Should You Be Co-Sleeping with Your Newborn?

Perhaps one of the most hotly debated topics when it comes to newborn babies is co-sleeping. There are certain risks involved in this practice along with many widely circulated myths. Ultimately, it's not a practice that is encouraged by medical or safety authorities, but in the end, it's up to the parents to decide. Please note that "co-sleeping" refers to having a baby in the same bed with the parents. Often, the term is used to describe having a child in the same room, but this isn't what is being discussed in this article.

Hazards of Co-Sleeping

According the Centers for Disease Control and Prevention (CDC), about 4,500 infant deaths each year can be contributed to sudden unexpected infant death (SUID). Most of these deaths occur during sleep and can be attributed to SIDS, or accidental suffocation or strangulation. It is the leading cause of death among infants.

There are several hazards of placing a newborn baby in bed with adults. The most glaring hazard is the risk of a parent rolling over a tiny newborn. According to the American Academy of Pediatrics, the number of infant deaths associated with co-sleeping quadrupled over a 20 year period, though the reason for this is unknown. However the number of deaths of infants who slept in their own bed has remained constant.

Another risk of co-sleeping with a newborn is suffocation. A study, published in Pediatrics, the journal of the American Academy of Pediatrics, found that babies who share beds with their parents experience more oxygen de-saturation during the night. The study found that this was related to a much warmer microenvironment and that babies who co-sleep also experienced more re-breathing (inhaling CO₂ that had previously exhaled) events as a result of head covering by things like bedding or parents clothing.

There is overwhelming scientific evidence that points to co-sleeping as being dangerous, especially for newborn babies. Another startling article from Pediatrics looked at 119 cases of infant deaths in which the infant died of SIDS, accidental suffocation or undetermined causes and found that in 75.9 percent of those deaths babies were sleeping on a surface not intended for babies to sleep on. The article also noted that 47.1 percent of those cases occurred in co-sleeping situations.

According to the policies of most child health experts, there is simply no way to share a bed with a baby safely. Co-sleeping parents often point to the work of Dr. James McKenna Ph. D., an anthropologist who runs Notre Dame's Mother-Baby Behavioral Laboratory, which states that parents should co-sleep with their babies. But this is not entirely true.

Dr. McKenna says that each parent should make the choice for themselves. His website does offer some "safety guidelines" on co-sleeping, and most of them concur with the recommendations of the American Academy of Pediatrics, Centers for Disease Control and Prevention and other authoritative bodies, with one major exception. These groups maintain that there is no safe way to co-sleep with a newborn. However, Dr. McKenna's own website illustration, which depicts a "safe" co-sleeping environment, might be viewed as hazardous since there remains the possibility for the child to fall off the bed.

Other hazards of co-sleeping include the risk that the baby will fall out of the bed or become trapped in cracks and spaces in the bed. Even a mother's long hair poses a strangulation hazard.

The current recommendations from the American Academy of Pediatrics include:

• Newborns should be in the same room with its parents, but in a separate bed with a firm mattress.
• They should also be placed on their backs, and have no pillows or loose bedding that could pose a suffocation or strangulation hazard.
• Positioning devices, like wedges, should be avoided.

Benefits of Co-Sleeping

Many parents who choose to co-sleep with their children believe that doing so creates a stronger bond with their children, encourages breastfeeding and creates a more secure and independent child. The vast majority of these parents also adhere to the "attachment parenting" philosophy.

One notable benefit for some is that co-sleeping can make breastfeeding a baby easier, and by making breast feeding easier, mothers are more likely to breastfeed longer. It's true that for some women, co-sleeping would be more conducive to breastfeeding.

Some parents say that they and their babies sleep better in the same bed. Some also say that their baby's sleep cycle adapts to their own much faster so everyone gets more rest. Since quality of sleep is highly individual, this may be true for some.

The problem is that most of the evidence for these benefits is anecdotal. There is simply a lack of positive evidence to support putting an infant in bed with his or her parents, and the majority of these benefits can be achieved by having the baby in the same room, but not the same bed.

Using Co-sleepers

There are several devices on the market designed to make co-sleeping with an infant safer. Whether it's a basket in the bed with the parents or a bassinet-like device attached to the side of the bed, these devices can prevent parents from rolling on top of or suffocating their babies. These devices also prevent the baby from falling off the parents’ bed.

When looking for a co-sleeper, look for one that has some type of rigid frame to it. This will keep parents from being able to roll over on top of it. One of the best designed co-sleepers is the one that attaches to the side of a parents bed. It allows for the baby to be in a separate area of the bed with a very short (perhaps a couple of inches) barrier that a mother can easily reach over and touch her child. But it also allows the sleeper to be detached from the bed with a full side so that the child can be moved into its own space gradually, making the transition from the parent's room to the child's own room easier.

In the end, each set of parents will need to decide together what works for their family. The overwhelming evidence demonstrates that co-sleeping is not safe or necessary for a strong bond between parents and their children. It's important for parents to remember that the safety of their precious baby is paramount always.

Sources:

• Centers of Disease Control and Prevention
• Pediatrics: US Infant Mortality Trends Attributable to Accidental Suffocation and Strangulation in Bed From 1984 Through 2004: Are Rates Increasing
• Pediatrics: Hypoxic and Hypercapnic Events in Young Infants During Bed-sharing
• Pediatrics Vol. 106 No.3. September 1, 2000, pp. e41
• American Academy of Pediatrics