Bed-sharing with Young Infants: Is It Safe After All?

Does bed-sharing with infants increase their risk of SIDS, even without known risk factors such as alcohol use, smoking, and co-sleeping on a couch or chair? A recent study makes what is probably the best attempt to date to answer this question. The study, led by U.K. researcher Peter Blair, was published last week in the journal PLOS ONE and is freely available to the public (yay!).1

mother and baby

How you bed share can make a big difference to safety. Co-sleeping on couches, alcohol use, and smoking are all very risky. The mom in the photo could keep her baby safer by removing the swaddle and ensuring that her baby sleeps on his back.

Many studies have found that co-sleeping is associated with an increased risk of SIDS, but most of this risk doesn’t come from co-sleeping per se, but rather doing so in particularly hazardous conditions, such as on a couch or with a parent who has been drinking. However, there’s an important, albeit controversial, caveat to this conclusion. Several studies have looked specifically at infants younger than 3 months and still found a significant risk of bed-sharing even in the absence of these other risk factors.2–6 The current study comes to conclusions much more reassuring to bed-sharing parents. In this study, bed-sharing without alcohol, smoking, or couch/chair co-sleeping was not associated with a significant SIDS risk in infants younger than 3 months and even seemed to be protective in older babies. Both of these findings run counter to previous studies and to the sleep recommendations of the AAP, so they deserve a close look.

How was the study conducted? Continue reading

Book Talk: Sleep Choices

Photo Credit: Lori Cole

Photo Credit: Lori Cole

I’m working on the sleep chapters of my book right now. I had originally planned one sleep chapter, but I’m realizing that it’s such a huge topic that it needs to be split into two chapters: one on the question of where baby should sleep and one on sleep strategies and sleep training.

I have been focusing on the question of bedsharing for the last several weeks. I have read the major studies associating bedsharing with SIDS and suffocation and studied the professional opinions of those recommending against bedsharing from a public health perspective. I have also read the studies coming from James McKenna, Helen Ball, and others that take a more holistic view of bedsharing. These authors talk about bedsharing as the cultural and physiological norm for human infants, particularly in the context of breastfeeding. They advocate for a more tempered view of bedsharing safety, one that recognizes that all bedsharing situations are not alike and that, though not proven, it is certainly possible that a safe bedsharing environment can exist.

I’m trying to understand both the science and the controversy of this topic. There are the data, and there are the people analyzing it and interpreting it. Reading these papers, I get the feeling that it is difficult to find someone conducting research in this field who isn’t at least a little invested in the outcome. I wonder if these guys ever sit in the same room together and talk it out, because it feels like they are coming from different planets. There’s the epidemiology planet, where numbers rule and nuance is scorned. (And don’t get me wrong – I’m a numbers girl – but I can see the limitations in them here.) Then there’s the anthropology planet, a beautiful land of skin-to-skin, breast milk, and perfect physiological attunement between mother and babe. In my opinion, neither world completely represents the reality facing new parents in today’s world.

I wonder, for example, if the members of the AAP committee, which recommends against bedsharing, have ever cared for a baby who had extreme difficulty sleeping alone. And I wonder if the anthropologists have ever cared for a baby who wanted her own space, perhaps needing a break from all that day-and-night sensory input. I have met both types of babies, and as parents, I think we have to recognize that their needs are not the same.

In the real world, lots of factors determine how different families handle sleep. Infant temperament is one of them. Safety is another. There are also cultural expectations, family dynamics, work schedules, parenting styles, and feeding methods to factor in. Where baby sleeps is a complex parenting decision, one that is exceedingly difficult to study in a quantitative manner.

As I’m writing this chapter, I’m trying to present the science in a balanced way. I also recognize that this parenting decision – and most of them for that matter – can never be reduced to science and statistics. Parenting is about people and their stories. I know that I need to understand those stories as well as the science to write a worthwhile book.

So, I’m hoping you can help me.

Help me understand WHY your babies slept where they did – in your bed or in a crib or some combination of the two. What factors were important in your decision? Did your baby sleep where you had planned, or did you have to adjust your expectations? What worked well about your arrangement, and what didn’t?

I may be interested in including some of your stories in my book, but I’ll send you a direct email if that’s the case. Thank you – as always – for sharing your stories!

 

New Research on Bedsharing and Infant Breathing

Berthe Morisot [Public domain], via Wikimedia Commons

A study published online last week [1] in the journal Pediatrics gives new information on the breathing environment for bedsharing and crib-sleeping infants. Dr. Sally Baddock and colleagues from the University of Otago in New Zealand conducted the study.

This study included 40 routinely bedsharing infants and 40 routinely crib-sleeping infants, all of which were healthy and between 0 and 6 months old. Few mothers in the study were smokers, and most of them breastfed.

The infants and mothers were videotaped on two consecutive nights. On the second night, the babies were also fitted with several sensors for physiological measurements. Their blood oxygen was measured by pulse oximetry. Other sensors measured breathing rate, and thermometers measured body temperature during the night. The air in the space directly around the infant was also sampled periodically through a small tube attached to the infant’s face. Although these measurements bring to mind a picture of lots of tubes and wires, the authors say, “All leads were secured to allow mothers to handle infants freely during the night.”

The purpose of the study was to better understand the breathing environment for bedsharing and crib-sleeping infants. Specifically, the study reported two main measures: Continue reading

Infant Sleep Research: Bedsharing, Self-Soothing, and Sleep Training

This is the fifth post in my sleep series. In my last post, I discussed how my view of infant sleep has evolved to be more inclusive of a wide range of solutions that can work in different families. In this post, I look at what the research tells us about infant sleep across the spectrum of nighttime parenting philosophies.

[Please note: It is beyond the scope of this article to discuss the bedsharing/crib/SIDS/suffocation debate, but suffice it to say that parents should pay careful attention to making baby’s sleep environment safe, whether the baby bedshares or sleeps in a crib.]

Bedsharing Infant Sleep

Let’s say that you choose to bedshare. You feel that the best place for your baby is right by your side, in your own bed. (I use the term “bedsharing,” because the more commonly used “cosleeping” can also mean sharing a room but sleeping on separate surfaces.) Many parents choose to bedshare because it just feels right, even if they had carefully prepared a crib before the baby’s arrival. BabyC slept in my bed for a couple of weeks early in her life, though it was not my plan and ultimately ended up not being the choice that Husband and I made. Still, in those weeks, I felt a real shift in my bond with BabyC. It certainly made breastfeeding during the night easier, and it was sweet to wake up and watch her sleeping next to me. I understand the choice to bedshare, and I think that for many families, it can have numerous benefits. These benefits are not well-defined by research, however. For example, I have yet to find study that investigates if bedsharing actually increases infant attachment. Continue reading