Co-Sleeping: Examining Risks & Rewards

Let me tell you a secret.

Despite strong recommendations and campaigns with dire warnings about the dangers of co-sleeping, most mothers sleep with their babies. They often confess to me their “transgressions” against recent pediatric guidelines struggling with guilt and concern for their baby’s safety. And frankly, the fact that their babies are in their beds does not concern me as much as the fact that women are not informed about how to sleep safely with their babies. 

Compared to other mammals, human babies are one of the most dependent on their parents at birth. We have traded off our independence for the prospect of an easier birth. Babies of larger mammals born in the wild need to be born ready to run from predators, so their pregnancies are longer and their babies are bigger so they can get up and go! Put this into perspective and imagine giving birth to a toddler. . . Ouch.

Babies learn independence

Human babies continue to develop significantly after they are birthed.  Initially, they are born helpless and fully dependent on their mothers for food and protection. They have emerged from the most protected of environments, the womb where they have had the perfect climate control. They have never experienced cold or hunger. They have never been ‘”alone”. In fact, they have been surrounded by a symphony of their mothers’ ever-present sounds. A steady heartbeat and ebb and flow of breath sounds. There is the gurgling babble of bowel sounds. And, of course, the recognizable voices of their mother and family. 

After birth, babies continue to be soothed by these sounds. In fact, a mother remains the best habitat for a growing baby. Babies not only regulate their temperature to their mother they also regulate their own heartbeat and breath!

And while they are getting used to new sensations and learning new skills to survive – like feeding – they learn that their needs will continue to be met and that they can trust their parents. Knowing these facts, it is hard to imagine a more counter-intuitive place for a baby to sleep initially than in a cold, quiet dark place. In time, they learn to trust a larger environment. Some babies learn quickly and will move to independent sleep situations early, while others need more reassurance and will take more time.   

Posters showing babies sleeping contentedly and alone in cribs and cradles create unrealistic expectations for mothers and babies. Parents are confused why their baby isn’t “behaving” as they should and become exhausted and frustrated by baby’s night-time demands. They are confused by the reality that their baby settles best when they are close to them.  And that their lives work better when both mothers and babies are getting enough sleep.

It often seems women are fighting the biological drive to stay close to and protect and nurture their babies. 

In fact, having baby close enables mothers to respond to baby’s needs without completely disrupting their sleep. It also allows for better night-time breastfeeding and therefore, maintaining better milk supplies. Perhaps the most compelling reason to sleep close to your baby is the fact that there is a 50% reduction in SIDS (Sudden Infant Death Syndrome) when families sleep in the same room. 

Throughout history and the world, most mothers sleep with their babies. It is strange and I would argue, harmful to recommend otherwise (with the rarest of exceptions). After birth most mothers and fathers develop a heightened sense of their baby – we are hard-wired to respond to our baby’s needs. Just watch a mother who is unable to comfort her crying baby, they become agitated, they become protective, they reach out to comfort, and uncontrollably milk starts to flow from their breasts. Just like a mama bear, it is our biological imperative to protect and nurture our young. 

I believe the recommendation for mothers to sleep in separate rooms interrupts this biology and is in fact, causing harm. Our hyper-awareness decreases over time.  Also, the confusing and threatening messaging hammered into parent’s heads about the dangers of sleeping with babies is putting babies at risk as desperate sleep deprived parents attempt to find alternate solutions to make their child settle and sleep. THIS is the time babies are at most risk.

Teaching and promoting SAFE SLEEPING not only protects babies from harm but also validates what most mothers are already doing!

Safe sleeping guidelines

  1. Make room for your baby. If you have a crowded bed already you may need to invest in a larger bed. It may be time for the toddler to graduate to their own bed either in their own room or next to yours. Some people invest in or create a “co-sleeper” that can be placed right next to your bed. Place the co-sleeper against a wall and position the bed snugly alongside to ensure there are no gaps between the mattresses. 
  2. Be sure the sleep surface is firm.  Beware of super soft pillow-top mattresses or memory foam which would make it difficult for your baby to adjust its position or move away from harm. This includes lying your baby on pillows or sheep skins!
  3. Ensure the surface is flat. Avoid any sleep surface that would allow a baby to fall into cracks or crevices. Couches, pillow props or gaps between mattresses can pose a danger. 
  4. Get rid of extra pillows, stuffed animals, garments or bedding with long strings that can entangle a baby. 
  5. Recent evidence about SIDS (Sudden Infant Death Syndrome) prevention has shown a reduction in risk when placing babies on their backs to sleep.
  6. Avoid overheating. Babies should have their own way to regulate their temperature and therefore, need their own blankets.  Avoid over swaddling and use natural fiber blankets and clothing (like wool or cotton) that breathe and assist in temperature regulation.  A natural fiber sleep sac is a great alternative.

DO NOT sleep with your baby:

  1. DO NOT sleep with your baby if you are taking medications that interfere with state of consciousness and therefore, your ability to arouse. These can include medications for pain, sleep, nausea or colds. 
  2. Some women should not sleep with their babies immediately postpartum – especially if they have had a C-section and/or a long labour requiring medications.  Medications postpartum can interfere with biological awareness.  Parents should wait till they are no longer consuming narcotic medications that have a drowsy effect. 
  3. DO NOT sleep with your baby if either you or your partner has consumed alcohol or drugs. These substances dull your senses and decrease your awareness and response time. 
  4. DO NOT sleep with your baby if you or your partner has a sleeping disorder.  Some parents do not arouse easily either biologically or require sleeping medication to get enough sleep. 
  5. DO NOT sleep with your baby if you or your partner smoke.  Unfortunately, the toxins found in cigarettes leach through the skin and long exposures at night next to their parents has found to INCREASE the risk of SIDS (Sudden Infant Death Syndrome). 
  6. DO NOT sleep with your baby on a couch or arm chair.  A baby is much safer on a flat firm surface such as a bed.
  7. Most importantly, DO NOT sleep with your baby when you are exhausted. Sleep deprivation is a form of impairment similar to drugs and alcohol! If you are not getting approximately 7 hours of sleep in a 24 period you will become sleep impaired which can seriously impact your judgement and awareness. Unfortunately, this type of sleep deprivation is found mostly in mothers trying not to sleep with their babies. At this point, a mother needs help from a partner, family member, friend or doula to help catch up on rest! After she has gotten some well-needed sleep, she should be encouraged to make choices that support her rest and minimize the risk to her baby. 

Interestingly, “co-sleeping” has been found to be one of the most effective ways of getting sleep.

References:

1. Mitchell EA, Thompson JMD. (1995) Co-sleeping increases the risk of SIDS, but sleeping in the parents’ bedroom lowers it. In: Rognum TO. (Ed.) Sudden Infant Death Syndrome: New trends in the nineties. Scandinavian University Press: Oslo: 266-269.

2. Carpenter RG, Irgens LM, Blair PS, England PD, Fleming PJ, Huber J, Jorch G, Schreuder P. (2004) Sudden unexplained infant death in 20 regions in Europe: case control study. The Lancet 363 (9404): 185-91.

3. McKenna JJ, McDade T. (2005) Why babies should never sleep alone: A review of the co-sleeping controversy in relation to SIDS, bedsharing and breastfeeding. Paediatric Respiratory Reviews 6(2): 134-152.


 

Sarah Cosman

Cosman & Webb Townships Organic, Bury, Quebec, Canada