Even before you bring your baby home from the hospital, you have to make a major decision on your baby’s behalf: Where is she going to sleep? In a crib? A bedside sleeper? In your bed? A bassinet in your bedroom? In the family bed at night, but in a bassinet for naps during the day? Where babies are “supposed to” sleep is a raging hot-button topic for expectant and new parents: blogs, message boards, and parenting groups practically burst into flames when this subject comes up.
To vehement pro–bed sharers who believe in bringing their babies into bed with them, crib sleeping approaches child neglect. To the pro-crib camp, bed sharers are indulging in a bad habit that will endanger their babies and their marriages.
The truth is, there are advantages and disadvantages to every type of baby sleeping arrangement, and your relationship to your baby is not going to be made or broken based on where you choose to put her to sleep.
In this chapter, we look at all the different places where babies can sleep, and the pros and cons of each. We’ll start with bed sharing, the world’s oldest baby sleep arrangement, discuss crib sleeping, then co-sleeping, and finally, the “buffet” in which baby sleeps in multiple places. We will then discuss specific sleep-related products and how to shop for them, from cribs and bassinets to night-lights and rockers.
WHERE DO MOST BABIES SLEEP?
According to the National Sleep Foundation’s Sleep in America poll, about 60 percent of infants under the age of 1 sleep most of the night alone in their own rooms, 24 percent sleep in a parent’s room but in their own bed, and about 12 percent sleep in their parents’ bed.1
An Informal Survey
We posed the question, “Where does the baby sleep?” on the bulletin board of a popular parenting Web site,2 and found the response revealing: Parents use a surprisingly wide variety of sleeping arrangements for their babies, such as:
• Crib. “Our daughter slept in the crib as soon as we got home from the hospital. It has never been a problem for us. She’s 10 months old now and still sleeping well in her crib.”
• Crib and bassinet to crib. “My first child slept in a crib and had no problems. My second child slept in a bassinet for a couple of months in my room and then went to a crib. I think it all depends on the child.”
• Crib, swing, parents’ bed, car seat, crib. “For my first child I was determined that she sleep in her crib from day one. That started a yearlong sleep battle as she was not a big fan of the crib. She spent most of her day asleep in her swing. For my second I was much too tired to battle the issue. I tried a bassinet, which he hated. So he alternated sleeping in my bed and sleeping in his car seat on the floor next to my bed. At about 4 months old he became a very squirmy sleeper and none of us could sleep in bed at night. When I would wake up I would find him asleep under my bed as he had slid under there from his car seat. My pediatrician suggested the crib at that point. It took a few nights but he has been comfortable there ever since.”
• Bedside co-sleeper, crib. “My now 9-month-old daughter slept in a co-sleeper next to me until she was 16 weeks and then we moved her into her crib. Prior to 16 weeks, she would never nap in her crib and I was very worried that we were going to have a fight on our hands. She made the transition like a champ, though.”
• Bassinet, portable crib, and parents’ bed. “All three of my kids started out in a bassinet or portable crib next to the bed. When they were nursing in the night I would bring them into the bed with us.”
• Bassinet, portable crib, car seat, crib. “We started with my son in the bassinet, but he was 9 pounds when he was born, so he only got to stay in the bassinet until he was about a month, I think. We then started putting him in his portable play yard to sleep. I know that sounds strange, but my husband and I took sleeping shifts. Once Dave got home from work at about 5 we’d eat dinner and then I’d nurse the baby. By about 7 I’d go to bed. My husband would feed the baby expressed milk at about 10 and wake me up at 12 or 1 for the next feeding and we’d switch. Needless to say he was very sleep deprived since he left for work at 6:30 a.m. and I wanted to give him as much peace during his sleep as possible. So I slept on our couch next to the playpen until morning. It’s a VERY comfortable couch. My son was also a marathon eater and would nurse for 20–30 minutes at a time. Being in front of the TV was nice for me, and I was able to hear him breathe all night, which gave me peace of mind. Oh, I forgot, we had a 2-week period in there somewhere where he slept in his car seat, I think at about a month old. He had a really nasty cold, and the doctor said it would help him breathe easier. Shortly after 2½ months, he started sleeping through the night (I know I’m really lucky), and we put him in the crib.”
• Parents’ bed. “Our son has slept in our bed from day one . . . and still does at 20 months!”
• Parents’ bed, crib. “My child slept with me. When he was first born we lived in a one-bedroom apartment. Because my husband had to get up early to go to work, I put him in bed with us instead of fussing and waking everyone up. Then we moved when our baby was 10 months old and he got his own room.”
• Parents’ bed, bouncy seat, and crib. “We set up a bassinet next to our bed for my daughter and I think she slept there for about 10 seconds. She was just one of those babies who needed to be more secure, so she slept in my arms in our bed for about 2 months . . . She napped well in a bouncy seat, so she slept in the bouncy seat, at the foot of our bed, for about a month, and slowly we moved the chair from our room into her room at the foot of her crib. I think she was about 4 months when she finally slept alone in her crib.”
• Parents’ bed, portable play yard. “Our 4-month-old feeds in bed, then we move him to a play yard in our room, but somehow we always wake up with him in our bed in the morning.”
From the variety of responses, it’s clear that the bed sharing versus co-sleeping versus crib sleeping debate isn’t necessarily black-and-white. Many babies start out sleeping in one location and then end up somewhere else. Some babies even prefer to sleep in unusual places such as car seats, swings, or bouncy chairs. As long as your baby is properly attended and her sleep spot is safe, there’s nothing wrong with letting her sleep somewhere unusual in the short term, although cushy surfaces, such as couches, waterbeds, and beanbag chairs, can pose a suffocation risk.
In fact, some parents find it helpful to have more than one baby sleep spot—for example, if you’re bed sharing, it isn’t safe to leave your baby alone in an adult bed, so it makes sense to provide her with a different daytime nap spot.
Bed Sharing: The World’s Oldest Sleeping Arrangement
A mother sharing a bed with her baby is the most common sleeping arrangement in most of the world, but in the United States, Canada, and Western Europe it is not the norm. As recently as a century ago in the United States, however, it wasn’t considered unusual for parents to share their bed with an infant—or the rest of the family, for that matter. Only very rich families could afford homes with private quarters for everyone. Back in the old days, before central heating was widely available, parents slept in the same bed with babies, older siblings slept in the same bed with each other, and family members shared bedrooms to stay warm and conserve heat.
During the post–World War II construction boom, bigger houses were built, and private bedrooms became accessible to every family member in America’s fast-growing middle class. Having a separate bedroom for baby became a status symbol and bed sharing or co-sleeping was associated with poverty.
Having baby sleep alone also reflected the conventional parenting wisdom of the post-war era, which was based on the popular psychological theories of the time. Too much affection and intimacy was thought to “spoil” babies and spawn overly dependent and clingy children, while keeping emotional and physical distance from one’s offspring was thought to toughen them up to face the world.
Promoting solo crib sleeping over the family bed had more to do with cultural and social notions of values and morality than it did with the actual biology of newborns, or evidence-based information on the psychology of children. Now that we know more about the biology of brain development, the evidence is clear that physical and psychological closeness to caregivers makes for more secure, attached, and resilient children and grown-ups.
Today, in the United States, bed sharing with a baby is still generally regarded with great suspicion in some circles. Safety concerns have dominated much of the debate, along with the concern that once a baby gets used to the adult bed, she’ll never learn to sleep alone. And, if you’re not the bed-sharing type, a baby in bed can put a serious damper on your sex life.
PROMOTING— OR HINDERING— INDEPENDENCE
Some experts have opined that independent sleep fosters self-reliance and confidence, but there has never been a single scientific study that supports that theory.
One study from the University of California at Irvine dealt with the question of bed sharing, co-sleeping, and preschool children’s independence and found that children who shared a bed or room with their parents actually became more self-reliant. For instance, they were more able to dress themselves and exhibited more social independence—they were better able to make friends independently than children who had slept in a crib in their own rooms.3
“When I say to a mother or father of a day-old infant, ‘we want to help her become independent,’ they sometimes look at me. ‘Independent? She’s only a few hours old.’ So I ask, ‘Well, when would you start?’ That’s a question no one can answer, not even the scientists, because we don’t know the precise moment when an infant begins to truly comprehend the world or develop the skills she needs to cope with her environment. Therefore I say, start now.”
—Tracy Hogg, Secrets of the Baby Whisperer4
It’s important to keep in mind, though, when it comes to studies that involve the personality traits of individuals, it’s impossible for researchers to take every single variable in a person’s life into account to come up with a “pure” result. Maybe the bed-sharing parents were doing so because they were too poor to afford a crib, and that could also explain why their kids grew up to be more self-reliant. Perhaps co-sleeping parents are more outgoing socially, and their kids are that way, too.
Bottom line: Be wary of anyone who claims that your sleeping choices will determine what kind of personality your child will have when she grows up, because that’s a question no one can credibly answer accurately. There are plenty of healthy, well-adjusted adults who grew up with all sorts of sleeping arrangements.
The Biology of Mother-Baby Night Closeness
“It isn’t obvious to me how a baby would develop a robust sense of autonomy while being confined to a small cubicle with bars on the side and rendered powerless to influence its environment. (Nor is it obvious these days, when many kids spend 40 hours a week in day care, that they need extra autonomy training.) I’d be willing to look at the evidence behind this claim, but there isn’t any.”
—Robert Wright, Slate magazine5
Only within the past few decades have scientists begun to study human infancy from the perspective of evolutionary biology, studying the interactions between mothers and infants sleeping together in labs, in hospitals, and at home. The results point to what mothers and babies have known for millions of years: Sleeping together is a natural, normal human behavior, and it offers numerous benefits. For instance, it:
• Encourages breastfeeding. A newborn needs to get about half her calories overnight, and at 8 weeks, a baby will still get about 1/3 of her daily calories overnight. Human milk is low in fat and protein and high in sugar to provide energy and stimulate baby brain growth, but those nutritional qualities also mean that it doesn’t satiate a baby for very long. Typically, a breastfeeding newborn will feed every 1½ to 2 hours, sometimes less, sometimes more, according to her individual nutritional needs. Having a nursing baby sleep within arm’s reach helps to conserve a mother’s energy and provides her baby with ready access.
• Protects against SIDS. Some research appears to show that bed sharing may have a protective effect. Infants who share a bed with their mothers don’t sleep as deeply, and it appears that a mother’s exhaled carbon dioxide could stimulate infant respiration.6
• Means better sleep for baby and mom. Research shows that new babies sleeping alongside their moms tend to synchronize their sleep schedules and cycles with their mothers’.
• Helps moms recovering from surgery. Being spared getting in and out of bed is an especially important issue for the moms who have cesarean sections (over 30 percent of Western births are c-section) and spend the first weeks of their baby’s life recovering from surgery.
• Regulates baby body temps. The physical proximity to a parent helps regulate baby body temperature, and studies have shown that the physiology of bed-sharing babies is more stable. For example, bed-sharing babies have more regular heart rhythms and fewer long pauses in breathing than babies who sleep alone.7 The more time a baby spends in physical contact with her mother, the less time on average she will spend crying.
• Promotes touching. Primate studies appear to show that the amount of touch infants receive during the first 6 months of life is directly related to their ability to fight illness.8
• Reduces cortisol levels. Cortisol is a stress hormone produced by adults’ and babies’ bodies when they encounter stress, and it can be measured in saliva. Studies have shown that stress hormones, including cortisol, are lower in mothers and babies who co-sleep and bed share. Some cortisol is necessary to wake up fully and function, but it is thought that an overabundance of cortisol in a baby’s body can affect her growth.
While sleeping next to your baby is safe, normal, and natural, certain bed-sharing circumstances can be lethal. For example, your baby can get wedged between the mattress and the wall or become entangled in bedding, or you or your partner can suffocate your baby if you accidentally roll over or lie on her. Some studies have suggested that as many as two-thirds of deaths attributed to SIDS were actually accidental asphyxiations. Although babies have always bedded down with their mothers, we now have bedroom fixtures that are a far cry from the sleeping mats and leaf nests of our ancestors. Headboards, bed frames, squishy mattress pads, elevated sleep surfaces, comforters filled with polyester fluff, waterbeds, nightstands, and sofa beds, as well as parents’ sedating medications all pose a risk to the survival of babies.
Breastfeeding in the Side-Lying Position
If you’re bed sharing, mastering breastfeeding in the side-lying position is the key to a good night’s rest. However, it may take a while before your baby masters latching on to your breast in this new position, because it’s not as easy to guide your baby to the breast as it is when you are holding her in your arms. At first you may need to switch your baby from one side to the other to feed, but as you become experienced you may learn to alternate breasts while your baby stays on the same side.
When Baby Shouldn’t Sleep with You
The safest sleep scenario for your baby will depend on your individual circumstances. Crib sleeping is the safest option for your baby when:
• You smoke. Smoking is a major contributing factor for SIDS, even if only dad smokes and mom doesn’t, and even if no one smokes in the house or around the baby. Toxins in exhaled smokers’ breath appear to disrupt the signals to a baby’s brain that cue breathing.
• Your adult bed is not safe for your baby. If the adult bed has a gap between the mattress and headboard larger than two and a half inches, and you are unable to remove the mattress from the frame and put it on the floor, your baby shouldn’t sleep with you in your bed.
• Young siblings or territorial animals sleep with you too. If other children are sharing your bed or you have territorial pets that sleep in your bed—and you’re not willing to banish them from the bedroom— they pose a risk to your baby.
• You drink or take drugs or sedatives. Don’t share a bed if you or your bed partner have been drinking or taking sedating medications before bed, or if your partner sleeps like a log. (Plenty of dads can sleep lightly in a bed, conscious of where the baby is at all times. But some dads say they’re conscious when they actually aren’t [“Oh, I see him, I’m not going to hit him in the head with my elbow . . . zzzzz”]). If this is the case, you’ll need to put your mattress on the floor or install a bed rail, and sleep with the baby on your side of the bed with you between baby and dad.
For parents who smoke or drink or who are obese, sleep heavily, or use any kind of drug that inhibits awakening, bed sharing is dangerous! If you (or your partner) sleep like a log, have been drinking, are obese, or have taken sedating medications (sleeping, allergy, or anti-anxiety medication, for instance) then a crib, bassinet, or other baby bed is the safest answer.
You can sue the manufacturer of a crib if it hurts your baby, but if she is injured or dies while sleeping in an adult bed with you, you and your partner could be the subjects of a criminal investigation. If it can be proven that you were drinking or using drugs when your baby was injured or died, you can be prosecuted for criminal negligence in some jurisdictions.
It cannot be emphasized enough: If you choose to share a bed with your baby, you must take complete responsibility for her safety while she’s in bed with you, since adult beds are not made to be safe for babies. If you have any doubts about the safety of your bed, yourself, or your partner, when it comes to protecting your baby through the night, let her sleep in the same room, but put her down in her own bed—a portable crib, for example, or a cradle or bassinet. This will protect her from adult-bed hazards while giving her some of the same benefits of bed sharing.
THE BED-CRIB CONTROVERSY
As the result of a 1999 published report of its survey of adult-bed-related baby deaths, the Consumer Product Safety Commission (CPSC) issued a warning to parents against bed sharing with children younger than 2 years old.
According to the CPSC, from 1990 to 1997, 515 babies died in adult-bed-related accidents in the United States. Of those deaths, 128 appeared to be caused by babies being wedged between the mattress and the wall; 145 were from the baby becoming trapped between the mattress and bed frame; 121 appeared to be caused by being unintentionally smothered by a parent, pet, or child; 68 suffocated on waterbeds; 31 were trapped between restraining railings placed on the side of the adult bed; and 22 were trapped between the mattress and adjacent furniture.
Is sleeping in adult beds more dangerous than sleeping in a crib? The same year that CPSC’s survey results were released that appeared to prove that babies’ sleeping in adult beds was a dangerous practice, a separate survey of suffocation and strangulation deaths of babies and children was published in Pediatrics, the journal of the American Academy of Pediatrics.9 It appeared to show that out of 2,178 children who died over the course of the survey’s 17 years, 139 died from suffocation in an adult bed, while 428 died in crib-related accidents. Of the remaining deaths, babies were in other places, such as infant beds, high chairs, or strangled by a drapery cord, or there was insufficient information as to where, or how, the deaths occurred.
In a more recent, systematic review of the benefits and dangers associated with the practice of bed sharing based on 40 highly controlled surveys of infant death, the most frequently cited association with infant death and bed sharing was smoking by the mother, either during pregnancy or afterward.10 Babies younger than 11 weeks were found to be the most at risk for SIDS when they slept in adult beds or on soft surfaces.
Bottom line: Babies can be endangered by unsafe practices in both adult beds and cribs. Wherever your baby sleeps, it’s important to take steps to protect your baby from accidental suffocation and strangulation hazards.
No studies of which we are aware have created risk ratios for baby deaths attributed to sharing a family bed with non-smoking, sober parents who have made reasonable efforts to protect their babies from suffocation and entrapment hazards.
PEDIATRICIANS AND THE FAMILY BED
In 2000, one year after the CPSC issued its recommendations, the American Academy of Pediatrics (AAP) issued its own statement that appeared to straddle the line by proclaiming both solitary crib sleeping and bed sharing to be less than optimal. The AAP suggested, instead, that during the first 6 months, babies should sleep in cribs, bassinets, or co-sleepers in the same room as adults while also using pacifiers at the time of sleep.
The AAP’s recommendation states: “Although electrophysiologic and behavioral studies offer a strong case for bed sharing’s effect in facilitating breastfeeding and the enhancement of maternal-infant bonding, epidemiological studies of bed sharing have shown that it can be hazardous under certain conditions. Several case studies of accidental suffocation or death from undetermined cause suggest that bed sharing is hazardous.”
If you ask your pediatrician about bed sharing, he or she may inform you of the AAP’s stance but add that bed sharing is a personal choice, advise you to research the risks and benefits, and then support your choice anyway. Or, your pediatrician may give you a unilateral statement about bed sharing being dangerous and say you shouldn’t do it.
Unfortunately, the AAP has not issued any guidelines to help pediatricians advise parents on bed-sharing safety, perhaps out of concern that providing safety information could appear to be an endorsement of the practice. Of course, this lack of information only makes bed sharing more dangerous, because many parents don’t start out intending to bedshare but end up bringing their babies into bed for nursing or after a particularly rough night.
The AAP’s “just say no” approach also can have the side effect of driving a wedge into the parent/doctor/patient relationship, forcing parents to choose between being dishonest with doctors or facing their doctors’ disapproval.
Why would the AAP take such a severe stance? Pediatricians tell us that dealing with babies who have been killed and injured in adult beds is so traumatic, they come away understandably determined never to repeat the experience. Also, there are so many types and styles of adult beds on the market—none constructed with infant safety in mind—so perhaps the AAP decided that the task of attempting to educate the public on sleep safety was too complicated and more of a consumer-product issue than a medical one.
This brings us to another point: Pediatricians are doctors, after all, which means that they are experts on the physical health of babies and children. If your baby is sick or injured, your pediatrician is of course the go-to guy or gal. But when it comes to parenting decisions, you are the expert on your baby. For matters of parental judgment, a doctor can tell you what’s worked for other parents, recommend resources, let you know what her professional organization has to say on a given topic, and offer you an opinion based on that information. But you, the parents, are the parenting experts of your baby. Only you have the right to decide where your baby sleeps, and the responsibility to keep your baby safe.
Before you bring your baby into bed with you, always do a safety check. There should be:
• No places where baby can get trapped. Babies and young children can be killed when they get their heads wedged in the gaps in furniture. Headboards, footboards, and side rails can be unsafe, especially if a baby is left alone to sleep in a bed. Just as with cribs, head- and footboard railings should have spaces that are no wider than 23.8 inches apart when an adult’s weight is in the bed.
• A firm mattress. The surface you share with your baby needs to be firm. Avoid waterbeds, lambskins, fluffy mattress pads, and other soft bedding. Keep stuffed animals and toys out of the baby’s sleep environment. Do not sleep on a sofa or a chair with your baby or leave a sleeping baby alone there. And, make sure there’s enough room on the mattress for you, the baby, and your partner with no crowding. A king-size bed is ideal, a queen-size bed is fine, but a full (double) bed or a twin is simply too small.
• No pillows, quilts, or blankets. Don’t give pillows to babies or young toddlers, and keep your pillow away from your baby’s sleep area. Don’t put a blanket over your baby at all; instead, dress her warmly enough not to need one (babies will kick off blankets, anyway). Keep a night-light on so that you can check on your baby throughout the night.
• No swaddling. Do not swaddle a bed-sharing baby.
• No overheating. Bed-sharing babies are kept warmer than solitary sleeping babies, so they need lighter pajamas. (Being too warm may be a factor in SIDS.)
• No other children or pets in the bed. Toddlers and young children should not be allowed to sleep near your baby. Nor should you bed share if you have a territorial pet that you’re not willing to banish from the bedroom.
• Proper restraints. Don’t try to prevent falls with pillows. If your mattress can’t be taken off of the frame and placed on the floor without a box spring, then you will need to get a bed rail suitable for infants for the baby’s side of the bed to prevent falls. There should be no spaces between the rail and the mattress greater than 2 3/8 inches. Bed rails can be inconvenient because they block off a whole side of the bed so you have to scoot to the foot of the bed to get out, and if you remove the bed rail to change the sheets, it may be tempting to just leave it off. But, in order to work, the bed rail must be properly installed and used after every linen change.
• No bed wedging. Avoid placing an adult bed directly alongside furniture or a wall. Babies and young children have very vulnerable windpipes and can become trapped between the bed and other furniture or a wall and can be strangled when their throats are pressured.
• No excuse to leave your baby alone. Do not leave your baby unattended in an adult bed, because even newborns can scoot into a suffocation or entrapment hazard, especially if they wake up to find that mom isn’t there. The strategy to sleep when your baby sleeps may be fine for the first 6 weeks or so, but as soon as your sleep needs change and your baby’s naps come in longer stretches, you will need to find a safe nap spot for her.
No matter where your baby always sleeps, place her on her back to sleep. Research clearly shows that this can help protect your baby from the risk of SIDS and the hazards of suffocation and overheating.
In addition to some of the glaring safety issues, there are some other potential downsides to bed sharing that you need to consider. Your baby will have to learn to sleep in her own bed eventually, unless you are committed to sharing the family bed for an extended period of time.
Many parents opt against bed sharing because they don’t intend to share for an extended period of time, and they don’t want to have to go through the process of transitioning their baby to her own bed. How difficult it will be to transition your baby will not be possible to determine ahead of time. Some babies take to solo sleeping like champs after just a few nights of mild fussing; for others the transition is more difficult.
A shared bed may also mean less intimate time for you as an adult. Many couples appreciate the time before bed to talk and relax together, and enjoy the bed as one of the few kid-free zones in the house. With a new baby, grown-up time can be harder to come by, and yet such time is more essential than ever for supporting your relationship.
And then there’s your sex life. Sure, sex doesn’t have to be at night and in bed, and plenty of bed-sharing couples have robust sex lives that involve finding new places around the house and taking advantage of baby nap times—but for other couples who are thoroughly wiped out by the new-baby lifestyle, planning a laundry room adventure is far too ambitious.
If you’re a single mom, you can run into problems if you want to have a guest over for an adult sleepover. It could be very upsetting to a tot if she’s temporarily evicted because a stranger is taking over “her” place in bed.
If you’ve been bed sharing for an extended period and find yourself pregnant again, it’s also important to transition your baby or child into her own sleep area before you’re visibly pregnant. Otherwise, it may cause deep and long-lasting resentment if the new baby appears to be responsible for pushing her out of her bed and into a crib in another room. And it’s dangerous to bed share with both an infant and a toddler, because toddlers sleep deeply and don’t fully grasp the concept of injuring others.
What About Co-sleepers?
Currently, there are no safety standards for the bassinet-like devices that are designed to go in between parents or alongside an adult bed. In 2008, two babies died when they slipped through an opening in the frame and were asphyxiated by the Simplicity bedside sleeper/bassinet. If you plan to have your baby sleep in the same room as you, it’s safest to put a mini or full-size crib in your room.
Sleep Positioners
With both the incidence of bed sharing on the rise (or, perhaps, the numbers of parents willing to admit to bed sharing), and the growing awareness of bed-sharing safety concerns, there are some new products on the market that are designed to make adult beds safer for young babies. Sometimes called “snuggle nests” by Baby Delight, adult-bed sleep positioners are foam-lined enclosures with mesh sides designed to be used on the surface of an adult bed.
Parenting Issues and Bed Sharing
The following are the results of an informal survey conducted by Babytalk magazine:
11 percent of expectant parents planned to co-sleep with their babies.
42 percent of parents reported sharing a family bed once the baby arrived.11
Most are specified for babies up to the age of 4 months, and are designed to keep pillows and blankets from accidentally covering a baby. They also provide an extra barrier to keep an adult from rolling over on her. Some sleep positioners also come with night-lights and a wedge shape that keeps a baby positioned on an incline, ostensibly to address reflux problems (for more on reflux).
There are serious safety concerns related to these positioners. The AAP advises, “Although various devices have been developed to maintain sleep position or to reduce the risk of re-breathing, such devices are not recommended, because none have been tested sufficiently to show efficacy or safety.”
“I just don’t think I would have made it through those first few months if every time he fed, I had to get out of bed, go downstairs, pick up the kid, stay awake while nursing him, soothe him to sleep, and then go back upstairs to try to fall asleep again while calculating in my head how soon I’d have to get up for the day.”
—Elizabeth S.
Parents have reported that babies can easily scoot or slide out of positioners that are not enclosed on all four sides, especially if the bed has an incline. Consumer Reports, the publication of the nonprofit group Consumers Union, has reported death by asphyxiation of at least one baby whose nose and mouth were obstructed by a foam positioning device. These positioners also potentially create a false sense of security: Parents don’t make their beds baby-safe, relying on the positioner to keep the baby in place.
How and When to Stop Bed Sharing
No one can pinpoint the exact age that a bed-sharing baby or child should start sleeping alone. On one end of the spectrum there are parents and experts who claim you should never bedshare in the first place, and on the other side of the fence there are families dedicated to extended bed sharing, who maintain that parents and children should share a bed until the child decides she’s ready for her own room.
Both extremes are, in our opinion, perhaps a little too extreme. Never sharing the bed can be tough, especially if you’re sleep-deprived, you’ve had a c-section, or your baby is simply the type who goes ballistic every time you put her down. And, if you opt for the “let-them-decide-for-themselves” route, most kids will opt to sleep in the parental bed until peer pressure sets in to deter them, which may not happen until grade school.
So, unless you plan to share your bed indefinitely, it’s easiest to start to transition your baby into her own sleeping spot between 6 and 8 months of age. That’s when your baby’s stomach will be big enough so she can sleep for longer phases, you’re out of the SIDS risk zone, and it’s early enough to pre-empt the separation-anxiety phase (which can begin as early as six months for some babies). It will also make things much easier if you make the transition before your baby is mobile enough to climb out of her crib or toddler bed and walk into your room of her own accord, which obviously will present much bigger challenges.
Or, you may decide to transition your baby out of your bed sooner, if:
• Sleeping positions or situations have made sharing unsafe. When baby becomes so mobile that she can no longer bedshare safely—if you wake up and the baby has wiggled down to the foot of the bed, for instance, take that as a sign that she may need her own bed for her own safety.
• It’s affecting your relationship. When you (or your partner) begin to resent sharing the bed, it’s time to reconsider.
• It’s affecting your sleep. When baby’s noises or movements make it difficult for you or your partner to get needed sleep.
• Your baby is sleeping in very short stretches. It’s not unusual for breastfeeding babies who bedshare to feed on and off for most of the night. To them, it’s probably like sleeping next to a plate of hot cinnamon rolls—they can smell a delicious meal, and it wakes them up. If you don’t mind keeping the all-night buffet open, there’s nothing wrong with that, and a side effect will be that the baby will need to feed less often during the day. But if your baby is “snacking” every hour and you don’t like it, crib sleeping could help everybody get more rest.
• You know you don’t want to bedshare for a long period of time, and your baby has not yet started climbing. It’s good to make the transition sometime before your baby is able to climb out of a crib—because once she is able, if she can vault herself out, she will. If your baby has not yet started pulling up on furniture, that will make the transition much easier for everyone.
Bed sharing is when babies or children and parents share a bed, and co-sleeping is when a baby sleeps in the same room, but not in the same bed with parents (though sometimes the term co-sleeping is used as a “blanket” term for any kind of sleeping that happens in the same room).
Though the AAP favors co-sleeping as a compromise between bed sharing and crib sleeping in a separate room, if you poll parents you’ll hear that the picture for co-sleeping isn’t always rosy, and the phrase worst of both worlds will pop up a lot. Parents who are awakened by baby’s sleeping noises will still be disturbed by them, and a parent will still have to get up to tend to the baby, even with the “sidecar” sleepers that attach to the side of the bed. If baby is in a crib in another room, one parent can be “on duty” to get up and tend to him, but if baby’s in the same room, both parents will hear the baby’s sleeping noises and listen to him being soothed and fed.
Also, babies who don’t like sleeping in a crib won’t like sleeping in a bassinet or a co-sleeper any better. As far as a baby’s concerned, being a foot away from mom is not much of an improvement over being 20 feet away. Babies crave skin-to-skin contact.
What typically happens is that a baby begins the night in a bassinet or co-sleeping sidecar, but moves into the parents’ bed for the first feeding of the night and doesn’t move back. Breastfeeding is sedating for both mom and baby, so it may be unrealistic to assume you’ll be awake enough at the end of every feeding to get up and put the baby back. And as you may notice, the “end” of a feeding can be difficult to determine, especially with newborns. Your baby’s nursing may slow down, but then speed up as soon as you try to unlatch her. If you wait for your baby to unlatch herself when she’s done, you could be waiting for a long time. And if you unlatch her yourself before she’s finished, that may wake her up completely.
So this is how “accidental” bed sharing begins, and this situation may have the potential to create the most dangerous sleeping environment of all, because parents may not make the bed baby-safe on the assumption that the baby’s “real” sleeping place is somewhere else.
CRIB SLEEPING PROS
• Contains the baby. Unlike bed sharing, where it’s unsafe to leave a sleeping baby alone in an adult bed, crib sleeping allows parents to do other things around the house while baby is sleeping.
• Sometimes is safer. May be safer than bed sharing under certain circumstances—if parents drink or smoke, for example.
• May be more restful for you. If your baby is a nighttime kicker and thrasher or makes a lot of noise in her sleep, crib sleeping may turn out to be a lot more restful for you than bed sharing or co-sleeping.
• Couple privacy. Many parents prefer having the bedroom a grown-up-only area. Crib sleeping promotes marital harmony when one parent favors co-sleeping or bed sharing and the other doesn’t.
• Requires no transition later. If your baby starts out sleeping in a crib, you don’t have to worry about transitioning her to it later.
• Is more travel-friendly. If you travel, you don’t have to worry if a hotel bed is baby-safe.
CRIB SLEEPING CONS
• Could negatively affect breastfeeding. Compared to rooming-in, crib sleeping makes overnight breastfeeding inconvenient, and feeding overnight is important to keep up your milk supply and keep the baby nourished. Skipping night nursing can lead to painful engorgement.
• May seem inconvenient. If your baby is sleeping in another room, that means that you (or your partner, if you’re formula feeding or pumping milk) will have to get up several times a night, walk into the baby’s room, feed and lull her back to sleep, and then go back to your own room to get some sleep. There is no magic age at which a baby will stop feeding at night. According to surveys, at one year of age about 80 percent of babies sleep through the night without waking up to feed, leaving one out of five still getting up at night after the baby’s first birthday.
• May isolate baby. Newborns rely on mom and other caregivers not only for food but temperature regulation and sleep-cycle regulation, and a healthy newborn separated from her mother will protest, loudly. After all, in hunter-gatherer times, the only time a baby would find herself sleeping alone was if something horrible happened—mom was killed by a beast—and the wail was needed so other family members could find her and come to her rescue.
• Is sometimes physically uncomfortable. Bending over to lower your baby into the crib and lifting her out can be a pain in the back, especially for physically challenged parents. Getting in and out of bed can be painful and difficult for moms who had c-sections.
• Carries its own risk. Even though they are covered by stringent federal regulations, cribs are still responsible for numerous baby deaths every year, most commonly due to malfunctioning parts, or hardware or slat failures.
PICKING A CRIB
A non-full-size crib resembles a standard crib complete with wooden (or metal) bars except at three-quarters the size. (And it may not have all of the extra features that the big models do.) Portable cribs are priced between $90 and $200.
A bassinet is a small baby bed supported by a frame with legs and usually with wheels. Bassinets come in a wide variety of price ranges from about $30 to more than $200. You can expect to pay around $50 for a bare-bones model, $60 to $150 for models with fabric skirts, a hood, and a storage compartment underneath. Models priced at $150 and above come with advanced electronic features, such as lights, sounds, vibration, and a moving mobile, as well as novel designer shapes and plush fabrics.
A bedside sleeper attaches onto the side of an adult bed and allows baby to be easily lifted from sleeper to bed, and back. Some allow the open side to be closed for use as a portable bed or changing station. Prices range from $100 to $300. The lowest-priced models are made of tubular metal and mesh; the highest-priced versions are made of wood and are convertible to children’s desks and other kinds of furniture.
A cradle is a rocking baby bed, and a bassinet/cradle is the newest product combination. It combines the comfort features of a bassinet’s basketlike sleeping area with the rocking capability of an old-fashioned cradle. Bassinets can be made of wood or molded plastic, and they offer just rockers or combine rockers with wheels that fold into the rocker frame.
Hammocks and motion beds are designed to allow parents to provide soothing motion and most offer a semi-upright position for babies, which is especially helpful if your baby has gas or reflux.
We don’t recommend hand-carried baby beds, sometimes called carrycots or Moses baskets, which are oval baskets with carry handles. Some safety warnings are in order for these beds because not all of them are made with the same quality and durability as full-size cribs. Often the mattresses supplied with the beds are flimsy, thin, and overly soft, and could be covered in inexpensive vinyl that isn’t breathable and traps moisture. In some cases there’s a gap between the mattress and the side of the basket that could allow a baby’s neck to be entrapped, causing suffocation. These small, portable baby beds are also difficult to balance, since the heaviest part of the baby is her head, putting most of the weight at one end of the carrier. And some Moses baskets come with a warning that you shouldn’t carry them with the baby inside, making us wonder, what’s the point of buying one?
BABY BED SHOPPING CHECKLIST
No matter what type of sleep arrangement you choose—whether a bassinet, a small crib, a cradle, a full-sized crib, or a combination of products—safety should be your number-one consideration. Here is a basic checklist to make your shopping decisions easier:
Sturdy construction. A baby bed should be firmly put together with no wobbling when jiggled.
Stability. Childproof leg locks are especially important if there are other children in the house, particularly toddlers. Check that the bed can’t be pulled over sideways. Keep casters locked except when you’re moving the bed.
Quality mattress. An extra-firm quality mattress won’t create a suffocation pocket around your baby’s face if she accidentally turns over—try punching your fist into the mattress to test it. And if you can fit two fingers between the edges or corners of the bed and the mattress, it could pose an entrapment or suffocation hazard.
Solid construction. For safety, the sides of a bassinet should be made of solid, unbendable material, rather than fabric over a tubular frame. Loose fabric sides could allow your baby’s neck, head, or limbs to get trapped in fabric pockets.
Washability. Bedding and liner fabrics should be completely washable. (Read the manufacturer’s instructions.)
Folding locks. Folding components, such as legs, frame, or canopy, should lock securely with no danger of collapsing.
Safe rocking and swinging. Beds with rounded rockers prevent it from tipping. However, they should not stick out so far that they pose a tripping hazard. Beds that hang and swing from a frame should have a locking mechanism to make them stationary. Beds with wheels should have locking casters to make them more stable and to keep children from pushing them around.
Fitted sheets. Elastic sewn around the corners makes fitted sheets less likely to be pulled loose and potentially entangle your baby. Buy three or four sets in exactly the same size.
Storage and travel options. Consider a compactly folding non-full-size crib if you have limited storage space or plan to use the bed for sleepovers away from home. (Plus it can be used a lot longer than a smaller baby bed.)
CRIB SAFETY SHOPPING CHECKLIST
Here’s what to look for when you shop for a crib for your baby:
Certification. A JPMA certified sticker means the crib brand passes a voluntary safety test overseen by manufacturers.
Easy-to-use side lowering. Try lowering the side yourself. A simple lift and knee-press action works more easily and is quieter than models that require the use of a foot pedal or a spring-action knob.
Frame and slat integrity. Make sure the frame doesn’t rattle when shaken. The slats should be firmly fastened at top and bottom, with no twisting or moving. Glue residue spilled out onto the wood is a sign of poor craftsmanship.
Proper finishes. All surfaces must be smooth and splinter free.
Single dropside. A crib with only one side that can be lowered (dropside) will be quieter and more stable than models that have two sides that lower.
Teething rails. Most models have a small plastic covering that lines the tops of the railings to prevent teething on wood or other surfaces. Make sure it doesn’t have sharp edges or broken pieces and make sure it can’t be pulled loose.
Mattress support. The metal support that goes under the mattress must be sturdy with no sharp points that could puncture the underside of the mattress. Make sure it fastens to the crib with strong, thick hardware.
Locking wheels. If the crib has wheels, they should be lockable to prevent a baby’s motion from “walking” the crib.
Underside storage drawer. Storage drawers that slide or roll out from under the crib can be useful, but check out their quality and how easily they open and close before paying extra for them.
CRIB SAFETY
Here are some tips to ensure that your baby’s crib is as safe as possible:
• Wait to tighten the bolts. Put the crib up a few weeks before you plan to use it and let it “settle”—allow the wood to expand or contract according to the temperature and humidity, and then tighten all the bolts and hardware.
• Inspect hardware. Make sure the metal hardware on the crib has no rough or sharp edges, in case your baby falls against it.
• Check teething rails. Periodically check the teething rails, which should run the length of the railing tops, to make sure they’re not cracked and don’t have any sharp edges.
• Check mattress support. Babies can fall from their cribs if the side rails are not at the right level in relationship to the mattress surface. Periodically adjust the height of the mattress supports under the mattress and adjust it to your baby’s height and abilities. When your baby learns to sit up, lower the mattress level so she can’t fall out or climb over the side rail. When she learns to stand, set the mattress level at its lowest point. When she reaches a height of 35 inches or the side rail is less than three-quarters of her height, move her to another bed.
Crib Assembly 101
Crib assembly is a two-person job, and it can be a relationship-testing experience, especially if neither of you is particularly handy.
Expect it to take two people of reasonable intelligence at least half an hour for the initial assembly (although, if it turns out you have missing or damaged parts and need to order replacements, it could take a month or more!) and plan to take 5 to 10 minutes to re-tighten the bolts and screws before you put baby in it for the first time.
Make sure you have the complete parts list and assembly instructions and all the hardware you need to put the crib together before you start to put the crib together. Never attempt to use a crib that is missing slats, spindles, or hardware.
If you don’t have the instructions or parts list, phone the crib manufacturer and have replacements sent to you before you begin to assemble the crib, so you won’t end up with a half-put-together crib lying around, or a potentially dangerous disassembly.
If the baby-gear store or catalog you order from offers crib delivery and assembly for free or at a reasonable price, that’s a huge perk. But be sure to keep the assembly instructions that come with the crib, because you will have to follow them backward to take it apart one day.
Make sure your crib is set up in the room where you intend it to stay, because once it’s built it will be too large to be rolled, intact, through most doorways.
• Use only fitted sheets. Babies can get entangled in loose sheets and blankets and strangle themselves. Use only tightly fitted sheets.
• Avoid “cushy.” Soft mattresses and padded quilts have figured in SIDS deaths and suffocations. Rather than using blankets, keep your baby warm by dressing her in a blanket sleeper. If you use a blanket, make sure your baby’s head remains uncovered during sleep.
• No crib bumpers. The American Academy of Pediatrics does not recommend using crib bumpers, because they pose a suffocation risk and restrict the flow of fresh air around a baby; some experts believe this restriction increases the risk of SIDS. In addition, once your baby grows into a toddler and starts climbing, the bumpers will give her a foothold to climb out of the crib.
• No blanket. Because of the potential for strangulation, don’t put a blanket in your baby’s bed. All you need is a crib sheet. Your baby should sleep in a bunting (also known as a sleep sac, blanket sleeper, or baby sleeping bag), a swaddling blanket, pajamas, a onesie, or just a diaper, depending on the temperature.
Time to Play or to Sleep?
When you put your baby in her crib to go to sleep, you want her to get the message that it’s time to go to sleep—not stay awake and play with toys or watch a stimulating mobile spinning around. It’s okay to put your baby down when she’s awake to watch her mobile or play with toys in her crib; otherwise you might never get a shower! But when it’s time to sleep it’s more restful for your baby—and safer—to remove the mobile and take the toys out of her crib.
• No pillow. Pillows are for children 2 years and up. Babies don’t need pillows for head support, and like crib bumpers and quilts, they create a suffocation hazard.
• No toys in the crib or hanging over it. Toys can suffocate and can also be used by your baby to climb out of the crib. Crib gyms and mobiles should be removed when she starts to sit or reaches 5 months of age, whichever comes first. Mobiles become strangulation or choking hazards if a baby can reach them or fall into them.
• Keep cords out of reach. Keep the crib away from windows, window blinds, and/or drapery cords. Children can strangle on window cords or can fall through screens. If it’s not considered a fire-escape hazard to use window guards, install them. Make sure that all drapery or window blind cords are out of your child’s reach. The CPSC has received numerous reports of strangulation deaths involving window blind cords over the years. To keep cords out of reach of children, use tie-down devices or take the cord loop and cut it in half to make two separate cords. Consumers should call toll-free 800-506-4636 or visit the Window Covering Safety Council Web site at www.windowcoverings.org to receive a free repair kit for each set of blinds in their home.
HOW TO CHOOSE A SAFE CRIB MATTRESS
Your baby will be sleeping on a crib mattress for approximately 2 years—and maybe a couple of years longer if you buy a pint-sized toddler bed that has the same dimensions as her crib. Firmness is more critical than internal structure or padding.
Granted, getting a quality mattress is important, but there’s no need to pay extra bucks because a salesperson convinced you that your baby needs extra back support. She doesn’t. Babies’ bodies are quite flexible. It’s the grown-ups who carry babies around who need the help.
There are basically two types of mattresses: innerspring and foam. Innerspring crib mattresses resemble miniature adult mattresses. Underneath the ticking are thick layers of padding, a series of metal coils, and thick metal support wires to hold up the edges of the mattress. Costlier innerspring mattresses generally have more coils than less-expensive versions, and the coils are made from higher-quality metal, such as steel. The quality and price of the mattress often depends upon the number of coils, such as 180 tough steel springs and steel-reinforced edges. Their advantage is that they offer variable support to different parts of your baby’s body as she grows and gains weight, but they are substantially heavier and less flexible than foam versions, which makes sheet changing a challenge. Plus, most tots like to use innerspring mattresses like trampolines, which could lead to falls and injuries.
Foam mattresses come in a variety of prices and grades. The higher the quality of foam, the more it weighs and the denser the mattress will be. Denser versions are less “squishy” when you squeeze them, while poorer-quality mattresses are mushier, which could create a suffocation pocket if your baby turns facedown.
Quality foam mattresses are really firm, almost like bricks— an advantage when it comes to preventing potentially dangerous “suffocation pockets.” They’re lighter than hefty innersprings, and have clear-cut corners that help keep fitted sheets on. Choose a thick, firm version from a name-brand manufacturer.
Federal regulations enforced by the U.S. Consumer Product Safety Commission (CPSC) mandate all crib mattresses to be the same length and width so that they fit flush against the sides of cribs. In turn, full-sized cribs must also have identical interior dimensions. But some mattresses may be deeper than others.
Sometimes manufacturers will claim that a mattress has “antibacterial” qualities. That means that an anti-bacterial chemical has been added to the vinyl used in the laminate to help destroy bacteria on the surface of the mattress. Unfortunately, a baby’s continual wetting is more than any surface material can handle.
Some mattresses claim they are “non-allergenic,” or “hypoallergenic.” That simply means they’re made of foam instead of cotton and other fibers that attract dust mites and that can cause allergic reactions.
Manufacturers will also use the selling ploy of a “lifetime warranty” to get parents to pay more for a crib mattress. But you’d better read the fine print, since the actual warranty may come with lots of loopholes in favor of the manufacturer, such as special conditions and a pro-rated payback scale that depends upon the age of the mattress.
We suggest using a snug-fitting washable pad to protect the mattress, turning the mattress over frequently, and following the manufacturer’s directions for cleaning (usually wiping the surface down with a mild soap solution and then cleaning off the soap residue using a cloth dampened with clear water).
Organic Mattresses and Bedding:
Are They Worth It?
When the term organic is applied to crib mattresses or bedding, it may mean that the fibers were produced using organic farming methods, or it may just mean that they are made of materials thought to be non-toxic for babies. Most are made of unbleached or “natural” cotton and/or materials that don’t contain phthalates, including polybrominated diphenyl ethers (PBDEs), or polyvinyl chloride (PVC), polyurethane foam, and other fire-retardant chemicals.
By law, though, even organic mattresses must meet certain standards for flame retardancy. And that means treated with chemicals. Boric acid, formaldehyde, melamine, antimony trioxide, vinylidene chloride, zinc borate, and decabromodiphenyl oxide are all either suspected or known carcinogens or developmental toxins12 used in making mattresses flameproof, and there’s no requirement that a manufacturer of mattresses, organic or otherwise, reveal what chemicals were used to get the mattress up to standard. And, since cotton mattresses are highly absorbent (and breeding grounds for dust mites), “all-natural” mattresses will still contain plastics in their water-resistant barrier.
All-cotton sheets and blankets wick moisture away and allow your baby’s skin to breathe. Some parents are concerned about pesticide residues that are thought to remain embedded in typical cotton bedding. If that’s your concern, then you may want to seek out organic cotton sheets, which may be pricier than non-organic versions. Again, they may have been treated with any number of chemicals, as there is no agreed-upon definition or legal standard for what organic means when it comes to non-food products. For any sheets or bedding, launder in fragrance-free detergent before use.
CRIB SHEETS AND MATRESS PADS
Start out with at least three fitted crib sheets. Don’t try to use other sheet sizes, such as twin-sized fitted sheets tucked under the crib mattress, because they can come loose and create a strangulation hazard.
There are newfangled crib sheets that are easy to remove and replace. They have either zipper or Velcro tops, or have corners that snap onto the crib bars, which can be very helpful.
If you use the conventional crib sheets that need to be tucked under the mattress, select a crib with casters (pivoting wheels) or one that allows easy access for tucking in the sheets.
Crib mattresses are waterproof, but having an extra pad between the mattress and fitted sheet can help with cleanup in case of diaper leaks or spit-up incidents. However, a mattress pad will also create more laundry and one more bodily-fluid-soaked item to hassle with in the middle of the night, so consider it optional. If you use one, it should fit snugly on all corners with elastic, so there is no danger of it becoming lumpy or bunching up.
Since babies are sensitive to aromas and laundry chemicals, sheets and bedding should be laundered in hypoallergenic, fragrance-free liquid detergent. If you use fabric softeners, make sure they are also fragrance-free. Powdered detergents don’t completely rinse out and may cause an allergic skin reaction and may affect the sheet’s absorbency.
The biggest advantage to using a portable crib is that it will be slender enough to roll through most doorways, and unlike bassinets and most cradles, it will offer a clear, unrestricted view of the baby from all sides. Typically, such cribs can be used with a baby of up to about 2 years of age and weighing between 40 and 50 pounds, so it will be good for much longer use than a bassinet. Most offer a lowering floorboard that allows the crib to be used as a small playpen later.
On the downside, miniature cribs are heavier than bassinets and some other baby beds; they also cost more. Only a few models have sides that lower, so they may be less convenient to place baby in or lift him out. Some may require non-standard-size sheets and offer only a single mattress height. Of course, they are also subject to other safety concerns, such as soft mattresses, sharp-edged hardware, and poorly secured floorboards.
BASSINETS
Bassinets are small beds on a stand that are much more compact than portable cribs. Some come with electronic extras, such as vibrations, small night-lights, or musical features that are operated with buttons.
It’s worth noting that extra electronic perks eat up a lot of batteries, and you (and your baby) may not find them all that pleasing. On the other hand, a bed that rocks itself or vibrates could help temporarily soothe your baby when you’re at wit’s end. Just don’t expect it to convince your baby she’s not hungry!
The bassinet’s narrow dimensions and its wheels allow it to be rolled through doorways, something full-size cribs can’t do. Some newborns appear to prefer being in small, enclosed spaces.
The negatives are that bassinets are generally limited to babies weighing up to 15 pounds. Mattress pads tend to be soft and cushy, which could affect a baby’s air supply if she accidentally rolls facedown. Closed sides shut out airflow, potentially making the bed stuffier and increasing the risk of SIDS.
Fitted sheets may be hard to find in off sizes, and loose sheets pose an entanglement or even a strangulation danger. The long narrow design of bassinets makes them vulnerable to toppling and sometimes leg locks fail, causing the bed to collapse. You may strike your baby’s head on the rigid hood, especially if you’re using the bassinet in low-light conditions. Bassinets with tubular frames and fabric liners to keep the baby in place have been recalled when the liners allowed babies’ limbs, heads, or entire bodies to become trapped between component parts.
BEDSIDE SLEEPERS
Bedside sleepers resemble small cribs or “sidecars” that attach onto the side of an adult bed and keep an open side toward the bed so a baby can easily be lifted from sleeper to bed and back. Some allow the open side to be closed for use as a portable bed or changing station.
The concept is to give parents easy access to their babies without the risks of SIDS and suffocation that occur when babies sleep in their parents’ beds.
They’re especially handy if you’re nursing and want to be able to move the baby in and out of your bed without getting out of bed yourself. However, placing babies in a bedside sleeper after they have fallen asleep at the breast means rousing them and removing them from the warmth of their parent’s body. Putting them onto the cold sleeper surface is likely to awaken them (but placing them in a crib or other bed can do the same thing).
Some parents dislike that the co-sleeper gets in the way of their getting in and out of bed, an unavoidable side effect. To get the baby in and out of the co-sleeper, you must sit up in bed, twist at the waist, and lift, which can be difficult and painful if you have recently undergone a c-section.
As with bassinets and other baby beds, these beds should have no gap between the railings that could capture and strangle a baby if her body slips through; and be sure to follow the manufacturer’s instructions to the letter about how the co-sleeper is fastened to the side of your bed. Make sure it is completely flush with your mattress.
MOTION BEDS AND HAMMOCKS
One advantage to waiting to buy a crib until after you give birth is that you have ample time to explore all your infant bed options. Springing for a hundreds-of-dollars designer crib (motion bed-hammock) may seem like a wild move while you’re pregnant, but if your baby turns out to be bothered by reflux or to be the sort that demands constant motion to fall asleep, you may find that a motion bed is your best option.
Night-lights and Baby Sleep
Dimming the household lights in the evening may be one way to encourage your baby to become a more predictable sleeper, especially at night. A study of baby sleep found differences in day and night sleep patterns between 1- and 3-month-old babies exposed to bright lights at night, such as when parents turned on an overhead light to feed or diaper their babies versus those who cared for them in dim light or in darkness. Babies handled in dimness or dark developed more regular day- and night-sleep patterns than those exposed to bright lights at night.13
The hammock style allows the baby’s head to be higher than her belly, which can help if she has GER (gastroesophageal reflux), and its swaying motion helps soothe your baby to sleep.
Whatever model you decide upon, make sure there are no suffocation pockets or places that could capture your baby’s head, neck, or limbs, and make sure that there is no danger that your baby could fall out.
Here are a few tips and products that can make your baby’s room comfortable, safe, and conducive to sleep:
1. Blackout shades. Newborns spend half of their time asleep. At first, it won’t matter how bright or dark your baby’s nursery is. But, once the production of the hormone melatonin begins at 12 weeks, keeping her room dark may help her sleep longer in the mornings, rather than waking up like a rooster at the first light of the day. Blackout shades are also most helpful for when you have to put the baby to bed in the summer months, when it can be as bright as daylight in the evening.
2. Night-light. For all of those nighttime trips to the crib (at least three or four a night for the first weeks), you’ll want a nightlight to keep you from stumbling into furniture or having to turn the overhead lights on completely. You may have heard that night-lights can cause baby nearsightedness, but that isn’t true (nearsightedness is caused by having nearsighted parents); however, light exposure, even to electric lights, can disrupt both baby and human sleep cycles, making the deep-sleep phase shorter. So you want a night-light that’s just bright enough to do the job.
3. Ventilation and humidity. Proper ventilation and a clean environment are important for a baby’s good night sleep. One 2008 study appearing in the Archives of Adolescent &Pediatric Medicine appeared to show that sleeping in a room with an open window cut the risk of death from SIDS by 36 percent, while sleeping in a room with a fan lowered the risk by 72 percent.14
Also, a dry, dusty room can lead to a stuffy nose, and that can disrupt baby sleep. Because of babies’ tiny nasal passages and delicate tissues, it only takes a little swelling to cause blockage. (A few drops of infant saline solution work better than a nasal aspirator, which can cause swelling in the nasal passages.)
A cool-mist humidifier will help keep nasal discharge from drying out and backing up, especially in the winter months when household heating systems dry out the air. A fan and open bedroom door will also help air circulate in the house, and can provide some soothing “white noise,” too. If weather and safety permit it, open a window to let in some fresh air also.
4. Comfortable temperature. The thermostat for your baby’s room should be set to between 65°F and 72°F (18–22°C). Newborns are comfortable at the same temperature as adults,but babies have a hard time regulating their body temperature, and are less able to cope if it’s too hot or too cold. Fresh air is a good thing, but position the crib away from heating and air-conditioning vents and direct drafts.
5. Toy basket. Newborns are generally uninterested in anything that’s not mom. But when your baby gets to be about 3 months old she’ll start to grasp objects and stuff them into her mouth, and at that point you’ll want a place to toss all her loose toys. A simple basket is a great place to store them in the nursery.
6. Crib tent. If your baby is going to be sleeping in a crib and you have cats, then a crib tent is a must. Cats are naturally attracted to the cozy, safe perch a crib provides, and they’re also attracted to the warmth of a sleeping baby. We know your kitty is a saint, but babies have been scratched and even suffocated by felines looking for somewhere to nap. Employing a tent is not a good safety measure for a climbing toddler, though; children can become dangerously trapped between the crib tent and crib rails. Once your child becomes able to climb out of the crib, it’s time to transition her to a toddler bed.
7. Clear path from door to crib. Your baby doesn’t care how tidy her room is, but you should always have a clear path from the door of the room to the crib, even if you have to use a snow shovel to achieve it.
8. Rocking chair or glider with comfort items. You’ll be visiting the nursing station one to four times a night for the first year or so, so you’ll want a comfy rocking chair with a footrest. Within arm’s reach: books and magazines nearby to catch up on reading; breast pads; burp cloths, and paper towels in case of spit-ups; pacifiers, if your baby uses them; powdered formula, bottles, and nipples, if you’re bottle feeding; and bottled water if there’s no sink nearby, for middle-of-the-night mixing and for the thirsty caregiver.
9. Arm support. Holding your baby to nurse can put a strain on your arms and shoulders and can quickly become tiring. A semi-circular nursing pillow that fits around your waist, such as a Boppy, can be an important comfort item to reduce the strain.
10. Diaper changing station. You’ll want to have a place in your baby’s room (or yours) dedicated specifically to diaper changing, something you’ll be doing hundreds of times over the coming months. It helps to take the diapers out of their package ahead of time so you don’t have to fumble with packaging with a baby in your arms.
11. Wipes and wipe warmer. Some parents opine that warmed wipes are the height of frippery, but we say if it helps you accomplish a quick change without fully rousing the baby, it’s money well spent.
12. Paper towels. You’ll want a roll of these handy for spit-ups, blowouts, and the like.
13. One-handed or hands-free diaper pail or trash can. You don’t want to be wrestling with a diaper pail in the middle of the night while you’re holding a stinky diaper! Before you bring a diaper pail home (or add it to your baby registry) make sure that it can be operated with one hand or with a foot pedal. Also opt for a pail that uses regular trash bags, and not special refill bags. Not only are regular trash bags cheaper, but also you’re less likely to run out of them, because they’re more readily available. A trash can with a lid that springs closed is even better, because it holds more diapers, and after your child is potty trained, you can put it to other uses after a thorough cleaning.
14. Plastic laundry hamper. You’ll need a place to store soiled baby clothes and linens until you can get them to the washing machine. It’s always when you least expect it that your baby throws up in bed or has a diaper blowout.
15. No clocks. Do you really need to know what time it is when you’re up feeding the baby for the third time? No, you don’t.
Preventing Baby Nasal Congestion
• Keep baby’s room vacuumed and dusted. During your last weeks of pregnancy, use your nesting urge to fuel giving the baby-to-be’s room a good once-over, dusting surfaces such as baseboards, bookshelves, and ceiling-fan blades and vacuuming. After baby’s born, touch up as necessary and your energy permits.
• Use a fan. Having a fan circulating air can help reduce dust and may also help prevent SIDS.
• Buy an air filter. If your baby’s room has poor ventilation, seems to get dusty in a hurry, or your baby is constantly congested, consider buying a HEP A (high-efficiency particulate air) filter for her room.
16. A baby monitor with volume control. The big plus to having your baby sleep in her own room is that you won’t be awakened by every little snuffle. Unless your bedroom is so far way from your baby’s you can’t hear her cries, or your baby has an exceptionally weak cry, you may find that the monitor is more of an irritant than a help at night. Most babies are quite capable of crying loud enough for caregivers in adjoining rooms to hear.
However, for naps, it can be helpful to have a way to keep tabs on baby from farther away.
SOUND MACHINES AND CDS
Babies appear to be soothed by specific sounds that mimic what they heard in the womb. For some babies, monotonous sleep sounds, such as canned white noise similar to radio static, appear to encourage slumber. Infant studies show that babies can also be soothed by the sound of the human heartbeat (and are roused and start to cry at the sound of other babies’ crying). The droning of a vacuum cleaner also seems to work with some babies, as does the humming of a car engine or a clothes dryer, which you can record for an hour or so, and then play back to your baby.
“It took a few months for us to realize that the baby monitor wasn’t helping us, especially at night. One of us (usually me) would jump up every time there was a sound. Finally we decided just to turn it off, trusting that if our baby really needed us, he’d let us know.”
—Diane M.
There are also specific “go-to-sleep” CDs that you can order online. These recordings generally contain a white-noise track along with a choice of heartbeat sounds combined with lullaby-like music and nature sounds, such as a rainfall or pounding surf. You can also download sleep sounds from the Internet in MP3 format onto your computer or iPod. And sleep machines with similar sounds are also available, but with varying sound quality.
You may discover that your baby couldn’t care less about the special sounds you play for her, particularly if her wakefulness has to do with hunger, discomfort, or missing your physical contact. Some parents find that having the volume loud works better than quiet sounds. On the other hand, an adult or baby machine may be helpful for a toddler’s room to help mask traffic noises outside or the cries of a newborn sibling.
Dangerous Crib Toys
We don’t recommend teddy bears or other stuffed animals with embedded, battery-operated heart sounds. Safety issues are the problem. Inquisitive babies and toddlers shouldn’t be left alone with products that contain batteries, nor should soft objects, including stuffed animals, be kept in the crib, because of their suffocation potential. Similarly, sound makers and lights should not be fastened inside your baby’s crib, since she could fall into them and get injured.
A potential downside to using sounds to soothe your baby to sleep is that she may get so attached to having a specific sound or CD played as she goes to sleep that she becomes dependent on it. Problems can arise when the CD becomes scratched or lost, or you need to travel somewhere without your sound machine. If you find a CD that works, it’s a good idea to make copies of it right away.
BABY MONITORS
Nursery (or baby) monitors use electronic transmitters and receivers to allow you to hear your baby’s every whimper and snort from another room or even when you’re on the way to the mailbox. Monitors have two basic parts: a transmitter that sends a baby’s sound—or sound plus image—and a receiver that you carry around to pick up on your baby’s signals. It’s important to remember that monitors don’t make babies sleep better, nor do they protect your baby from SIDS, but they can allow you to keep tabs on your baby when you’re out of earshot.
Monitors vary in quality and sensitivity. Some have multiple channels that let you select the best “station” for your location. Their biggest problem, other than eating up batteries, is that they may make you hypersensitive to your baby’s every move and snuffle as she stirs in the night, which could interfere with your dropping off into the deep sleep you so desperately need.
Some parents purchase video monitors, which allow them to see their babies as well as hear them. And some video versions equipped with special lenses can pick up the baby’s image even in dim light. The question is whether you really need to watch your baby sleep or awaken, since most babies are quite vociferous in signaling their parents when they’re awake and want to be picked up. And, as with audio monitoring, video images offer no insurance against SIDS, since you can’t tell from a tiny screen whether your baby is breathing or not.
NIGHT-LIGHTS
Given that you’ll be waking up over and over to tend to your baby in her first year, some type of dim lighting system is needed that won’t be so glaring that it will startle your baby or keep her awake. You need just enough light to change diapers if you have to. You have a choice between lights that you have to manually turn on and those that automatically turn on when the ambient light becomes dim, which may be an advantage. Note: Night-lights attract tots as playthings and could present a shock hazard.
ROCKING CHAIRS AND GLIDERS
A good rocking chair or glider with supportive armrests can be an indispensable piece of baby equipment. Rocking, especially the vigorous kind, appears to have the powerful effect of relaxing babies and helping them to drift off into sleep. Premature babies who were rocked in small hammocks in NICUs were found in one study to gain more weight and get to go home earlier than babies planked out on flat beds with no motion, so there’s something to be said for the effects of movement not only on baby soothing, but also on baby development. A comfortable leg rest, such as a footstool or hassock, will make the chair much more comfortable.
SCENT SOOTHERS
The sweet, camphor-like scent of lavender blossoms is thought to act as a potent relaxant and soother. Unfortunately, the research on the effects of lavender on babies is scant, and side effects are unknown. It’s worth noting, too, that there are many varieties of lavender, with only certain types, specifically Lavender offininalis and Lavender augustfolia, thought to carry relaxation properties. Dab a small amount of oil extracted from one of these types of lavender onto the bottom sheet of your baby’s crib at the opposite end of where she sleeps to see if it helps her to relax, keeping it well away from her skin and at a good distance from her sensitive nose.