Motherhood

Demystifying Co-Sleeping & Bedsharing: Dispelling Myths & Safety Precautions

September 17, 2013
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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.

Sleep Training

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

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6 Comments

  • Reply Krista September 27, 2013 at 9:03 am

    I never pictured myself as a bed sharing parent. But the day I brought home my baby I put her in the co sleeper and listened to every peep she made. 15 seconds later she was next to me. It felt like I was doing something wrong, but I knew that she didn’t make any sounds while sleeping next to me. She’s almost 13 weeks now, how time flies and I can’t imagine a different situation. I love snuggling into her at night and waking up to her smiling face in the morning. I do wonder though, if we decide that it’s not the right choice for us later on, how do we help her make the transition easy for her? My instincts say slow and lovingly, but besides that I don’t have a clue. Any wisdom or resources you could impart?

    • Reply Natureal Mom September 27, 2013 at 9:43 am

      Congratulations on following your instincts, mama. Those same instincts are guiding you to transition your baby girl slowly, gently and lovingly when the time is right for your family. Dr. Jay Gordon’s “Sleep, Changing Patterns in the Family Bed” is a wonderful resource http://drjaygordon.com/attachment/sleeppattern.html as well as API’s “Baby Sleep Strategies” http://www.attachmentparenting.org/parentingtopics/babysleepstrategies.php

    • Reply Fat and Angry November 17, 2016 at 12:14 am

      I am severely obese, 5’2 and about 330lbs or so (and pregnant with baby #3) and I am quite irritated that you and Dr. Sears would say that obese mothers might have sleep apnea or don’t know the exact proximity of their babies. My husband and I have shared our beds with our two children and I have never had a problem being aware of any of them and nothing has happened to them. Even now, my youngest is 14 months and I still now when she moves and I wake up. A mother’s instincts are not deterred or dormant just because she is fat. My sister is also overweight and she has bedshared with five children. I understand the warning I guess, but I find it completely irritating that fat women are treated like we are less than as mothers just because of our weight or limits are put on us. It’s ridiculous.

      • Reply Natureal Mom November 17, 2016 at 7:42 am

        Thank you for sharing. I hear you. I don’t know what it’s like to be “severely obese” and I empathize that you feel angry and irritated. I am not a doctor or expert on safe bedsharing. The information I share in this post is science-based. This particular guideline is 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. He also serves on the Health Advisory Board of La Leche League International. He has served on the Executive Committees of the American Anthropological Association and Society For Medical Anthropology and is a member of the American Academy of Pediatrics. He lectures nationally and abroad on the importance of re-conceptualizing what constitutes healthy childhood sleep, and along with his undergraduate students, continues to study family sleeping arrangements and the importance of breast feeding in promoting the health of mothers and infants. As the author of this website and a professionally trained and certified birth worker, I do extensive research and have yet to find any scholarly article or information to say otherwise. James McKenna, Bob Sears and Jay Gordon are the experts in this area and it would be irresponsible of me to not share this guideline for safety. This post is in no way intended to cast judgment on any mother for her weight. Again, these are professional guidelines for those who are interested in the information.

  • Reply Lindsay March 1, 2014 at 5:29 pm

    My little guy is now 7 months old and we bed share, it was so normal and natural for us to do that. It now doesn’t feel right if he isn’t sleeping with me. These were good tips, thanks for sharing.

  • Reply Jenny May 17, 2014 at 4:04 pm

    I am not, by any means, a hippie mom (I think folks may believe this is only for folks on the fringe of society.) :0) Lol!! I do have to say that I was a bed sharing mom with both of my girls and I loved it!! As newborns they were so much calmer when next to me, and I felt so relaxed being with them. It was amazing how fully aware I was of my babies too. I would be sound asleep, but I swear I knew their every movement. They would nurse while I slept too. It really was some of the best moments with my babies. I know it may not be for everyone, but I adored it. Also, I was blessed with a wonderful doctor who encouraged bed sharing and also informed me on how to be safe when doing so. I was nervous when I started doing it (I never thought I would be a bed sharer, so I had never looked into it.) my doctor was so sweet and said that children love being close to their mothers and if it made us happy, to go for it. He was such a great resource for me as a new mother.

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