By Jan Tedder, BSN, FNP, IBCLC; President of HUG Your Baby; See Roadmap to Breastfeeding Success Online Course
One problem with this controversy is that the terms “bed-sharing” and “co-sleeping” are often interchanged. “Co-sleeping” means that the baby sleeps in close proximity to the mother—and either on the same surface, or not. “Bed-sharing” means that the baby sleeps on the same surface, and in the same bed, as the parent.
A 2013 study
concluded that “infants who share a bed with their parents during the
first three months of life increase their risk of SIDS by five times – even if
the parents don’t smoke, don’t use alcohol, and are exclusively breastfeeding”
(Carpenter et al., 2013). The American Academy of Pediatrics recommends
“room-sharing” (AAP, 2011), as does the Canadian Public Health Agency (Public Health Agency of Canada,
2012). Both these professional
groups conclude that it is safe for a mother to feed the baby in her bed and
then return the baby to the baby’s bed for sleeping.
Given the
complexity of the data on bed-sharing, co-sleeping and room sharing, it is not
surprising that other leaders
in lactation and pediatrics draw different conclusions from the SIDS and
sleep-related death literature, and from the literature on breastfeeding and
infant sleep.
Dr. William
Sears (Sears, n.d.), Dr. Nils Bergman (Morgan, et al., 2011), Professor Helen Ball of the
Parent-Infant Sleep Lab (Ball,
2011), the UK’s National
Childbirth Trust (NCT, n.d.), the Australian Breastfeeding
Association (ABA, n.d.), and Dr. James McKenna of the
University of Notre Dame’s Mother-Baby Behavioral Sleep Laboratories (McKenna, 2014) all conclude that there are
important benefits of co-sleeping and that parents should make their own
decision based on all available facts.
• if the baby is exposed to
smoking in the home;
• if the mother smoked prenatally;
• if the adult has consumed
alcohol, illicit drugs, or sleep-inducing drugs;
• if the adult is experiencing
extreme fatigue;
• if the adult is obese;
• if the bed is excessively
soft, or contains pillows or loose blankets;
• if there is a possibility
that the baby might over-heat;
• if the bed is also shared
by a sibling or pet.
In addition,
UNICEF discourages co-sleeping for babies born prematurely (UNICEF, n.d.).
Breastfeeding
advocates may wish that expert guidelines were clearer and simpler. It would
help us all if the sleep literature reached firm, universal conclusions that
BOTH enhance breastfeeding initiation and duration, AND promote safe sleep.
However, because the literature and recommendations are ambiguous and highly
qualified, and vary from state to state and country to country (Blair, 2008), those who promote breastfeeding
must stay aware of this controversial issue and provide a range of up-to-date
resources to parents who are considering where their baby will sleep (UNICEF, n.d; NC Healthy Start
Foundation, May, 2014; ABA, n.d).
REFERENCES:
AAP Task Force
on SIDS. (2011). SIDS and other sleep-related infant deaths: Expansion of recommendations
for a safe infant sleeping environment. Pediatrics. 128(5),
e1341-1367.
Ball, H.
(2011). Bed-sharing and co-sleeping: Research overview. Retrieved from
Blair, P.
(2008). Putting co-sleeping into perspective. Journal de Pediatria. 84(2).
Carpenter,
R., McGarvey, C., Mitchell, E., Tappin, D., Vennemann, M., Smuk, M. &
Carpenter, J. (2013). Bed sharing when parents do not smoke: Is there a risk of
SIDS? An individual level analysis of five major case-control studies. British
Medical Journal 3(5).
Kendall-Tackett,
K., Cong, Z. & Hale, T. (2010). Mother-infant sleep locations and nighttime
feeding behavior. Clinical Lactation 1, 27-31.
McKenna, J.
(2014). Safe Cosleeping guidelines. Retrieved from http://cosleeping.nd.edu/assets/32946/new_knowledge_new_insights_and_new_recommendations_2003.pdf
Morgan, E.,
Horn, A. & Bergman, N. (2011). Should neonates sleep alone? Biological Psychiatry.
70(9), 817-825.
NC Healthy
Start Foundation. (May, 2014). Infant Safe Sleep/SIDS. Retrieved from http://www.nchealthystart.org/public/babysleep/multimedia.htm
NCT. (n.d.).
Co-sleeping and bed-sharing. Retrieved from http://www.nct.org.uk/sites/default/files/Co-sleeping%20and%20bed-sharing.pdf
Public
Health Agency of Canada. (2012). Preventing sudden infant deaths in Canada.
Retrieved from
Rigda, R.,
McMillen, I. & Buckley, P. (2000). Bed-sharing patterns in a cohort of
Australian infants during the first six months after birth. Journal of
Paediatric Child Health 36, 117-121.
Sears, W.
(n.d.). Benefits of co-sleeping. Retrieved from http://www.askdrsears.com/topics/health-concerns/sleep-problems/scientific-benefits-co-sleeping
By Jan Tedder, BSN, FNP, IBCLC
©HUG Your Baby 2015