When my first child was born 16 years ago, I was told by my health visitor that under no circumstances was I ever to bed share with my baby.
She warned me that to do so was tantamount to a death sentence and that my baby might die of SIDS as a result. Due to her advice, we decided to put our baby in a crib next to our bed.
Our baby was bottle-fed because an infected episiotomy had left me seriously ill and unable to care for her for the first three weeks of her life.
Having subsequently breastfed my other children, I know that the behaviour and feeding patterns of breastfed infants are entirely different.
My bottle-fed baby was only too happy to fall asleep from 7 p.m. till 7 a.m., did not seem stressed to sleep on her own, fed only once every three hours during the day and was able to self-soothe efficiently.
My breastfed children wanted to feed all the time in the newborn phase and would cry if I put them down anywhere away from me. They all hated cribs and would sob inconsolably when I tried to lie them down in one.
In sheer desperation one night I picked up my crying baby and put her in the bed next to me. She fell asleep straight away. I never looked back after that.
When my son was born five years ago, the health visitor handed me a leaflet on safe co-sleeping, saying that co-sleeping is actually safe in the right circumstances and that it improved breastfeeding outcomes. I was shocked at the about-turn.
So, what should you do?
SIDS and Co-sleeping
Co-sleeping has been associated with SIDS. A study involving 184,800 live births found that 90 children died and were classified as SIDS deaths. The average age of death was 2 months, 4 days.
Of these babies 54 percent had been co-sleeping. However, 31 percent involved parents who were taking drugs or alcohol, 60 percent had mothers who smoked, 17 percent slept on the sofa, 26 percent of the babies were premature.
At the time of death, 28 percent were sick. The rest of the group who died had a parent who employed unsafe sleeping practices such as using a pillow or swaddling.
The study giving this elevated risk of death did not look at the death rate in the absence of these risks, and they also did not determine whether the parents normally co-slept.
Could it be that the babies were distressed or sick on the night they died and that is why the parents took them into bed with them?
The NHS said:
"A large proportion of this co-sleeping risk was attributed to sleeping with a parent on a sofa, or the parent’s prior use of alcohol or drugs. The study does not provide a separate estimate of the risk of SIDS while sharing a bed with a parent in the absence of these and other risk factors."
The control group in the study were mothers who were randomly selected and had "high risk of SIDS (young, socially deprived, multiparous mothers who smoked)."
Co-sleeping Benefits
Benefits of co-sleeping include:
- Decreased infant crying.
- More sleep for mother and baby.
- Waking up faster. Mothers wake up faster 30 percent more of the time, compared with mothers whose babies sleep in cribs. This might increase the chances that mothers detect and intervene in a life-threatening event.
- Increased likelihood of a successful breastfeeding relationship . (4)
Since a large percentage of crib death occurs in economically deprived, bottle-fed infants, and breastfeeding could prevent 720 American infant deaths per year, co-sleeping benefit to breastfeeding should not be ignored.(3)
Not only that, but when sleep studies of infants were first undertaken, they used bottle-fed, solitary sleeping infants as the norm. Due to the popularity of scheduled formula feeding in the 1950s and the fact that formula contains more fat so the baby will sleep longer, uninterrupted lone sleeping of infants came to be seen as "good" and "normal".
In fact, it is now known that increased infant awakenings can save lives, lead to more breastfeeding, increased heart rate and body temperature, increased mother and child interaction, less "deep sleep" and more ability for the baby to control his environment.
Most co-sleeping babies are also placed to sleep on their back so that they can access the breast more easily. In this position they can turn to and from the breast and remove blankets from their face.
Babies are programmed to respond to their mother’s body signals. When researchers placed a mechanical "breathing" teddy bear in babies’ cribs, it resulted in a 60 percent reduction in sleep apnea. The mother’s body regulates heart rate and breathing patterns of the infant in the same way. (4)
Safe Co-Sleeping
If you want to co-sleep, make sure:
• You don’t smoke at all.
• You don’t take drugs, including prescription drugs.
• You don’t use pillows for the baby.
• You don’t use heavy bedding.
• Your mattress is firm.
• You have had more than four hours sleep the previous night.
• You don’t sleep on a sofa or in an armchair.
If any of these apply, you could buy a co-sleeping crib for your baby that enables him to sleep next to you, but in his own crib.
Sources:
1. Cot Death and Shared Beds, NHS Choices. Web. 25 August 2012.
http://www.nhs.uk/news/2009/10october/pages/cot-death-and-shared-beds.aspx
2. Sharing a bed with a baby does not increase risk of cot death, research shows, The Telegraph. Web. 25 August 2012 -
http://www.telegraph.co.uk/health/healthnews/3501035/Sharing-a-bed-with-a-baby-does-not-increase-risk-of-cot-death-research-shows.html
3. Breastfeeding and the Risk of Postneonatal Death in the United States, Pediatrics Vol. 113 No. 5 May 1, 2004. Full Text:
http://pediatrics.aappublications.org/content/113/5/e435.full.pdf+html
4. Why babies should never sleep alone: A review of the co-sleeping controversy in relation to SIDS, bedsharing and breast feeding, PAEDIATRIC RESPIRATORY REVIEWS (2005) 6, 134–152. Full Text:
http://www.nd.edu/~jmckenn1/lab/articles/McKenna_why%20babies%20should%20n.pdf
Reviewed August 29, 2012
by MIchele Blacksberg RN
Edited by Jody Smith