Skip to content

Posts tagged ‘safety’

Are the Ingredients in the Newborn Vitamin K Shot Safe?

The newborn vitamin K shot prevents rare but potentially devastating vitamin K deficiency bleeding (VKDB). If you're concerned about the ingredients in the shot, I've investigated the science behind each one so that you can understand why it's included in the shot and why it's safe for your baby.

Read more

Pertussis Vaccination in Every Pregnancy: Safe and Effective

Receiving the Tdap vaccine during the third trimester of pregnancy is our best chance at protecting young infants from pertussis, a disease that can be particularly dangerous during the first few months of life. Research shows that vaccination in late pregnancy gives newborns the gift of pertussis-specific antibodies at birth and is safe for both mother and baby

Read more

Caffeine and Breastfeeding

How does mom's caffeine intake affect her breastfed baby? How much is safe? Let's take a look at the science.

Read more

SIDS and Bedsharing: A Pediatrician’s Perspective

I’ve been thinking about bedsharing and sleep safety for the last few months. I have devoted an entire chapter of my book to this topic. Not only is it an important question for parents, but it’s an issue with so much complexity — wrinkles and folds of factors like breastfeeding, bonding, instinct, culture, and just plain reality.

I think it is vitally important to understand the relationship between bedsharing behavior and risk of SIDS and accidental deaths. But our ability to tease apart every factor that might impact sleep safety is imperfect; there will always be factors that aren’t quantified in these studies, not to mention the fact that case control studies have some inherent limitations. You’ve probably heard about the study published this week by Carpenter et al. in BMJ. It combines 5 historic case control data sets from Europe, the U.K., and Australasia to specifically look at the risk of bedsharing in breastfed babies in nonsmoking households. It concludes that bedsharing poses an increased risk of SIDS, even in these ideal situations. I think it’s an important study, but it also has some limitations and doesn’t answer all of our questions with certainty. In fact, no study will probably ever do that. (You can read some critiques of the Carpenter study here and here.)

But even if we accept that bedsharing increases a baby’s risk of dying unexpectedly during sleep, we still have to answer the bigger question of how we translate this information to families living in the real, difficult world of infant sleep. Many families value bedsharing as a cultural practice; others choose it because it feels right. Still others bedshare because it is the only way that anyone gets any sleep at night, and we all know that sleep deprivation carries some risk, too, as does falling asleep on a couch with your baby. This is the reality.

Pediatricians face this reality in their clinics every day, when they talk with parents of new babies about sleep. In my book, one of the questions I explore is how pediatricians handle this conversation, given that their professional organization, the American Academy of Pediatrics, recommends against bedsharing. Several months ago, I sent some questions to one of my favorite pediatrician bloggers, Dr. Melissa Arca of Confessions of a Dr. Mom. She had initially agreed to a Q&A, but then she didn’t respond with her answers. It was the height of the busy flu season, and I figured that she was just busy. Then, this week, she surprised me with her responses. She had been thinking about bedsharing given the news of this recent study, and she was inspired to restart this conversation. We’ve cross-posted our Q&A on both our blogs. Check out her post for more about her initial hesitancy to address these questions, and please feel free to share your experiences in the comments below.

Alice: How did sleep look for your two children?

Melissa: My first child was a challenge to say the least. He is the one who made me question the safety of bed-sharing in the first place. For the first 6 months of his life, sleep was virtually non-existent (or at least that’s the way it felt to me) because he needed my arms and constant soothing throughout the night. But I was terrified to bedshare. I was literally at the end of my sleep deprivation rope. I had tried everything. And instead of listening to my instincts, I was fighting them. Because I was scared.

I never envisioned myself as a bedsharing parent. As a pediatrician, I was adamantly against it. But it was exactly what my baby needed and we struggled and limped along until I finally realized that.

My second child was a breeze and that’s no lie. She was always (and still is) an “easy sleeper”. She needed her space and showed clear signs of being tired. When she was tired, that was it. I didn’t need to bedshare with her. She slept in her own bassinet next to our bed during her first few months of life before being transitioned to her own room.

They could not have been more different in the sleep department. Same parents. Same environment. Different children.

Alice: As a pediatrician, how did you feel about bedsharing before having children? Did becoming a mother change that?

Melissa: I didn’t think it was safe. At all. I had read the studies and the official recommendations. Back to sleep, crib and/or bassinet in the same room with no hazards such as loose bedding, pillows, etc.

I never thought in a million years I would have become a bedsharing parent. But kids don’t have our same agendas. Read more

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!