breastfeed longer during the night than infants who sleep alone.

In one study cited by the WHO, co-sleeping infants fed three-times longer than non-co-sleepers. The authors of that study suggested that, by increasing breastfeeding, co-sleeping might protect against SIDS. However, the WHO said, those findings were not conclusive.

Dr. Sears may be best known for a 6,000-word post on his “Ask Dr. Sears” website in which he documents his family’s experiments in co-sleeping with their fourth child, Hayden, who “hated her crib.”

Dr. Sears contends that babies who co-sleep go to sleep peacefully and sleep better and longer. Also, mothers sleep better, and mother and child quickly sync their sleep cycles.

Breastfeeding is easier, too, and co-sleeping infants “not only thrive better, but infants and parents are more connected,” he says in his post.

Research shows that infants who sleep next to their parents are less likely to succumb to SIDS because, in addition to the mother’s awareness, a child that is more in sync with the mother is better able to be roused, according to Dr. Sears. He adds that SIDS is so rare that it should not be a factor considered by parents as they mull a co-sleeping arrangement with their child.

Dr. James McKenna of the University of Notre Dame, who is known as a mother-infant co-sleeping expert, agrees that co-sleeping promotes successful breastfeeding and may reduce the risk of SIDS.

At a 2013 conference in Boston, according to WBUR, McKenna said that human infants have evolved to be perfectly adapted to their mothers’ bodies. Close proximity during sleep between a mother and her nursing infant helps regulate the infant’s body temperature and breathing patterns, and creates a healthy synchronicity between the mother’s and infant’s arousals at night, in his view.

At a 2013 conference in Boston, according to WBUR, McKenna said that human infants have evolved to be perfectly adapted to their mothers’ bodies. Close proximity during sleep between a mother and her nursing infant helps regulate the infant’s body temperature and breathing patterns, and creates a healthy synchronicity between the mother’s and infant’s arousals at night, in his view.

Dr. James McKenna discusses the science and public policy surrounding the debate on co-sleeping

However, McKenna differentiates between “co-sleeping” and “bed-sharing.” Separate surface co-sleeping, such as with baby in a bassinet or crib next to the bed where baby and mother or father are within range of detecting each other’s signals and cues, “is all that is necessary,” he states.

Arguments Against Co-Sleeping
The American Academy of Pediatrics (AAP) has long advised against co-sleeping with children under age 1 due to the possible increased risk of suffocation – particularly in the first three months of life. The safest place for a baby to sleep is in the parents’ room, but not in their bed, the AAP states.

According to the AAP, parents should place their baby’s crib or bassinet within arm’s reach of their bed. This makes it easier to breastfeed and to bond with the baby.

The AAP also states that healthy infants should be placed on their backs for the safest sleep position. Putting a baby on his or her back decreases the risk of SIDS, which is responsible for more infant deaths in the U.S. than any other cause during the first year of life (beyond the newborn period), the AAP states.

Babies should sleep on a firm crib mattress covered by a sheet and not on soft, porous surfaces such as pillows, quilts, comforters or other soft materials, including stuffed toys. Such materials and objects may block the child’s airway if he or she burrows her face in them, according to the AAP.

A 2014 study in the AAP journal, Pediatrics, states that infants up to 3 months old were found to be more likely to die while sharing a sleep surface.

“Infants at this age do not yet have the motor ability or strength to move their head or reposition their body when in an asphyxiating environment, such as when another person rolls over or moves such that part of the adult’s body obstructs the infant’s airway,” the study found.

“It has been assumed by some that bed-sharing can be made safe if measures such as eliminating soft bedding from the adult bed are followed, but our findings raise questions about the validity of this assumption,” the authors added.

According to the AAP, infants do not need to be repositioned onto their backs if they roll into the prone position. However, parents should keep cribs clear of any objects, including toys, so that if the infant does roll over, the infant does not roll onto an object that can increase the risk of asphyxiation.

The NICHHD states that current evidence does not support bed-sharing as a protective strategy against SIDS. Instead, “evidence is growing that bed-sharing increases the risk for SIDS and other sleep-related causes of infant death, such as accidental suffocation and entrapment, or injury,” the organization states.

Parents Must Carefully Weigh the Decision on Co-Sleeping
In many cultures, co-sleeping is an age-old tradition that stirs no debate. In American culture, some dismiss it as a “New Age fad,” while others simply see it as a natural outgrowth of the maternal bond and the bliss to be found in a warm and peaceful sleep.

Whether a baby belongs in her parents’ bed ultimately is the parents’ decision. However, the risk of asphyxiation, SIDS and other sleep-disorders appear to outweigh the benefits.

McKenna, the Notre Dame expert, states on his mother-baby sleep behavior website that he could support bed-sharing for a portion of the night if it was a shared decision between the parents, all appropriate safety precautions were observed and a basinet or crib was within arm’s reach.

“I think it incumbent and appropriate, however, for parents to ask themselves before they bring their baby to bed with them to consider how they would evaluate [as much as might be possible] their choice if a tragedy were to occur and their baby died,” McKenna states.

“It is important to consider how much confidence you would have in yourselves, in the precautions you have taken, how much agreement you and your partner share as regards the importance to each of you and your baby of bed-sharing and appropriateness of bed-sharing for your specific family.”

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