Before I get into this question — a gray area for many — I need to make it clear that I’m not advocating cosleeping. As you’ll soon discover, I coslept with Hudson, as it made sense to me in our circumstances. But as someone who offers guidance to women, I cannot give an official thumbs-up to co-sleeping. What I can do is share studies and anecdotes about this practice, and leave it up to you to make the decision that feels best for your family.
I coslept with Hudson, and he’s still in our bed many nights. The literature told me repeatedly not to do it, but my instincts overpowered it all on his second night home. The moment I placed him in the crib a few feet from our bed, I felt off. Each time I couldn’t hear him breathing I would get up and stare at his chest until I saw it rise and fall — that happened about every fifteen minutes. I wasn’t getting any sleep. I was relieved when he finally cried for milk, as I could bring him into the bed. But then, staying true to the recommendations I had received, I carried him back to the crib and laid him down. He immediately woke up and started crying. We repeated the nurse, crib, cry, nurse again routine until the sun came up. I hadn’t fallen asleep once. The next day, I reread the studies, or at least their conclusions.
Here’s how I interpreted the information: cosleeping is most dangerous in a bed with parents who drink, smoke, take drugs, or are extremely heavy sleepers. Eric and I were none of those. “They” also advised against cosleeping in a soft bed. We had a super firm mattress. Regarding bedding, we didn’t sleep with a top sheet, and I knew I could keep the blanket away from Hudson by tucking it around my waist.
So I defied the expert advice and we coslept the following night — and it felt right. My blanket strategy worked, and I naturally slept with my arm arched around the top of his head (preventing the pillow from getting near his face), and my legs tucked up under his feet. He was in a mama cocoon, and I was immediately aware of anything that tried to invade it. I also stirred at his every movement — there was no heavy sleeping happening. But overall, we both got more sleep, as minimal shuffling and
waking were needed when he was ready to nurse. He never rolled out of the supine position (lying on his back), and he would simply turn his head to the side when he wanted milk. For me, this practice transformed early motherhood by allowing me to get decent sleep, almost entirely dissolving my fear of SIDS, and solidifying my bond with Hudson.
I don’t say any of that to convince you to do as I did. Because as I’ve learned from working with hundreds of mothers and babies, every pair has a unique experience with just about everything. I tell you that story because I want you to understand the thought process that led me to the decision to cosleep. Do with it what you will.
Now, let’s hear from science.
Cosleeping: What the Experts Say
Medical Experts
Here are key findings about bed-sharing from the medical community:
•A report published by the American Academy of Pediatrics states that regardless of parental smoking or breastfeeding status, there is an increased risk of SIDS when bed-sharing if the baby is younger than four months.
•A study in Morbidity and Mortality Weekly Report found that 61 percent of respondents from a 2015 Pregnancy Risk Assessment Monitoring System (PRAMS) survey reported bed-sharing with their infant, at least some of the time.
•According to a study published in Pediatrics, breastfeeding infants who routinely shared a bed with their mother breast-fed approximately three times longer during the night than infants who slept separately. The study also suggested that because bed-sharing could increase breastfeeding, it might protect against SIDS “in some contexts.”
•Showing how much care providers can impact our choices, a study published in JAMA Pediatrics stated that out of the 54 percent of 18,986 participants who talked with a doctor about bed-sharing, 73 percent reported receiving negative advice; 21 percent, neutral advice; and 6 percent, positive advice. Not surprisingly, those who received negative advice where less likely to bed-share, and those who received neutral or positive advice were more likely to bed-share.
•A study in Pediatrics analyzed 239 cases of SIDS, finding that bed-sharing was reported in 39 percent. In addition, 43 percent noted maternal smoking and 72 percent did not breastfeed. Researchers found that the bed-sharing cases had increased bedding risks and more babies in the prone (face-down) position. They also reported that bed-sharing was especially risky when the mother smoked, the mother slept with the baby on a sofa, the infant was younger than eleven weeks, or there was someone in the bed that wasn’t one of the baby’s parents, like a sibling.
•A study published in the British Medical Journal suggested that the risk of bed sharing seems to be more connected to the infant being exposed to secondhand smoke than to the possibility of a parent rolling on the baby, or to overheating.
•Another study in the British Medical Journal found that co-sleeping on a sofa significantly increased the risk of SIDS. The study also found that when parents do not smoke and the infant is older than fourteen weeks, cosleeping did not increase the risk of SIDS. In addition, the study stated that the SIDS risk for younger infants seems to be associated with recent parental consumption of alcohol, overcrowded housing conditions, extreme parental tiredness, and the infant being under a duvet.
•And to exhibit just how unlikely SIDS is while bed-sharing with a healthy baby: a person is more likely to be hit by lightning during their lifetime in the United States (1 in 15,300) than a low-risk baby is to die of SIDS while bed sharing (1 in 16,400). The takeaway from medical experts is that the risk of cosleeping is not the same across the board. It largely depends on the health of the baby and the risk factors in the sleeping environment, such as parents who smoke and drink.
Anthropologists
While I think it’s important to honor the research performed by medical professionals, I believe it’s equally valuable to consider the findings of experts in the field of human behavior and cultures.
•Anthropologist James McKenna at the University of Notre Dame performed a comprehensive cosleeping study that found that mothers create a type of “shield” around the baby as they sleep. Being in this shield helps the baby regulate their heart rate, and carbon dioxide from the mother collects around the baby’s face, prompting them to take a breath. They also observed that the baby rarely moved around during sleep, instead staying next to the mother, with their face pointed toward the breast. It’s like the mother’s body creates a microenvironment that helps the baby’s body learn how to stay alive.
•McKenna has also found that safely bed-sharing can be an important mechanism in regulating an infant’s sleep development, and that mothers in many other cultures, and in species like nonhuman primates, understand this connection and have thus practiced bed-sharing from the beginning. He also comments on how US culture strongly values independence and fails to honor the fact that infants are inherently dependent, especially on the mother. In addition, countries that commonly practice bed-sharing, like Japan, have children who gain a sense of safety and comfort from this close contact with the parents, which then gives them confidence to flex their autonomy. Instead of fostering dependence, the bed-sharing is promoting independence.
•Bed-sharing is a common practice in Japan, where it is referred to as kawa no ji. This term is represented by the character for river, which looks like this: 川. According to a study published in Pediatrics, Japan has one of the lowest rates of SIDS in the world, and the United States has one of the highest. Crosscultural data also shows that cultures where co-sleeping and breastfeeding are the norm have either no cases of SIDS or incredibly low rates.
•Studies have shown that bed-sharing causes mother and infant to spend more time in light sleep than deep sleep, and that they often arouse around the same times. This is especially supportive of bed-sharing with infants who have difficulty waking themselves when experiencing something like apnea (temporary cessation of breathing), which is a risk factor for SIDS.
•Historians have documented the origin of the practice of having infants sleep alone; it likely began in the last five hundred years, when poor, starving women in areas of Europe smothered the infant during sleep because they didn’t have the means to provide for them. After hearing women confess this, Catholic priests began banning parents from having their infants sleep in the parental bed.
•It’s common practice in Bali to hold a baby until it falls asleep, then have the baby sleep in its parent’s bed, as the Balinese believe the child is “vulnerable to spirit risks” during sleep.
•Research has shown that early mother-infant separation can impact a child’s long-term mental health. A study of 2,080 families showed that regular mother-child separation was related to higher levels of negativity and aggression in the child. The researchers found that it was essential that the child believe their mother would respond if they called, or cried in the case of an infant. They found that children who were securely attached to their mother were better able to tolerate physical distance as they aged. Essentially, more close contact with the mother in early life equaled more independence as the child grew up.
•A study done by anthropologist Helen Ball found that parents who bed-shared with their breastfed babies had safer sleeping conditions than parents who bed-shared with formula-fed babies. The formula-fed babies typically slept with their head level with the mother’s head, either on a pillow or between the parent’s pillows, did not arouse as much as their breast-fed counterparts, and had mothers who slept in a variety of positions. In contrast, the mothers who breastfed their babies slept the entire night with their baby level with the breast (far away from pillows), formed a protective arch around the baby, and aroused more often, usually at the same time as their infant.
What to do
Make the decision that feels safest to you. If you try cosleeping and you’re panicked the entire night, switch to a bassinet, bedside sleeper, or whatever your baby-bed of choice is. But if your instincts are screaming at you to try cosleeping, make sure you do the following first:
Confirm there aren’t obvious risks. I want to reiterate that although the American Academy of Pediatrics does not recommend cosleeping under any circumstance, they note that it’s especially dangerous if you or your partner drink, smoke, take drugs (even if they’re prescribed drugs — as they can make you drowsy), or are heavy sleepers. If you fall under any of those categories, cosleeping is ill advised. In addition, a baby under twelve months should not sleep in a bed with another child.
Create a safe bed. Before cosleeping, make sure you have a firm mattress, without a cushy topper. In addition, move out any nonessential bedding. For example, you could move all pillows out of the bed with the exception of one pillow for yourself and one for your partner, ditch the top sheet, and tuck the blanket under your hips to make sure the blanket won’t bunch up around baby’s face.
Consider baby’s health. Because a baby who was born prematurely, is underweight, or has health issues has a higher risk of SIDS, you might want to hold off on cosleeping until any health risks have passed. Your baby’s pediatrician can help you develop a thorough understanding of your child’s current health status.
Evaluate how the cosleeping trial went. After your first night of co-sleeping, consider how safe it felt. Did it transform your sleep and baby’s? Did feeling their warm breath on your chest the entire night make you feel secure? Or did it keep you awake and anxious? Did anything happen that could have threatened their safety? Does it feel like the most natural thing in the world? Or something you’re forcing? Listen to your instincts.
Continually reassess. Evaluate your decision as things change. For example, because respiratory infections are believed to increase the risk for SIDS, you might consider reassessing your cosleeping arrangement if baby develops this type of illness. Or if you or your partner drink one night, smoke a cigarette (or are even just around smoke), or take a medication that can cause drowsiness, carefully consider whether it’s safe for baby to sleep in your bed. The main point: always be considering what the safest sleeping arrangements are for your baby.
How’s that for a murky answer to this question?! This was one of the hardest questions for me to answer, as my feelings around cosleeping are such a mixed bag. As I recommend with all the information I provide, take it with a grain of salt, seek information from various sources, and make decisions that feel best to you. You are so much wiser than you likely give yourself credit for.
Bailey Gaddis Blog 