Co-sleeping: from Queen B, our Building Cathedrals Medical Mom

Thanks to Queen B, our dear sister and doctor mom, for the following information (and I tossed in an image for your enjoyment):

What a billboard to drive by!  If nothing else good can be said about it, it has sparked a great conversation about an important subject, namely co-sleeping.  It would be interesting to know who sponsored the billboard, because as with many things in life, context is everything.

The Family Bed: What God has joined together, let Dr. Sears put asunder

Juris Mater’s question about the safety of co-sleeping, prompted by the billboard, is an important one.  As mothers, we should all be informed and educated on the topic of co-sleeping so that we can make safe, satisfying decisions about our family sleeping arrangements.  Co-sleeping is a controversial topic for cultural, philosophical and medical reasons.  From a medical standpoint, some studies have highlighted potential short-term health benefits (including facilitation of breast feeding and maternal-child bonding) of mothers sleeping in beds with their infants.  The primary medical concern is, of course, that bed-sharing may be hazardous under certain circumstances, resulting in a sudden, unexpected infant death.

As we consider the concerns about bed-sharing, it is important to be aware of a few distinctions.

First, many lay people, and perhaps even some clinicians, may confuse this issue by lumping the terms “Sudden Infant Death Syndrome” (SIDS) and “sudden unexpected infant death” (SUID).  The currently accepted definition of SIDS is “the sudden death of an infant under 1 year of age, which remained unexplained after a thorough investigation, including performance of a complete autopsy, examination of the death scene, and review of the clinical history.”  Thus, if suffocation or asphyxia is a determined cause of death for an infant, that is not technically a case of SIDS.  SIDS is rare during the first month of life, peaks between 2-4 months of age and decreases dramatically after that.  The cause of SIDS remains unknown, however the American Academy of Pediatrics (AAP) acknowledges several scientifically identified independent risk factors.  It is worth mentioning that bed-sharing has not been consistently shown as an independent risk factor for SIDS.  Infants may die of SIDS whether in a crib or in a bed.  However, even if bed-sharing doesn’t carry a higher risk of SIDS, bed-sharing can be a risk factor for sudden unexpected infant death (including suffocation or asphyxia) under certain conditions.

The recommendations from the AAP regarding bed-sharing (co-sleeping) are all about risk reduction, not condemnation.  In other words, if you choose to sleep with your infant, whatever your reasons, do it as safely as possible:  make sure the infant is sleeping on their back on a very flat, firm surface on the bed (couch co-sleeping carries a much higher risk), free from wrinkled sheets, pillows, sheets, bedding and a safe distance from other bed-sharing family members.  Side-sleeping is not considered as safe as back sleep, so if you are side-nursing at night in bed, ensure that your infant returns to the back-sleeping position after nursing.  Avoid co-sleeping after the use of any alcohol or other impairing substance, when you or other bed sharers are overtired, and in all situations that might involve smoking family members.  Be especially vigilant with infants under 12 weeks of age, and continue safe co-sleeping practices until at least one year of age.

On a personal note, I have been wrestling with the benefits and concerns over co-sleeping myself, as my third child was born 2 months ago.  I can relate to the breastfeeding and bonding benefits of sleeping with my baby in my bed, and I have noticed that we both seem to sleep and cope better if we spend at least part of the night in bed together.  However, a few weeks ago I awoke suddenly with my son beside me, his face far closer to my pillow and blanket than I consider safe. I couldn’t remember bringing him into bed with me, and I wasn’t sure if he was breathing.    I must have reached down and lifted him into bed in an overtired state of sleep.  Praise the Lord, he was sleeping soundly, but the hair still raises on my arms as I write about it.  It drove home for me the important reality that in bed at night it only takes one terrible mistake to end a life.  Just as we employ extreme vigilance with our children at pools, in the car, near the street, etc, we need to be vigilant about safety in sleep.

I have very little admiration for the approach of the billboard or those who condemn co-sleeping all together.  But should someone in the medical profession (doctor, nurse, etc) make you bristle with their negative opinion of co-sleeping, consider extending them the charity of the benefit of the doubt.  For an invested, caring clinician, as for any of us, a preventable death is truly devastating to behold, especially when it is that of a helpless infant or child.  Encountering a SIDS or SUID case may color a person’s opinion of certain sleeping practices for life, whether scientifically validated or not.

For more up to date information on the pediatric consensus statements regarding SIDS, infant sleeping environments, and an excellent list of references for reading, see the following document from the American Academy of Pediatrics: http://aappolicy.aappublications.org/cgi/reprint/pediatrics;116/5/1245.pdf

  • Red

    Oh My gosh JM, the caption under the picture is hilarious!u00a0 nnAnd thank you Queen B for your time to write this post.u00a0 May I suggest a “co-sleeper,” which literally pushes up against the side of the bed but keeps the baby very safe, for those interested in co-sleeping but worried about the risks.u00a0 Even though I do not co-sleep after the first few hazy weeks, I use a co-sleeper for those first few weeks because I feel it is much safer for my newborns.u00a0 The mattress on the co-sleeper is very firm, and there is no risk of suffocation due to blankets/pillows (since my children are all born in the winter, removing the blankets from my bed just isn’t a good idea).u00a0

    • Kate E.

      I second this. We have a co-sleeper which we use for the first 2-3 months. We love it. Then we usually part ways since I am a very light sleeper and tired mama’s are no good for anyone. For our second child we actually switched sides of the bed. My husband sleeps next to the co-sleeper. He is a much more sound sleeper and isn’t disturbed by the various weird noises newborns make (mine grunt a lot in their sleep) and he passes the baby to me to nurse, I’m up just enough to get the job done and then pass them back. We usually have to do a diaper change with our super sensitive skinned kids. So side nursing and just rolling over never really happened.nOf course there are the first 2-3 nights with a new baby in which my husband sleeps not at all and just holds them and stares. Which is adorable. And I’m glad it’s not me doing it.

  • http://www.buildingcathedrals.com Kat

    Oh, JM, I know that you just couldn’t resist this picture :)u00a0nnQueen B, thank you so much for taking the time to write this article for us, and for your perspective. We all appreciate it very much!

  • mjdmom

    Ok, I will bite.u00a0 The photo is indeed funny, but the caption isn’t.u00a0 I love this blog, but as a co-sleeping more “attachment parenting” oriented mom married to an even more “attachment parenting” oriented Dad, I resent the insinuation that attachment parenting ruins all marriages.u00a0 I have been reading this blog for years and know where you guys stand on these issues, but please at least acknowledge that co-sleeping works extremely well for some Catholic families and doesn’t even mess up the proper order of loves in the family.

    • Jurismater

      MJDMom, totally, even among the “builders” there are differences of opinion on parenting philosophies; we run the complete spectrum from Babywise to babywearing. We enjoy a jab and a good-natured laugh every now and then, because I think after several children, we all hold fairly loosely to our own opinions and preferences about most things. And we respect each other so much that we appreciate the differences. You’re among our most wise, balanced and fair readers; thank you for continuing to read the blog and for your perspective.

  • Red

    MJDMom,nnSo sorry you were hurt!u00a0 I’m sure you know where I stand on these issues…and while I do think attachment parenting in it’s purest form is philosophically wrong (messes with the proper order of relationships in the family and leads to child-centered households), I also believe that parents can take some good from it’s ideas, throw out what isn’t working or is bad, and have very happy marriages and families.u00a0 I acknowledge that SOME families can co-sleep and have happy marriages and families.u00a0 When done safely, there is nothing wrong with co-sleeping or babywearing, or some of the other AP principals.u00a0 I just think parents need to make sure that co-sleeping is working well for them, and not co-sleep out of an attempt to be a good “attachment parent,” while Dad feels selfish and sleeps alone on the sofa! u00a0u00a0 Obviously, you are very happy with the balance in your own home, and you claim your husband supports the co-sleeping arrangement, and I’m glad you are speaking up about your success (and your husband’s success) at co-sleeping and adopting various attachment parenting practices.u00a0 nnnn

  • Jurismater

    Queen B, I SO appreciate this post and, most of all, I won’t soon forget the excellent point you make about how medical professionals tend toward conservative practices and recommendations because they have seen the devastating results of not being careful. I realize now that this applies to obstetrics too, and I’m always so skeptical of all the technology and interventions surrounding childbirth, but now I see much more clearly where they’re coming from. Thank you for taking the time to explain all this during your babymoon!!!

  • mjdmom

    Ladies, Don’t worry I am not offended, just wanted to make sure I was representin’ those of us from the other perspective!

  • Mary Alice

    Queen B, I think that your story points out something else that is important — mothers in the first few months are exhausted, sometimes to the point of making impaired choices.nnI really have come to think that unless I have enough help to be napping quite a bit, I should not try to do much, especially out of the house, for the first six weeks or more, because I am just too tired.

    • Jurismater

      Too true, Mary Alice, we’re right there right now. Thank goodness for sprinklers and crafts and other at-home activities. We’re a moving safety hazard when we’re out and about.

  • Amy B

    Thanks for your post Queen B!u00a0 We recently had a baby and he has been au00a0very “needy sleeper” from the beginning.u00a0 It was either co-sleep or no-sleep!u00a0 With a two year old to take care of as well, we opted for the co-sleep! :)u00a0 (He was so needy that the co-sleeper attached to the bed wasn’t close enough for him to stay asleep…sigh.)u00a0I have worried about his safety all along, but have been encouraged by the information onu00a0Prof. McKenna’s website and also your post!u00a0 Thanks again!


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