Friday, December 20, 2013

Co-sleeping and Bed-sharing


What is co-sleeping?
Co-sleeping essentially means sleeping in close proximity to your child. It may be in the same bed or just in the same room. Some ways of co-sleeping that different families use are:
  • Bed-sharing/Family Bed:
    Parent(s) sleep in the same bed with the child.
  • Sidecar arrangement: 
    Securely attach a crib to one side of the parents’ bed, next to the mother. Three sides of the baby’s crib are left intact, but the side next to the parents’ bed is lowered or removed so that mother and baby have easy access to one another. Commercial cosleeper/sidecar cribs are also available.
  • Different beds in the same room:
    This might include having baby’s bassinet or crib within arm reach of the parents (easier at night) or just in the same room; or fixing a pallet or bed for an older child on the floor next to, or at the foot of, the parents’ bed.
  • Child welcomed into parents’ bed as needed:
    The baby/child has her own bedroom, but is welcomed into the parents’ bed at any time. In many families, children start their overnight hours in a separate bed or room, but are welcomed into the parents’ bed after a night waking.
According to the American Academy of Pediatrics, “Room-sharing without bedsharing is recommended— There is evidence that this arrangement decreases the risk of SIDS by as much as 50%.” The AAP recommends that babies and parents sleep on separate surfaces, as this is the simplest way to eliminate the specific risks of bed-sharing.

Advantages of co-sleeping

Co-sleeping is not the best fit for every family, but it can have many advantages:
  • Parents often get more sleep.
  • Babies often get more sleep. Baby stirs and almost wakes up when she needs to nurse, but since she is right beside mom, mom can nurse or soothe her back to sleep before she fully wakes up.
  • Breastfeeding during the night is easier when baby is nearby.
  • Breastfeeding at night helps to maintain your milk supply.
  • Night nursing also tends to prolong the child-spacing effects of breastfeeding.
  • No nighttime separation anxiety.
  • Fewer bedtime hassles.
  • It’s lovely to wake up next to a smiling baby!

Co-sleeping Safety

The ISIS Infant Sleep Information Source website notes:
The most recent studies have shown that most bed-sharing deaths happen when an adult sleeping with a baby has been smoking, drinking alcohol, or taking drugs (illegal or over-the-counter medicines) that make them sleep deeply.
Sometimes people fall asleep with their babies accidentally or without meaning to. This can be very dangerous, especially if it happens on a couch/sofa where a baby can get wedged or trapped between the adult and the cushions.
General Safety Guidelines for Bed-sharing –
Any sleep surface that baby uses (including cribs, nap surfaces, or adult beds) should be made safe for baby:
  • The sleep surface should be firm. Do not put a baby on a waterbed mattress, pillow, beanbag, sheepskin or any other soft surface to sleep.
  • Bedding should be tight fitting to the mattress.
  • The mattress should be tight fitting to the headboard and footboard (or sides of the crib).
  • There should not be any loose pillows, stuffed animals, or soft blankets near the baby’s face.
  • There should not be any space between the bed and adjoining wall where the baby could roll and become trapped.
  • The baby should be placed on his back to sleep.
  • Babies (with or without an adult) should never sleep on a sofa, couch, futon, recliner, or other surface where baby can slip into a crevice or become wedged against the back of the chair/sofa/etc.
Additional guidelines if baby is sharing sleep with another person:
  • Do not sleep with baby if you are currently a smoker or if you smoked during pregnancy – this greatly increases SIDS risk.
  • Do not sleep on the same surface as your baby if you are overly tired or have ingested alcohol/sedatives/drugs (or any substance that makes you less aware).
  • Older siblings or other children should not sleep with babies under a year old.
  • Other potential hazards: very long hair should be tied up so that it does not become wrapped around baby’s neck; a parent who is an exceptionally deep sleeper or an extremely obese parent who has a problem feeling exactly how close baby is should consider having baby sleep nearby, but on a separate sleep surface.

Night nursing and ear infections?

You might hear that breastfeeding your baby in a lying down position will cause ear infections. Research indicates that this is not true. Also, keep in mind that with most nursing positions, baby is lying down while nursing anyway – whether mom is or not!

Can co-sleeping cause psychological problems in my child?

People who are uncomfortable with the idea of co-sleeping often suggest that co-sleeping is “less healthy” than the child sleeping alone and will cause psychological damage to the child, cause baby to become too dependent on the parents, etc. Dr. James McKenna counters these suggestions:
In part, this view represents a personal and arbitrary judgment that anyone is entitled to make as long as it is not passed on as scientific fact. Such judgments are based on Western values favoring the perception of how individualism and infant autonomy are best promoted and obtained. No study has shown, however, that the goals for separateness and independence (or happiness, for that matter) are obtained in the individual by, among other things, separate sleeping arrangements for parents and children, nor do any studies demonstrate negative consequences for children or parents who choose to cosleep for ideological or emotional purposes, except when cosleeping is part of a larger psychologically disordered set of family relationships or when cosleeping occurs under dangerous social or physical circumstances. The only studies of the psychological or social effects of cosleeping reveal not negative but positive consequences. One study among military families revealed that cosleeping children receive higher evaluations of their comportment from their teachers than do solitary sleeping children and are under-represented among psychiatric populations, when compared with children who do not cosleep [Forbes JF, Weiss DS: The cosleeping habits of military children.Mil Med 1992; 157:196-200]. Lewis and Janda found that college-age students who coslept as children were better adjusted and more satisfied with their sexual identities and behavior than college-age students who did not cosleep [Lewis RJ, Janda H: The relationship between adult sexual adjustment and childhood experience regarding exposure to nudity, sleeping in the parental bed, and parental attitudes towards sexuality. Arch Sex Behav 1988; 17:349-363] . Clearly, we need to change our conceptualization concerning what constitutes a normal or healthy childhood sleep pattern!
– From: Stein MT, et al. Cosleeping (Bedsharing) Among Infants and Toddlers. Pediatrics 2001 Apr; 107(4); 873-877

More information

Co-sleeping safety

Safe Sleep Resources from Platypus Media
Where Babies Sleep from the ISIS Infant Sleep Information Source
Guidelines to Sleeping Safe with Infants by James J. McKenna, Ph.D.
Bed-sharing and infant sleep from the UNICEF UK Baby Friendly Initiative
Guideline on Co-Sleeping and Breastfeeding, Clinical Protocol Number 6 from the Academy for Breastfeeding Medicine
The New Zealand Experience: How Smoking Affects SIDS Rates by Barry Taylor, Sally Baddock, Rodney Ford, Ed Mitchell, David Tipene-Leach, and Barbara Galland, from Mothering magazine (Issue 114, September/October 2002)

Logistics: Making co-sleeping work for your family

Rooming-in at the Hospital: Assessing the Practical Considerations by Martin Ward-Platt and Helen L. Ball, from Mothering, Issue 114 September/October 2002.
How to make sleep sharing work from, with input from James McKenna, PhD
Co-sleeping: Yes, No, Sometimes? by William Sears, MD

Collections of co-sleeping articles

Sleep & Family Bed articles from
Sleep & Family Bed Articles at The Natural Child Project

Making & defending the decision to co-sleep – Research and opinion articles on co-sleeping

Responding to criticism @ Kellymom.comis written about breastfeeding, but can be applied to any other parenting choice that draws criticism from others. Some of the links included are directly geared toward co-sleeping.
Somebody’s been sleeping in my bed! by Amy Spangler, from Amy Spangler’s Feeding Times, December 2004.
Ten Reasons to Sleep Next to Your Child at Night by Jan Hunt at The Natural Child Project
Sleep With Me: A Trans-Cultural Look at the Power – and Protection – of Sharing a Bed by Meredith F. Small, from Mothering magazine, Nov/Dec 1998″
The Family Bed: An Expert’s Opinion by David Servan-Schreiber, MD, Ph.D.
Sleeping Through the Night by Katherine Dettwyler, Ph.D.
Annals of Parenthood: Sleeping with the Baby – Which Side of the Bed Are You On? The Author and His Wife Defied the Experts by John Seabrook. This article is reprinted from an article first published in the Nov. 8, 1999 issue of the New Yorker Magazine, and includes the interview with Dr. Richard Ferber where he said
“…There’s plenty of examples of co-sleeping where it works out just fine. My feeling now is that children can sleep with or without their parents. What’s really important is that the parents work out what they want to do.”

Research and discussion of research

Mother-and-Baby Behavioural Sleep Laboratory Professor James J. McKenna’s area at the University of Notre Dame website. Dr. McKenna is best known for his pioneering studies of the differences between the physiology and behavior of solitary and co-sleeping mothers an infants-and the connection these data might have in addressing SIDS risks. He is a Professor at the University of Notre Dame and runs the University of Notre Dame Mother-Baby Behavioral Sleep Laboratory.
Parent-Infant Sleep Lab, Department of Anthropology, University of Durham, UK. The Parent-Infant Sleep Lab is the home for a team of researchers led by Dr Helen L. Ball
who are examining various aspects of infant sleep and night-time parenting. Their website includes research papers, project descriptions, presentations and other resources.
Okami P, Weisner T, Olmstead R. Outcome correlates of parent-child bedsharing: an eighteen-year longitudinal study. J Dev Behav Pediatr. 2002 Aug;23(4):244-53.
Baby bedsharing fears dismissed. Discussion of the above Okami study from BBC News.

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