I wanted to write about the importance of safe co-sleeping and bed-sharing and also dispel any myths associated with it. Many families either believe it is unsafe or don’t fully understand its benefits and aren’t open to it, or alternatively, they don’t take proper safety precautions and put their babies at risk.
What is the difference between co-sleeping and bed-sharing?
Many terms related to infant sleep are used interchangeably, which can create confusion. API (Attachment Parenting International) uses the following definitions:
- Co-sleeping refers to sleeping in “close proximity,” which means the child is on a separate sleep surface in the same room as the parents. This includes the use of a co-sleeping bassinet or “sidecar,” which is a crib-like bed with only three walls, with the fourth side remaining open and pushed up against the parents’ bed. For the older child, this can include sleeping in a separate bed in the same room as the parents, or two or more older siblings sleeping together in a separate room.
- Bed-sharing, also called the “family bed,” describes a sleep arrangement where the family members sleep on the same sleep surface. This practice is recommended for breastfeeding families using safe sleep guidelines. Co-sleeping is a safer option for bottle or formula feeding families.
What is safe bed-sharing?
Below is a summary that highlights some of the issues to be concerned with as you make your own decisions about where and how your infant should sleep adapted from: Maximizing the chances of Safe Infant Sleep in the Solitary and Cosleeping (Specifically, Bed-sharing) Contexts, by James J. McKenna, Ph.D. Professor of Biological Anthropology, Director, Mother-Baby Sleep Laboratory, University of Notre Dame.
What constitutes a “safe sleep environment” irrespective of where the infant sleeps?
Safe infant sleep ultimately begins with a healthy gestation. Specifically, safe infant sleep begins without the fetus being exposed to maternal smoke during pregnancy.
A second factor that has a strong influence on safe infant sleep is breastfeeding. Breastfeeding significantly helps to protect infants from death including deaths from SIDS/SUDI and from secondary disease and/or congenital conditions. Post-natally safe infant sleep begins especially with the presence of an informed, breastfeeding, committed mother, or an informed and committed father.
Regardless of whether an infant sleeps on the same surface as his or her parents, on a same-surface co-sleeper, in a bassinet or in a separate crib, in the same room as their parents or in a separate room, all infants should follow these same guidelines: infants should always sleep on their backs, on firm surfaces, on clean surfaces, in the absence of (secondhand) smoke, under light (comfortable) blanketing, and their heads should never be covered.
The bed should not have any stuffed animals or pillows around the infant and never should an infant be placed to sleep on top of a pillow or otherwise soft bedding.
Sheepskins or other fluffy material and especially beanbag mattresses should never be used with infants. Waterbeds can be especially dangerous to infants too, and no matter the type of mattress, it should always tightly intersect the bed-frame to leave no gaps or space. Infants should never sleep on couches or sofas with or without adults as they can slip down (face first) into the crevice or get wedged against the back of a couch where they may suffocate.
Bedsharing: It is important to be aware that adult beds were not designed to assure infants safety!
- It is important to realize that the physical and social conditions under which infant-parent cosleeping occur, in all it’s diverse forms, can and will determine the risks or benefits of this behavior. What goes on in bed is what matters.
- Bottlefeeding babies should always sleep alongside the mother on a separate surface rather than in the bed.
- If bedsharing, ideally, both parents should agree and feel comfortable with the decision. Each bed-sharer should agree that he or she is equally responsible for the infant and acknowledge before sleeping that they are aware that the infant is present in the bed space. Do not place an infant in the bed with a sleeping adult who is not aware that the infant is in the bed with them. My feeling is that both parents should think of themselves as primary caregivers.
- Infants a year or less should not sleep with other/older child siblings — but always with a person who can take responsibility for the infant being in the bed.
- Persons taking sedatives, medications or drugs, or intoxicated from alcohol or other substances, or otherwise excessively unable to arouse easily from sleep should not cosleep on the same surface with the infant.
- Excessively long hair on the mother should be tied up to prevent infant entanglement around the infant’s neck (yes, this has very unfortunately happened).
- Extremely obese persons or others who may have difficulty feeling where exactly or how close their infant is in relation to their own body, may wish to have the infant sleep alongside but on a different surface, such as a cosleeper attachment.
- Finally, it may be important to consider or reflect on whether you would think that you suffocated your baby if, under the most unlikely scenario, your baby died from SIDS while in your bed. Just as babies can die from SIDS in a risk-free solitary sleep environment, it remains possible for a baby to die in a risk-free cosleeping/bedsharing environment. Just make sure, as much as this is possible, that you would not assume that if the baby died, that either you or your spouse would think that bed-sharing contributed to the death, or that one of your really suffocated (by accident) the infant. While this is an unpleasant and uncomfortable topic, it is one that is worth thinking about before you make the choice to cosleep/bedshare with your infant.
Aside from never letting an infant sleep outside the presence of a committed adult, i.e. separate-surface cosleeping which is safe for all infants, I do not recommend to any parents any particular type of sleeping arrangement since the circumstances within which particular parents live are not known. What is recommended to consider is all of the possible choices and to become as informed as is possible matching what you learn with what you think can work the best for you and your family.
Does bed-sharing cause SIDS?
Recently, there have been efforts by various medical and professional organizations to discourage parents from sleeping with their children for fear that it contributes to an increase in Sudden Infant Death Syndrome (SIDS). However, research demonstrates that bed-sharing, when practiced by informed parents, can be safe and beneficial. In fact, many cultures where parents routinely sleep with their children report some of the lowest SIDS rates and in some of these cultures, SIDS is non-existent. Studies led by Dr. James McKenna support this. “The sensory-rich sleep environment of bed sharing, which leads to more frequent arousals during deep sleep and more light sleep, from which it is easier for the infant to arouse, appears to confer a survival advantage for children at risk of SIDS” (McKenna, 1996; McKenna and Mosko, 1990; McKenna et al., 1993).
Will co-sleeping or bed-sharing disturb my sleep?
Everybody actually gets more sleep. Co-sleeping and bed-sharing babies tend to be more settled at night generally because their need to be close to mom is continuously being met. More settled babies = more well-rested parents. Moms and babies who bed-share are also more in sync with each other’s wake and sleep rhythms, making it easier for mom to tend to baby when both wake.
What are the benefits of breastfeeding and bed-sharing?
Breastfeeding is much easier when bed-sharing. Instead of getting out of bed throughout the night to feed, simply put baby to breast and go back to sleep. Many moms and babies “dream-feed” and sleep right through the baby feeding. Breastfeeding at night also helps to maintain your milk supply when prolactin levels are highest.
Will co-sleeping or bed-sharing ruin my relationship or marriage?
Co-sleeping and baby-sharing probably save more relationships and marriages than it ‘ruins.’ For bed-sharing families, there are plenty of other places in the house other than bed that are suitable for marital activities. And besides, co-sleeping and bed-sharing mamas are more likely to be well rested – and therefore more likely to have the energy to or want to engage in those activities!
Will co-sleeping or bed-sharing make my baby spoiled or too dependent?
It’s important to note that infant solitary sleep is a relatively new practice that has evolved in the western world only within the last 100 years. Babies have been cradled tightly in mother’s womb their whole lives. Sharing a bed with mom is soothing, comforting, and helps their transition from being within mom to living in the world. Babies have needs at night just as they do during the day. From hunger, loneliness and fear, to feeling too cold or too hot. They need the reassurance of a loving parent to feel secure during the night. For more information, read What are the long term effects on my baby of sharing a bed? by Dr. James McKenna.
If you become frustrated with frequent waking or are sleep-deprived you may be tempted to try sleep training techniques that recommend letting a baby cry in an effort to “teach” baby to “self-soothe.” New research suggests that these techniques can have detrimental physiological effects on the baby by increasing the stress hormone cortisol in the brain, with potential long term effects to emotional regulation, sleep patterns and behavior. An infant is not neurologically or developmentally capable of calming or soothing himself to sleep in a way that is healthy. The part of the brain that helps with self-soothing isn’t well developed until the child is two and a half to three years of age. Until that time, a child depends on the parents to help calm down and learn to regulate intense feelings. If you are considering sleep training, please read Dr. Jay Gordon’s sleep method in his article Sleep, Changing Patterns in the Family Bed.
I personally believe bed-sharing is a wonderful way to bond with baby and has many benefits. It was especially invaluable when I was breastfeeding and working outside of the home. That nursing and snuggle time was so precious and strengthened and preserved the special connection between me and my son. However, I am aware that this is one of those issues that can make people feel attacked. Please know it is not my intention to tell you what is right or wrong – only you can decide what is best for your individual and unique family. Also, don’t be hard on yourself if you tried it and didn’t like it or if you can’t do it due to medical reasons or for any other reason.
For more information, please visit: http://cosleeping.nd.edu/why-this-website/
Image via Fabrizio Salvetti