It’s time we got real about infant sleep.
Be honest. When your pediatrician asked you if your baby was sleeping in a crib, did you lie and say yes even though your baby was actually sleeping with you in your bed? If you did, you’re not alone. Far from it.
A new survey from the Lullaby Trust in the U.K. shows that 9 out of 10 parents of infants have practiced bedsharing. The same survey showed that only 4 out of 10 parents were given information on how to do this safely.
Why do parents bedshare?
The most common reason cited is to breastfeed in the night with little disruption for parent and baby.
As we know, breastfed babies nurse frequently because human milk is easily digested. Many breastfeeding parents find bedsharing makes nighttime nursing less disruptive, resulting in more sleep overall. Parents who bedshare generally continue breastfeeding longer than parents who don’t.
Bedsharing is not a new trend. We’ve been keeping our children close to us, day and night, for all of human history. It’s common in many parts of the world, including across Asia, Africa and Central and South America. It’s mainly the Western world that tends to see it as a controversial topic.
Why is bedsharing so taboo in the Western world?
The practice of sleeping in separate spaces from our babies is largely cultural. In the U.S., independence is a very important value, and we believe that it must be taught to our children from day one. The ability to sleep in separate spaces from our children is seen as “normal” and as a sign of healthy development.
Nobody wants to be lectured to or shamed by their child’s provider, so parents tend to keep information about their child’s sleep to themselves. Unfortunately, many U.S. pediatricians are using the “just don’t do it” approach, which is missing a huge opportunity to provide helpful information on how to safely bedshare.
Another reason for the Western focus on separate sleep is the correlation that’s been made between Sudden Infant Death Syndrome (SIDS) and bedsharing.
SIDS is complex and we still don’t understand what causes it, but bedsharing is often cited as one of the risk factors. This is why many U.S. pediatricians tell parents to never share their bed with their baby.
When we examine the data more closely, we find that the deaths blamed on bedsharing involved other risk factors, such as parental smoking, not breastfeeding, babies sleeping on their stomachs or being on an unsafe sleep surface such as a sofa.
“..bedsharing deaths are associated with at least one independent risk factor associated with an infant dying. These include an infant being placed prone (on its stomach) and placed in an adult bed without supervision, or no breastfeeding, or other children in the bed, or infants being placed in an adult bed on top of a pillow, or who bedshare even though their mothers smoked during the pregnancy therein compromising potentially the infants ability to arouse. Drug use and alcohol have historically been associated with poor outcomes for bedsharing babies so if drugs and/or alcohol are present, please don’t bedshare.”
Let me be clear. I am not suggesting that all families should share a bed with their baby. My concern is that parents who want to bedshare are not given information on how to do this safely. Instead, the approach is to give all families the same blanket guidance, which is that bedsharing is never safe.
This lack of any nuance or individualized approach is doing a disservice and is, frankly, dangerous.
Many babies sleep better when they are close to a parent. This means that parents are likely to bedshare at some point, whether intentional or not.
So, when parents struggle to follow this advice, only to be chronically sleep-deprived because of it, the situation becomes risky. Now these sleep-deprived parents, desperate for their baby to sleep, may resort to holding their sleeping baby in a recliner. The parents tell themselves that they won’t fall asleep holding the baby, but eventually they will. Now the situation is quite dangerous.
Instead, our approach should be similar to how we teach adolescents about sex. We know at some point they will probably have sex, so we make sure they know how to do it safely. For an approach that is more realistic about infant sleep, see the video below.
“One of the big reasons that bedsharing is safer when you’re breastfeeding is the way you position your body next to your baby. During sleep, you’ll automatically go into the same position as breastfeeding mothers all over the world and throughout time. It’s called a cuddle curl, and it’s nature’s way of protecting a baby during sleep. Your knees come up and your arm tucks under your head or pillow, or curls around your baby, creating a protected space. ”
How is bedsharing practiced safely?
All parents should be given this list of guidelines. The Safe Sleep Seven rules are easy to follow:
The adults are non-smokers.
The adults are sober and unimpaired.
The baby is exclusively breastfed.
The baby is healthy and full-term.
The baby sleeps on their back (it’s fine for baby to be on their side while feeding).
The baby is lightly dressed.
The sleep surface is safe (no toys, blankets, pillows, cords near the baby, the mattress is firm.)
I recommend that all expectant parents, even if they don’t intend to bedshare, understand how to do so safely before their baby is born. Figuring out how to bedshare should be done in advance of being in a desperate, sleep-deprived situation at 2:00am.
Having a plan for safe bedsharing doesn’t mean that you will bedshare, it just means that it will be safe if you do.
The reality is that infant sleep is a complex topic. When we try to make it black and white, it leaves parents feeling confused if their baby doesn’t fit into what is being recommended. All parents deserve to know the truth about safe infant sleep, and should be encouraged to make informed decisions for their families.
