Rethinking Bed-Sharing: Why I slept with my Infant

This is a guest post from fellow blogger, Alicia of Life Lived Mindfully. I wanted to share her experience with my readers since we did not "officially" co-sleep with Sawyer in infancy, although we have found many benefits to bed-sharing in various stages of her growth. I also happen to have tons of experience from the other end since I slept in my parents bed until I was 9! This wasn't a true co-sleeping arrangement as I would run to their bedroom every night in fear of a robber outside my window. Perhaps this is why I had more of an open mind letting Sawyer fall asleep with me or letting her crawl into our bed more often than not. Whatever your experience with or opinion about co-sleeping, I'd encourage you to give Alicia's post a read!


Over the past two hundred years industrialized Western societies have adopted the notion that it is normal and biologically appropriate for a mother and her infant child to sleep apart. I once shared in this view; however, after my son was born, it was impossible to ignore the natural instincts fighting against this perception. 

With a background in psychological research, I sought to find out why the practice of parents and infants sleeping together came to be thought of as controversial, strange, “unhealthy,” and most commonly – dangerous – and whether there was any truth to it...

Historically and cross culturally, co-sleeping and nighttime breast-feeding were and are inseparable family practices. Infants' physiological, psychological and social needs as well as maternal responses to them have evolved in a co-sleeping environment and the human experience worldwide supports bed-sharing. With an emphasis and appreciation of understanding rather than ill-informed judgment, I will share why one should reconsider what “healthy” infant sleep is. Bed-sharing, specifically, has a myriad of benefits for the health and wellbeing of mother and child when made safe.

Rewind

Rethinking Bed-Sharing: Why I slept with my Infant

When pregnant, my husband and I agreed to co-sleep for about the first six months before transitioning my son to his own bed. I had preconceived notions that all babies slept in their own sleep space (e.g., bassinet) and would easily transition to a crib located in a separate room. However, I also knew that a newborn baby's circadian rhythm is not established, and early infant-mother bonding (contact and proximity) is essential for development, especially during the first few days and months after birth.

When I came home from the hospital, I was ill-prepared for the reality of the lack of sleep that would occur. With an innate sensitivity of a mother and an instinctive response or care for my son, this entailed responding to every cry, and feeding “on demand.” In case you did not get the memorandum: Motherhood is 24/7.

When my son slept in the bassinet beside our bed I found myself frightened that something bad would happen. I compulsively ensured my son’s wellbeing and watched his chest rise and fall aimlessly to verify that he was still breathing. 

Sleep deprived and anxious after weeks of not sleeping, I accidentally fell asleep with my son on my chest while in bed (not a recommended method of safe co-sleeping, albeit it happened). When I awoke I was remarkably refreshed. My son and I had slept the longest and most peaceful in each other’s arms showing that “healthy” infant sleep was with my baby beside me.

From that moment on, I refused to follow the prescribed Western norm of sleep. I instead, followed my natural instincts to ensure that my son and I were healthy. Knowing that my health was compromised, I immediately researched safe co-sleeping guidelines and found that consistent to my instinctual self-care and care for my son, bed-sharing is the normative and natural human behavior. This is the biological norm as nature intended.

With more than 90% adults of the minority who shared their beds with their infants, I felt compelled to demystify and provide further information about this family practice. I write to those mothers and fathers – to nearly half of a norm sample - which will now know that bed-sharing, when made safe while breastfeeding, is biologically appropriate for breastfeeding mother and baby/child. While I understand that this is a controversial topic of discussion I also write to those who indignify us, “bed-sharers.” But this is my only note: I respect your decision to parent as you choose, and have faith that you will mindfully accept that there is no “right” way to parent and positively no need to cast judgment.

I found that my family is certainly not “abnormal” and aligns with large portion of others’ whom have chosen to bed-share. According to the National Infant Sleep Position study, conducted between 1993-2000, forty-five percent of infants spent at least some time at night on an adult bed in the last 2 weeks (sample size = 8453).

What Exactly is Co-Sleeping?

In response to media images that improperly portrayed mother-infant sleep, Durham University’s Parent-Infant Sleep Lab illustrates bed-sharing positioning as depicted in studies.

In response to media images that improperly portrayed mother-infant sleep, Durham University’s Parent-Infant Sleep Lab illustrates bed-sharing positioning as depicted in studies.

Co-sleeping arrangements vary by family. Some include:

  • Sidecar arrangement/room-sharing: A bedside bassinet or “co-sleeper” which attaches to the parents bed but provides a separate sleep space for the infant is securely attached to one side of the parents’ bed, next to the mother. One side may be removed or lowered to allow easy access to infant.
  • Different sleep spaces in the same room/room-sharing: A bassinet, Moses basket, crib, “co-sleeper,” or bed (toddler-age or older) is located in the same room as parent(s).
  • Bed-sharing/Family Bed: Parent(s) sleep in the same bed with child.
  • Child welcomed into parents’ bed as needed throughout the evening/Bed-sharing: The baby/child has his own bedroom, and usually initially falls asleep in this bedroom, but is welcomed into the parent(s)’ bed at any time during the evening after waking.

“Note that these arrangements are not synonymous and must be distinguished since reports inaccurately suggest that all types of co-sleeping are the same, dangerous, carry the same high risks, and that no co-sleeping environment can be made safe” (McKenna, 1996).

Facts

The fear of suffocating infants has a long and complex cultural history. Unfortunately, bed-sharing as a behavior in isolation is not usually the only cause assigned to infant deaths. In my research I have found that many argue a one sided story with a flawed foundation. So what are they leaving out?

Rethinking Bed-Sharing: Why I slept with my Infant

Sudden infant death syndrome (SIDS) and Sudden unexpected infant death (SUID)

I will not negate the fact that, sadly, infants die due to accidental suffocation and strangulation in bed. However, one cannot assume that the death itself was caused by the bed-sharing environment alone, or by suffocation, as many legal and medical authorities assert. In many cases, medical authorities and coroners make assumptions and are not usually forthcoming about the details associated with bed-sharing deaths, such as, if the infant was sleeping prone (on the stomach) in the bed, an independent risk factor for SIDS, due to the lack of checks and balances.

We still do not know what causes SIDS. What we do know is that, overwhelmingly, the disproportionately high number of bed-sharing deaths are associated with at least one independent risk factor associated with an infant dying. These include:

  • placing an infant a prone position for sleep (on its stomach)
  • placement on a soft sleep surface such as water bed, couch/sofa
  • exposure to maternal smoking (and/or use of other substances that cause impairment)/secondhand smoke/bed-sharing though their mothers smoked during the pregnancy/history of parental drug use
  • an infant being placed in an adult bed without supervision/ other children sharing the bed
  • no breast feeding/formula-feeding (see below for why nursing is protective)
  • overwrapping babies or blocking air movement around their faces (including use of blankets/pillows/objects that cover infant’s ability to effectively breathe)
  • infants being placed in an adult bed on top of a pillow
  • maternal overexhaustion

Even more terrible is that organizations such as the America Academy of Pediatrics now perpetuate aspects of these tragedies by assuming that American parents, in contrast to mothers elsewhere in the world, are unable to be educated as to how to breast feed, nurture, and safely sleep with their infants.

Bed-Sharing: The Normative and Natural Human Behavior

Our ancestral mothers slept alongside us and breastfed us throughout the evening and there is good reason why…

  • Put simply, it is much easier to breastfeed when room-sharing, but especially while bed-sharing.
  • More importantly, and more complex - an infant’s immune, respiratory, thermo-regulatory, neurological, and digestive systems are not yet fully functional at birth. Biologically speaking, the human infant’s physiology is not designed to function optimally without compensation by breastfeeding mother for these infants’ developmental vulnerabilities. Infants’ responses to maternal smells, movements and touch regulate the infant’s breathing, body temperature, absorption of calories, stress hormone levels, immune status, and oxygenation. We are the only mammals that require extended period of development (14-17 years). This is not profound, it is biology – it is natural phenomena!
  • When given a choice, infants (and humans in general) innately prefer the comfort of a warm comforting body to solitary contact, especially to stolid mattresses. This is not new research. If you’ve ever taken a Psych:101 course then you likely learned about the wire/cloth monkey experiment. In the late 1950’s, psychologist, Harry F. Harlow, PhD found that greater than the need for warmth, animals, like humans, need closeness and affection for basic needs such as food, safety, love, acceptance, and affection from their caregiver.

Bed-Sharing As A Protective Factor

Rethinking Bed-Sharing: Why I slept with my Infant

SIDS rates in relation to percentage of societal bed-sharing (per culture, country or region).

Contrary to what would be predicted, some of the lowest SIDS rates are associated with the highest bed-sharing or co-sleeping cultures. This information suggests that it may not necessarily be bed-sharing that is the problem, but how it is practiced.

  • In sleep studies conducted by James McKenna, PhD mothers and babies who were bed-sharing and night nursing shared a “nighttime harmony” in which bed-sharing infants nursed more often, slept more lightly, and had practice responding to maternal arousals. At the same time, bed-sharing made it easier for a mother to detect and respond quickly to an infant in need.
    • Note: studies show that impaired arousal from sleep is associated with SIDS.
  • There is a strong relationship between breastfeeding and bed sharing/co-sleeping. Sleep laboratory studies have shown that bed-sharing, in contrast to sleeping in separate rooms, nearly doubled the number of breast-feeding episodes and tripled the total nightly duration of breast-feeding. Why would I want to be up more at night feeding my infant?
    • The need to feed frequently is necessary given that human milk is composed of relatively low amounts of protein and fat, and high amounts of quickly absorbed and metabolized sugars. Therefore, an infant’s hunger cycle is short. By sleeping together, the infant can receive breast milk in the forms and quantities that nature intended all while providing more antibodies to fight disease.

Psychological Effects: Will My Child Ever Sleep Independently?

One of the most common concerns regarding bed sharing is whether children will sleep independently and how codependent they will become. I get it. Sometimes I think to myself or say to my bed-sharing girlfriend that I would love to have my bed to myself again – and sooner rather than later. But then I recall this information:

  • Interestingly, but not really surprising, people confuse an infant’s willingness to “self-soothe” as a sign of “independence,” self-sufficiency or autonomy and co-sleeping/bed-sharing as a sign of dependence. The reverse, according to science, is true. Life long independence has absolutely nothing to do with the age at which an infant puts himself back to sleep or sleeps by himself.
    • Psychologists, Keller and Goldberg (2004), found that routine solitary sleepers, not bed-sharing toddlers, were the toddlers less able to be alone and less able to solve problems presented to them. Self-sufficiency as well as the ability for full engagement with others, and “problem solving skills” were enhanced by routine co-sleeping from birth.
  • While Dr. Ferber may lead you to believe that bed-sharing has adverse psychological and emotional effects by stating that “sleeping in your bed can make a child feel confused and anxious rather than relaxed and reassured,” new research shows that the opposite is true.
    • Children who ‘never’ slept in their parents’ bed were rated as ‘harder to control,’ ‘less happy,’ less innovative and less able to be alone and exhibited a greater number of tantrums. Bed-sharing children were actually less fearful than children who never slept in their parents’ bed throughout the night a finding.

With this said, human development is complex. No one single kind of experience or condition is determinative of a person’s psychological skills or behavior. Therefore, it is a matter of education and perspective.

All children eventually learn how to put themselves back to sleep and will eventually sleep alone, in their own sleep environment. Assumptions made in mainstream press, which guides Western ideologies, overlooks or dismisses the diverse ways that humans develop at different rates and in extremely different contexts.

Safe Bed-Sharing Guidelines

When practicing bed-sharing, I encourage education on the minimization of risks. Safe Cosleeping Guidelines to Sleeping Safe with Infants adapted from: James J. McKenna, PhD’s Mother-Baby Behavioral Sleep Laboratory can help guide your decisions. Professor James J. McKenna is the single most respected leader in the field of infant-parental sleeping arrangements, nighttime breastfeeding and SIDS prevention. Click here to learn more

Parting Thoughts

I recognize that not all families and babies are the same, and that bed-sharing, and especially co-sleeping, is a diverse family practice cross-culturally. While there is no scientific consensus surrounding bed-sharing, an important distinction must be made on how bed-sharing is practiced. Cosleeping, including bed-sharing, can be a safe and healthy sleep practice.

It is your right as a parent to become informed and make this choice to bed-share for yourselves. As a mindful mother, I will continue to share my viewpoints and knowledge and to treat all families with dignity, respect, understanding, and compassion. In such a world, it is what is necessary for our future generations to grow into adulthood with a capacity for love and trust.

As Always,

live life mindfully


References

1.     Academy of Breastfeeding Medicine. ABM clinical protocol #6: Guideline on co-sleeping and breastfeeding. Breastfeeding Medicine. 2008; 3(1): 38-43.

2.     American Academy of Pediatrics. SIDS and other sleep-related infant deaths: Expansion of recommendations for a safe infant sleeping environment. Pediatrics. 2011;128(5).

3.     Ball HL, Russell CK. SIDS and infant sleep ecology. Evolution, Medicine, and Public Health. 2014; 2014(1): 146.

4.     Ball HL. Parent-infant bed-sharing behavior: Effects of feeding type and presence of father. Human Nature. 2006; 17(3): 301-318.

5.     Centers for Disease Control and Prevention. Sudden Infant Death Syndrome (SIDS). Retrieved on August 10, 2016 from http://www.cdc.gov/features/sidsawarenessmonth/

6.     Gessner BD, Ives GC, Perham-Hester KA. Association between sudden infant death syndrome and prone sleeping position, bed sharing, and sleeping. Pediatrics. 2001;108(4):923-7.

7.     Hunt CE. Impaired arousal from sleep: relationship to sudden infant death syndrome. Journal of Perinatology. 1989; 9:184-7.

8.     Keller M, Goldberg W. Cosleeping and children independence: challenging the myths. Infant and Child Development. 200413(5): 369-388.

9.     La Leche League. Should I sleep with my baby? 2016. Retrieved on July 29, 2016 from http://www.llli.org/faq/cosleep.html

10.  McKenna JJ, McDade T. Why babies should never sleep alone: A review of the co-sleeping controversy in relation to SIDS, bedsharing and breast feeding. Pediatric Respiratory Reviews. 2005; 6, 134–152.

11.  Nelson E, Taylor B, Jenik A et al. International child care practices study: infant sleeping environment. Early Human Development 2001; 62: 43–55.

12.  Steinfield MB. Bonding is essential for normal infant development. UC Davis Medical Center. Retrieved on August 10, 2016 from http://www.ucdmc.ucdavis.edu/medicalcenter/healthtips/20100114_infant-bonding.html

13.  University of Notre Dame. Department of Anthropology. Anthropologist James McKenna says babies can sleep safely next to mothers. 2012. Retrieved on August 1, 2016 from https://anthropology.nd.edu/news/36261-babies-sleep-best-and-most-safely-next-to-mothers/

14.  University of Notre Dame. Mother-Baby Behavioral Sleep Laboratory. Retrieved from http://cosleeping.nd.edu

15.  Willinger M, James LS, Catz C. Defining the sudden infant death syndrome (SIDS): de- liberations of an expert panel convened by the National Institute of Child Health and Human Development. Pediatric Pathology. 1991; 11(5):677– 684

16.  Willinger M, Ko CW, Hoffman HJ, Kessler RC, Corwin MJ. Trends in infant bed sharing in the United States, 1993–2000: the National Infant Sleep Position study. Archives of Pediatric and Adolescent Medicine. 2003;157(1):43– 4