CoSleeping: sharing your bed with an infant. A somewhat controversial practice, however, it is common in many countries around the world where an entire family of all ages may share the same "family bed". In Japan for example, all families cosleep until the child reaches toddler age.

In America, cosleeping is often covered up by parents because the party line of the AMA is that it is dangerous and leads to dependency and manipulation by the child as you try to wean her from the family bed.

Independent studies have shown that babies who cosleep breathe better. There is an interaction between the exhaled breath of the parent and receptors in the infant's nostrils that stimulate deep breathing. It has been shown to reduce the risk of SIDS(Sudden Infant Death Syndrome) and other stress disorders. Infants are usually ready to stop cosleeping once they have normalized their breathing patterns around 5 months.

Cosleeping facilitates baby-mother interaction and allows the pair to synchronize their sleep/waking/feeding cycles.

Since cosleeping does result in the death of about 60 infants each year in America, the following precautions are imperative and must be followed when cosleeping, :

  • Parents should not sleep with their babies if they are smokers or have ingested alcohol or drugs.
  • Bedding should be tight fitting to the mattress.
  • The mattress should be tight fitting to the headboard of the bed.
  • There should not be any loose pillows 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 not be placed on its stomach.
  • Adjust sleeping arrangements as needed as baby develops new skills - rolling over, crawling, climbing

The safest arrangment for cosleeping is to place the infant between the mother and the edge of the bed, along with something to prevent the child from rolling off. This removes the danger of overlying by the father. It has been noted that there may be an awareness of the position of baby by a sleeping mother and a connection between them that does not exist with the sleeping father.

On a personal note, my little sister almost drowned in a water bed when she was sleeping in it and it sprung a leak. Absolute caution and awareness must be exercised while cosleeping.

references:
McKenna, J., Babies Need Their Mothers Beside Them,
Available March 25, 1999
http://www.naturalchild.com/guest/james_mckenna.html

McKenna, J., Rethinking "Healthy" Infant Sleep,
Available March 25, 1999
http://www.parenthoodweb.com/library/RethinkingSleep.htm

McKenna, J., Mosko, S., Dungy, C., McAninch, J.,
Sleep and arousal patterns of co-sleeping human mother/infant pairs: a preliminary physiological study with implications for the study of sudden infant death syndrome (SIDS),
Am J Phys Anthropol, 83(3):331-47 1990 Nov.

McKenna J; Mosko S., Richard C.,
Bedsharing promotes breastfeeding, Pediatrics, 100(2 Pt 1):214-9 1997 Aug.

McKenna J; Mosko S; Richard C; Drummond S; Hunt L; Cetel MB; Arpaia J,
Experimental studies of infant-parent co-sleeping: mutual physiological and behavioral influences and their relevance to SIDS (sudden infant death syndrome),
Early Hum Dev, 38(3):187-201 1994 Sep 15
Sears, W. SIDS: A parents guide to understanding and preventing sudden infant death syndrome,
New York: Little Brown & Company, 1995.

Co-sleeping has become controversial in the US for multiple reasons. To me the overriding theme is get those babies and mothers apart. Americans seem to have a big problem with the intimacy of the mother/infant bond. Co sleeping promotes breastfeeding and what could be more intimate?

There is a continuum of frequency of feeding with mammals. Some feed constantly, like marsupials, others feed only periodically and stash the baby while the mother leaves to forage for food, like deer. Biologically, humans are closer to the constant feeding end of the continuum than the stash and forage end. Look at the development of the above-mentioned animals at birth. Marsupials are totally helpless and immature at birth. Deer can stand, walk and have fur camouflage to help hide them from predators. Human infants are helpless. In evolutionary terms, they expect to be close to their mothers, day and night.

In addition to acknowledging our psychosexual problems with intimacy we also need to follow the moneyFormula companies fund much of the research against co-sleeping. They certainly promote mother/infant separation.

Despite much positive research on the benefits of co-sleeping the Consumer Product Safety Commission condemns it. The "science" behind these recommendations is shaky at best. James McKenna, referenced in lalala's W/U above has done some very impressive research showing not only the safety of co-sleeping but also the very real DANGER of infants sleeping alone! The historical name for SIDS was “cot death”. Cots = Cribs = infants sleeping alone.

During the time the infants in the CPSC study died in “adult beds” many more died in cribs. The Commission report doesn’t mention this. They make recommendations on how to make a “safe crib” and condemn infants sleeping in “adult beds”. Mandating the width between the crib bars and using safe construction materials does not make up for the absence of a parent in the bed.

McKenna’s sleep lab research compared the same mother/infant pairs in varying sleeping environments. The infants sleeping with a parent synchronized their breathing with the breathing of their co-sleeping mother. The infants sleeping in a room alone had more episodes of apnea. They breastfed less frequently. The co-sleeping infants roused more often and slept more lightly. For an infant to sleep lightly is a good thing, it is a protective thing. Infants are not meant to sleep deeply for long periods of time. They forget to breath and die more often when in prolonged, deep sleep states.

The Consumer Product Safety Commission report ignores the fact the very concept of a crib and infant isolation is a bad idea. McKennna and other researchers do have recommendations on how to maximize the safety of co-sleeping, as mentioned in the W/U above. Dr. McKenna says "it is important to separate the unsafe conditions within which co-sleeping can occur from the behavior itself." In addition to not drinking or taking drugs which cause changes in the parents’ level of consciousness parents should also not be abnormally fatigued or morbidly obese. Both these conditions cause sleep disturbances that prevent normal arousal and that can be dangerous. It has also been found that sleeping with an infant on a sofa is highly correlated to SIDS. Overheating of the room is also dangerous to infants, in any sleeping situation.

La Leche League International has long supported co-sleeping as a strategy to breastfeed successfully and still get mother’s sleep needs fulfilled. Research done at least 10, maybe 15 years ago showed that the closer a mother sleeps to her infant the more rested she will feel.

New parenting “gurus” have authored absurd books and parenting classes that promote infant and mother separation in the name of God, convenience and modernity. Please stay away from anything written by Ezzo, Robin or Hogg. Even the ubiquitous “What to Expect in the First Year” is big on schedules for babies – a practice contrary to successful breastfeeding - and promotes allowing babies to cry themselves to sleep, alone in their little baby jails. Tine Thevenin. wrote a wonderful book titled “The Family Bed” in the 70s. It is still good and recently reprinted. William Sears and Katie Allison Granju have contributed newer books covering this topic in a positive light.

Some products are available for those who want to co-sleep with their infant but wish for more space or what they may perceive as more safety.

  • The Arm's Reach Bedside Co-Sleeper® bassinet has 3 sides like a “normal” crib and one open side that attaches to the parents' bed. This allows the infant isolated space while still being close to the parents yet out of the actual adult bed.
  • The “Snuggle Nest® features include rigid protective walls, firm mattress, an envelope sheet, washable quilted cover, and an open end for touching and soothing”. It is designed to lay in the adult bed with the infant inside it.
  • Another invention, “The Baby Egg® is comprised of a dome shaped frame sized to extend over the baby sleeping on a bed with it's parent(s)” but doesn’t appear to be on the market as yet.


SOURCES:
The quoted statements come from the respective products home pages

http://www.armsreach.com

www.snugglenest.com

Co-sleeping with baby - research based information & products to facilitate safe parent/infant cosleeping http://www.babyfriendly.org.uk/bedshare.htm

In addition to the wonderful references to McKenna's work above by ereneta google "James McKenna infant sleep" and you will be reading for days. I especially liked the titles from La Leche League International's 29th Annual Physician Seminar "Don't Sleep With Your Baby? Never Let A Baby Fall Asleep at the Breast? Cultural Ideologies Masquerading As Science - James McKenna, PhD Dr McKenna directs the Mother-Baby Behavioral Sleep Laboratory at the University of Notre Dame in Indiana. He is the world's expert on sleep sharing, specializing in research about sudden infant death syndrome, parenting, and infant development. Dr McKenna will discuss the effects of co-sleeping on infant sleep patterns, mothers' responses to their babies' needs, breastfeeding success and to the risk for sudden infant death syndrome."

and from The University of Western Australia Institute of Advanced Studies presents Advances in Human Evolutionary Ecology "James J. McKennaProfessor of AnthropologyDirector, Mother-Baby Behavioural Sleep Laboratory University of Notre Dame, Indiana Title: Mother-Infant Cosleeping With BreastFeeding as Adaptation Not Pathology: How Western Folk Beliefs Against Cosleeping Achieved Scientific Validation"

"western folk beliefs and cultural ideologies masquerading as science" indeed!

My my! There certainly seems to be quite a controversy over cosleeping here in the states. The US Consumer Product Safety Commission issued a statement, or as they called it, a safety alert, warning caregivers of children under 2 years of age not to cosleep1. They issue this statement based on a review of a study of infant deaths, which claims cosleeping as the cause of death for over five hundred children! Sounds like a pretty good reason to put baby in a crib, doesn't it (that's certainly what the cosponsors of the review, Juvenile Products Manufacturers Association want you to think2)?

Let's look at the study a little closer. First of all, this study was conducted over a period of eight years. Five hundred and fifteen deaths in a period of eight years, although quite tragic (especially since those deaths could have been prevented), is nothing to alarm the public about. That comes out to around 65 deaths per year. Each year, cribs kill 50 infants, while injuring twelve thousand infants to the point of hospitalization 3!

According to the study, the cause of death breaks down into four categories.

A Suffocation due to entrapment between mattress and other object. Okay, just like in a crib, you wouldn't put anything in baby's reach which could cause suffocation.
B Suffocation due to baby lying face-down on waterbed. Babies should not be put down to sleep on waterbeds. Not only is the "wave" effect dangerous for helpless creatures, but they could overheat if the temperature is set too high, which leads to a higher risk of SIDS.
C "Strangulation in rails or openings on beds that allow a baby's body to pass through while entrapping the head."
Groups A,B, and C all have broken the guidelines of safe cosleeping!
D Suffocation due to adult/baby cosleeping. "One hundred and twenty one of these deaths occurred because a parent, sibling or caregiver rolled over or onto the sleeping baby, causing suffocation." 1 Wait a minute! That means that people, other than mommy and daddy were sleeping next to the infant. The study doesn't report how many of these parents/caregivers/siblings were under the influence of alcohol, sleep-inducing drugs, etc. nor how many of them were overweight. These are all major factors of risk when cosleeping.

Okay, it's obvious that parents are sleeping with their infants. So, if someone (such as the CPSC or JPMA) really wanted to prevent infant deaths, maybe they should educate the public on correct cosleeping habits. Of course, it's unlikely to happen, because there's no money in cosleeping.

1. News from CSPC.http://www.cpsc.gov/CPSCPUB/PREREL/PRHTML99/99175.html.Consumer Product Safety Commission.21 June 2004.
2. Alicia Bayer. Consumer Alert: The dangers of the U.S. Consumer Product Safety Commission. http://www.magicalchildhood.com/articles/cosleep.htm. 21 June 2004.
3. The Danny Foundation. http://dannyfoundation.org/alamo.html 21 June 2004.

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