The recent death of five infants in Travis County, Texas made headlines with cautions against bedsharing, but could the ensuing sleep recommendations be misdirected? No one would argue against cautioning parents against sleep habits which put babies at risk of suffocation. However, recommendations from the American Academy of Pediatrics like their “ABCs of safe sleep” that advise baby should sleep “alone, on its back, in a crib” may go past the point of cautioning against suffocation risk and actually recommend a dangerous sleep habit in the opposite extreme.
When discussing where and how baby should sleep definitions and parameters are important. Equally, when an infant dies in its sleep it is important to examine all the factors and determine what caused the death as opposed to simply attributing it to where the baby was sleeping. Factors such as drug use are important to consider, as even moderate cigarette smoking or alcohol consumption can have a dramatic impact on an adult’s ability to respond to their sleeping baby.
Co-sleeping is a broad term that includes any situation in which a caregiver sleeps in close proximity to an infant. Natural parenting advocates espouse co-sleeping as having many benefits for both babies and parents including increased ability to respond to each other’s biological signals and sensory cues, greater success in breastfeeding and in the ability to breastfeed on cue, as well as allowing more restful nights for the whole family.
Couch or sofa sharing, recliner sleeping, allowing an infant to sleep prone (belly down) next to a parent, and sleeping with too many covers and pillows in bed with a baby are all forms of co-sleeping; none of which are safe or advisable. Additionally, adults should never sleep on the same surface as an infant if they are inebriated or overly exhausted. These forms of co-sleeping need to be defined with separately from bed-sharing, which is not intrinsically safe or unsafe, and room sharing to avoid misdirected cautions. Room sharing, which is arguably the safest form of co-sleeping, has been shown in epidemiological studies to reduce an infant’s chance of death by 50 percent.
Many argue that sleeping next to one’s baby is biologically appropriate, especially when compared to putting a baby to sleep in a room by themselves. In countries where co-sleeping and breastfeeding are the cultural norm rates of sudden infant death syndrome are significantly lower. In Japan for example, where co-sleeping is standard and bed sizes are indicated by how many children can comfortably sleep alongside parents, the rates of sudden infant death syndrome are the lowest in the world.
A number of prestigious organizations support bed-sharing including the Academy of Breast Feeding Medicine, the UAS Breast Feeding Committee, La Leche League International, UNICEF, and the World Health Organization. These organizations base their bed-sharing and co-sleeping support on the best and latest scientific information in the interest of health for mothers and babies.
A parent who puts their baby to sleep in a crib every night based on accepted pediatric advice may not have been educated about the suffocation risk of an afternoon nap with baby on the couch. By defining the differences between the dangerous and beneficial forms of co-sleeping organizations like the American Academy of Pediatrics can do more for the health of families. Recommending babies sleep alone and other misdirected cautions can be avoided by informing parents about both safe and dangerous forms of infant bed-sharing and co-sleeping.
By Mimi Mudd