Co-sleeping

 

Should you let your infant share your bed? Or are the risks—primarily SIDS—so great that the practice should be avoided?

Competing Opinions

Perspective #1: Co-sleeping increases the chance of your child being smothered inadvertently (by you or by the covers) and increases the risk of sudden infant death syndrome (SIDS) or one of the other types of sudden unexpected infant death (SUID). In 2016, the AAP even released a new policy statement that bed-sharing should definitely not take place for the first six months, and preferably not until the baby turns one. Also, bed-sharing often leads to less overall sleep for both child and parent, at a time when meaningful rest is both crucial and hard to come by. Plus, once your child gets used to sleeping with you, it can be hard to get him to stop. It’s best not to co-sleep with your baby.

Perspective #2: While there are certain risks that come with co-sleeping, the rewards far outweigh them. Parents all over the world sleep with their babies. For many parents there’s a strong instinctual drive to sleep next to their newborn, and their family and cultural traditions support that drive. Plus, having the baby sleep close to the parent promotes bonding and more effective breastfeeding, both of which are important developmental processes. And while some claim bed-sharing prevents sleep for both baby and parent, many parents swear that it actually promotes it, since the baby can be more easily, quickly, and conveniently soothed when she wakes during the night. As for getting babies to sleep in their own bed when the time comes, there are plenty of ways to make that transition when it’s time. As long as careful safety precautions are taken, co-sleeping can be rewarding and beneficial for both parent and child.

What the Science Says

DESPITE THE AAP’S warning against it, co-sleeping has quadrupled in U.S. homes in the last twenty-five years as families have increasingly valued parent-child bonding. The AAP position, understandably, as it seeks to keep babies as safe as possible, appears to emerge from an abundance of caution, since the science isn’t quite definitive on the issue. For example, some studies correlating SIDS and bed-sharing have failed to take into account the type of sleeping environment, such as the surface the baby was sleeping on at the time. (Soft cushions are much less safe than a firm mattress.) As of this writing, almost no reliable data exists from rigorous studies that have examined the question while considering sleeping surface. The small amounts of data that do exist suggest that after three months of age, there is little or no additional risk of SIDS for babies who share their parents’ bed, if precautions are followed. For younger newborns, the danger appears to increase, but still can be relatively insignificant for babies when there are no risk factors present. However, and this is important, if certain risk factors do exist—if parents drink or smoke or use drugs, or if the child was born premature or with other health issues, or if caregivers are not following safe co-sleeping guidelines—the concern is greater, and it’s not safe to co-sleep. (Smoking seems to correlate especially strongly with the risk of SIDS.)

Several studies have also shown that co-sleeping correlates with important positive outcomes, such as better sleep, more stable infant heart rates, improved parent-child bonding, mutual soothing, and more effective and consistent breastfeeding. That being said, negative effects be- yond the risk of SIDS have been found as well. A recent study showed that “maternal distress” sometimes correlates with co-sleeping beyond six months, in that mothers who share either a room or a bed with their infants are more likely to feel depressed and criticized for their decision.

The Bottom Line

SIDS AND SUID are valid concerns when it comes to co-sleeping, and it’s likely safest not to have your young infant in the bed while you sleep. But the science isn’t quite as clear as many believe, partly because the research typically hasn’t looked at enough specifics to parse out which co-sleeping practices are safe and which are not, so they often lead to generalized conclusions or recommendations that co-sleeping is “safe” or “not safe.” My best understanding of the research is that co-sleeping can be safe or unsafe, depending on how you do it and what risk factors are present. For example, it’s actually less likely, statistically speaking, that a typically healthy baby will die of SIDS than be hit by lightning at some point in his life. Still, it’s a risk, one with unthinkable consequences. If, based on your values, instincts, traditions, and situation, you decide to co-sleep, you can do it in safer ways or in unsafe ways, so it’s very important that you follow up-to-date safety guidelines and discuss the decision with your pediatrician.

For example, you should never co-sleep in a recliner or on a sofa or beanbag or anything of the sort. Also, you shouldn’t co-sleep, under any circumstances, if you or anyone else in the bed has been drinking, using drugs or medications that have a sedative effect, or if you or anyone else in the house smokes. Likewise, you should follow the standard advice for all babies, including making sure they’re sleeping on their back, are wearing light clothes, and are not surrounded by bulky, soft bedding or stuffed animals. Similarly, some authorities recommend that you avoid co-sleeping if you aren’t breastfeeding, primarily because your biological rhythms aren’t as “synced up” with your child in that case. If you do decide to share a bed, make sure that you’ve created the safest possible environment by minimizing pillows and blankets, removing side rails that could entrap the baby, not having other children in the bed, assuming a safer co-sleeping position, and so on. This paragraph isn’t meant to be fully comprehensive regarding every precaution. If you choose to co-sleep, search online for the latest information from reputable sources and talk to your pediatrician, so you can mitigate the risk and make sleeping with your infant safer.

An even safer, hybrid solution that offers many of the benefits and less of the risks, and that is preferred by many parents, is to co-sleep on separate surfaces. You can use a “co-sleeper,” a bassinet that hooks onto your bed and allows your baby to sleep right next to you but sidesteps many of the dangers described above, or you can place the crib near your bed. If you want the potential benefits that come with co-sleeping but want to be as safe as possible, this is a great solution.

On a Personal Note

I LOVED USING a co-sleeper bassinet with all of my infants the first couple of months. I felt better having them close to me so that anytime I woke, I could check on them, change them if necessary, nurse them, and then put them back to sleep more easily. It also made it easier to pull our sons into our bed to hold them, or for my husband and me to chat while the baby was there with us and happy, just hanging out, especially in the early days when I was recovering from delivery. It was easy to see that our babies were happiest, felt safest, and rarely cried when they were physically close to us. And, I felt safer having them co-sleep on a separate surface, rather than in the bed.

Then when the babies outgrew the co-sleeper, or when I was ready for them to move out of the room, which was at different ages for each of our boys, I liked having them in the crib in their own room, which the kids shared with one another. I found that I slept much better knowing they were safe, and that I didn’t wake every time my baby made a noise or moved. Since I was nursing and did a lot of babywearing, I also needed the physical break at night so that I could be ready to do it again the next day.

The claim that parents should avoid co-sleeping because the baby will never learn to sleep in their own bed holds little weight for me. The same goes for the worry that the presence of a child in the family bed for a while will interfere with the couple’s sex life. Kids do learn to sleep in their own bed, and there are plenty of ways to maintain relational intimacy for the couple.

Fear-based, future-focused parenting often keeps us from fully attuning to who our children are at a particular point in their development, and it ignores how much things change in development month to month and even week to week. Those parental worries just aren’t rational when we understand development. Kids need different things from us at different times. The concern that letting a child sleep in your room will mean they won’t ever learn to sleep by themselves is as silly as saying, “If you let them use a diaper they won’t ever learn to use the toilet.” Each child is different, and each parent is different, and the reason our kids like to sleep near us is because it helps them feel safe, and it feels good to them. A lot of adults prefer not to sleep alone as well! This makes sense. Sleep, from a survival standpoint, is a very vulnerable time, and we’re less vulnerable if there are others in close proximity to alert and wake us for safety and protection.

As for the sex argument, if there’s a kid sleeping in your room, then have sex somewhere else in the house. Some creativity may be required, but a little novelty might come in handy right now as well!