Sunday, February 15, 2009

Co-Sleeping, Bed-Sharing, and Room-Sharing -- Oh My!

I have always referred to sleeping with our babies as "cosleeping," but recently there has been some discussion about the differences between the two. Here's a basic definition of each:

Co-Sleeping: This is where a baby sleeps in the same room, usually within arms reach, as his or her parents, maybe in a bassinet or side-sleeper.

Bed-Sharing: This is when a baby sleeps in the same bed with his or her parents.

Room-Sharing: This is when a baby sleeps in the same room as his or her parents, in their own crib, bassinet, or bed.

David and I have done all three. With the first couple of babies, we were probably more co-sleepers than bed-sharers. Over time, we definitely discovered bed-sharing to be easier.

The need to differentiate between the two has arisen because of an anti-bedsharing campaign in NY. They are trying to convince parents that bed-sharing is unsafe. If you have the current issue (Jan/Feb) of Mothering, you have probably read the article. I just want to mention a few key points that were mentioned.

Because the focus is on safety of the baby, I'd quickly like to mention that for every 87 babies that die of SIDS, only 3 of those babies are exclusively breastfed. I'd really like to see the focus for preventing SIDS be in the form of breastfeeding information, encouragement, acceptance, etc. instead of misleading parents to believe that bed-sharing is unsafe.

There are some general guidelines that should be mentioned about safe bed-sharing right off the bat. These appeared in the Mothering article just mentioned:

* If bottle-feeding, without breastfeeding, or if the mother smoked during the pregnancy, it is recommended to use separate-surface cosleeping such as a side-sleeper or bassinet.

* It is best to have the bed away from the wall, even without a bedframe. Mattresses can pull away from the wall and the baby can become trapped between the mattress and the wall.

* If you keep the bed frame on the bed, make sure there are no spaces between the mattress and the head-board and foot-board. Be aware, also, of furniture surrounding the bed, such as a nightstand, that the baby could fall and suffocate.

*No children should sleep in an adult bed with an infant.

*Bedsharing should be avoided under the following circumstances: the adult(s) are overly exhausted, desensitized by drugs or alcohol, or sleeping with an unrelated adult.

*Use a stiff mattress, lay baby on his/her back, avoid using duvets or heavy blankets, and keep baby away from pillows.

* Never bedshare on a waterbed, couch, sofa, recliner, or chair. Do not leave baby alone on an adult bed.

*Both adults should agree to the sleeping arrangement if choosing bedsharing. They should both be responsive to and responsible for the baby.

Now that "the rules" are out of the way...

With all the recent hype, there are some important items to mention about the possible dangers of not co-sleeping or bed-sharing. The American Academy of Pediatrics (AAP) has stated that it is important for an infant to sleep in close proximity to his/her parents. It is called roomsharing. In this situation, the baby and the parent(s) sleep close enough for sensory exchanges, but not on the same surface. Does the room protect the baby? Of course not. But being near the mother does. Babies who room-share are half as likely to die of SIDS as infants who sleep alone or with siblings. Why is this?

For starters, babies are programmed to be in constant contact with their mothers, especially in the early weeks. Their only form of communication is to cry when they are stressed. Generally, babies will protest being "put down" or left alone for long periods of time. They have a need to be with their mothers. It is physical, emotional, and psychological. When a baby is left to cry for long periods of time, that can cause severe stress, raising the cortisol levels in the infant. (This also happens when a male infant is circumcised.) High cortisol levels can lead to permanent changes in brain structures and leave the infant especially vulnerable to stress. (Dr. William Sears, in The Baby Book, said that when you leave a baby to cry, you are teaching him/her to just give up. You are not coming back.)

Other physical reasons that a baby should sleep near his/her mother include: Premature and full-term infants breathe more regularly when next to each other, infants use energy more efficiently, they maintain lower blood pressure, grow faster, and experience less stress, as previously mentioned. Being near the mother also helps regulate the baby's temperature, brain-cell connections, calorie absorption, breathing, sleep, arousal patterns, and heart rate.

These benefits are all well documented. So what's the deal with the "Babies sleep safest alone" (NY State) and "All babies should be placed to sleep in cribs" and "For you to rest easy, your baby must rest alone" (Philadelphia) campaigns? Especially when the AAP has recommended roomsharing, emphasizing close proximity with your infant? Parents are only getting half of the information they need. These public health campaigns are making it sound as though bedsharing in-and-of-itself is unsafe and is disregarding the importance of the mother and baby sleeping near one another.

All families are different. All couples are different. And, yes, all babies are different. You have the guidelines to safe bed-sharing and co-sleeping, if that's what you choose. It's important that your baby sleep, at the very least, in the same room, if not the same bed, with the parents. Maybe someday, AAP will declare that infants should never sleep alone and end all this nonsense. Maybe someday, American babies will sleep safely next to their mothers like they do in other cultures, breastfeeding -- because it's the norm, because there was a wonderful public health campaign that encouraged them to do so, for the safety and security of their baby.


Kristina said...

You know, I really wish we had this information when we had our first child. We didn't know anything other than what the docs told us and that allowing our baby to be in our bed could suffocate him and we were putting his life at risk for doing so. We came to our senses with our second child.

Alisa said...

It is so sad that some mom's don't get the support they need to share sleep- it really bothers me when I hear a mom say that they can't because their husband won't let them.
Its all really sad-

Katie said...

When babies bed share where do they nap?

Donna Ryan said...

Katie, this is a great question -- one that I am surprised does not come up more often.

The baby naps on the same bed he or she sleeps on at night -- your bed. I would put a monitor on the bed so I would know immediately when she woke up. I would also put pillows around the perimeter of the bed. I'd always get to them before they "went" anywhere."

Even as they got bigger, I showed them "feet first" and taught them how to get off the bed. Darcy still naps on my bed and she's 4 1/2. Love it. Such a special, tender time of the day.

TO Doula said...

WRT napping, with a young, breastfeeding baby I'm a fan of having the baby napping close to the mother wherever she is. I like a sleep space on each level of a house, or a reasonably portable sleep surface than can be moved around, such as a bassinet. No tearing up the stairs when you hear wiggling on the monitor, and your baby becomes accustomed to the normal sounds of your home. Also makes it easier if you ever travel, because the baby will sleep in a variety of places.

Cosleeping in whatever form rocks.

Anonymous said...

I know you posted this a while ago, but I was reading through old posts and just happened on this one.


My 4-month old parttime bed-shares with my husband and me. Basically, she goes to bed for the "night" in her crib but when she wakes up for her nighttime feed, gets into bed with us. We started this out, because 1) we want the "night" to ourselves, 2) I wanted her at least use to her crib for easier transition. With our oldest daughter (22 months) she never slept in our bed and I regret it. I really wish I had, but was so anti-bed-sharing as I thought it'd be the really bad thing.

Ok, I'm getting way side tracked. The one thing I wanted to mention was...

Last night my daughter was having a hard time falling back to sleep. She just kept tossing and turning. Anyways, I had her laying about 6+ inches from me and just put my hand on her tummy. Instantly she fell asleep. And the whole time I thought "Man, if she were in her crib this would have been such a pain. I love having my baby in bed with me!". It has been one of the best experiences of my life.

Anonymous said...

Anonymous said...

Unknown said...

Thank-you for this article. I have always slept with my babies and loved every minute of it. We were always careful in how we did it, and we never had a problem. I just love the bonding that came from sleeping together. So special. You have to be smart about it - firm bed, no bulky bedding around the baby, and both parents should be aware and careful. I am sad all my babies have grown out of our bed. It was a sweet time!

Unknown said...

To Katie ---
My babies always napped in a crib. For some reason, day naps were pretty uncomplicated. But at night it was always easier to sleep together. Sleeping in a crib for naps helped when it came time to transition out of our bed. It was something they new was safe as well - My babies usually left the bed when I stopped nursing. We would start by putting them in their crib for half the night, then eventually they would just go the whole night. Kind of sad when that special bonding time was over. :(

Unknown said...

Thanks for sharing Interesting post. Thanks for taking this opportunity to discuss this, I appreciate with this and I like learning about this subject. If possible, as you gain information, please update this blog with more information. I have found it really useful.
Bed Mattress in India