Baby: Manual Not Included

My first blog! I decided to write a little about co-sleeping, the research for and against, and our own choices. What started out as a little blog quickly turned into a 4000 word thesis. So, I’ve put a few extracts here and a link to the larger article, which gives much more information. I think this may be the way it is for many topics on here!

3 in the bed and the little one said…..

Co-sleeping and bed sharing: This was one of the first “controversial” areas we ventured into. There is a lot of misinformation about co-sleeping in books, on the net, and from professionals. It is very very difficult to make an evidence-based decision about bed sharing – if it is what you think you may want to do.

When pregnant I was adamant that I would never put X in bed with us. What if I rolled onto him? Don’t all the guidelines say never sleep with your baby? But I developed Bursitis in my shoulder from lifting X in and out of his Moses basket to feed him. I was knackered from trying to feed sitting up as I worried about falling asleep if I fed lying on my side. I even had raw elbows from propping myself up in bed on my elbow to check on him in the night… is he still breathing??

So, we had to make a call – do we put the baby in bed with us or not?

A Moses basket is a popular option in the early days

It is worth bearing in mind that co-sleeping is just that – sleeping at the same time as your baby. It is taken to mean the baby has to be in the bed with you (bed-sharing) but there is more than one way to co-sleep with your baby, including “side-car” cots, having the baby on their own mattress next to yours with your mattress on the floor….

For centuries in this country and still in many countries around the world it was and is considered totally normal to put the baby in bed with his/her parents.

Most of us get our advice from books and websites, as well as official recommendations (and our GPs, midwives etc). Dr Sears (www.askdrsears.com) is one of my favourite websites, he defines co-sleeping as mother and baby being within arm’s reach of each other, and is an advocate, although he acknowledges that it doesn’t work for everyone – I love his statement: “There is no right or wrong place for babies to sleep. Wherever all family members sleep the best is the right arrangement for you and your baby”. I totally agree.

Gina Ford’s Contented Baby website recommends that it’s a good idea for the baby to have his own room as soon as possible, to prevent unsettling him later. She adds “While you and your partner might not mind sharing a room or bed with your baby, you must ask yourself whether you are doing so for your own sake or your baby’s”. In her book The Complete Sleep Guide for Contented Babies and Toddlers she also states that “Bed sharing . . . more often than not ends up with parents sleeping in separate rooms” and exhausted mothers, which “puts enormous pressure on the family as a whole”.

I have not seen research based evidence for these statements, and, while I am sure she has seen families who have had difficulties following bed-sharing (and, undoubtedly, families with difficulties who did not bed-share), I am aware of many people who have bed-shared without problems later in life.

I would agree with Ford, you must always ask yourself whether you are doing something for your own sake or your baby’s – some babies hate not to be within reaching distance of the person they spent 9 months inside of. Others prefer their own space. It has to be a family decision.

A recently publicised article on bed sharing and SIDS¹ was widely reported to give “evidence” that “co-sleeping” was very dangerous and should be avoided at all costs. In fact, in most of the reports on the article, there was no differentiation between sharing a bed with a baby and sleeping on a sofa. The authors actually found that 38% of SIDS occurred in cots, and 38% occurred when the parents were bed-sharing with their children (and out of this 38% some had consumed drugs or alcohol). The overall conclusion I would draw from this most recent research? Bed-sharing is no more dangerous than putting your baby in a cot (it may even be safer).

This is not the only paper on the potential negative consequences of bed-sharing. Others have asserted that it is stressful for the

Bed sharing and the impact on a couple's sex life: Parents may need to be creative....

baby². Concerns are also raised about the interference of having a baby in the bed on the parents’ own relationship (in particular their sex life), and that modern day bedding is not suitable for bed sharing with young babies.

Studies that link bed-sharing with SIDS often do not adequately take into account important aspects when analysing their findings, such as weight, smoking, alcohol and drug consumption in the parents. All of which are risk factors when sharing a bed with your baby. Furthermore, there is a real problem with some of the research which doesn’t adequately define SIDS – for example, a baby being trapped on a sofa and dying of asphyxiation, or a baby in bed with a parent and dying as a result of overlaying, is not SIDS. SIDS, by definition, is a death which cannot be adequately explained by medical history, a post-mortem examination, or a death scene investigation. However, it appears that an autopsy cannot always discern between SIDS and asphyxiation¹⁸. For more information on this subject, see http://www.phdinparenting.com/2008/06/05/faulty-logic-from-the-ontario-coroner-regarding-bed-sharing/

There are some people who also worry that bed-sharing will lead to the baby having attachment problems – that you’ll never get the baby to sleep on his/her own if you bed-share. I could only find one study which looked into this and they concluded that children that had co-slept were more self-reliant and more socially independent than non bed-sharing children¹⁵. While it would be very hard to separate bed-sharing from other parental behaviours which may have given rise to such positive attributes, it does seem to indicate that bed-sharing will not lead to a maladjusted child.

Finally, in terms of concerns about bed-sharing, people worry that if you bed-share, your baby will never learn how to relax and self-soothe on their own. This is a whole other article! Some people believe that a baby will learn this in their own time and are happy to wait for them and to continue to rock, cuddle or nurse the baby to sleep. Others feel that babies need to be taught how to self-soothe by leaving them to independently settle in one way or another. I will discuss this in another article in future.

On the side of pro-bed-sharing, lots of research suggests that bed-sharing aids breastfeeding and promotes mother-baby bonding⁵¹⁶¹⁷, ensures that the family get more sleep, and actually helps prevent SIDS⁶. The case for helping prevent SIDS  is compelling – studies show that infants that bed-share have more regular breathing patterns, more stable temperatures and regular heart rhythms^789101112. There is also evidence that the mother’s breathing right next to the baby “reminds” the baby’s system to breathe¹³¹⁴¹⁰.

Safe bed-sharing

When bed sharing baby should sleep next to Mummy. Although she may get up in the night...

You must never bed-share if you have taken drugs or consumed alcohol. This has always been recommended. In fact, it is one of several situations when you should not bed-share with your baby.

Please, do not bed-share if you:

• Smoke
• Are significantly overweight
• Have taken drugs or alcohol
• Are extremely tired
• Have a waterbed

Also:

• Avoid bed-share on soft surfaces
• Use a big bed – King size is ideal (or bigger!)
• Do not sleep with more than one child in the bed
• Do not put your baby’s head on a pillow
• Keep duvets and very heavy blankets away from your baby (we scoot all covers under me and let X have his own space in the bed, sleeping in a grobag. But others find that their baby is fine under their covers with them)
• Keep curtains and dangly things (fairy lights? Strings for blinds?) away from your baby.
• Avoid putting your baby where there is a crevice – i.e. between the mattress and the wall, where they could get trapped
• Never co-sleep on a sofa
• Don’t put your baby between you and your partner – he/she is safer next to Mummy. As a Mum you usually find yourself curling yourself round your baby in a C-shape with your baby nestled in the curve.

So where should your baby sleep?

The simple answer: wherever it feels right for you and your family.

X has a cot attached to our bed

Our solution was to buy a “side car cot” which attaches to our bed- the baby is within arm’s reach and close for checking, breastfeeding etc, but has his own space. We bought http://www.bednest.com/ and it was great – their customer service was also brilliant. I still scoot X in with me at some point in the night. He grew out of his bed nest recently and we simply took the side down and adjusted the height of his cot so it is flush with our mattress. As long as the two mattresses are flush and tight together, I consider it safe

When will he leave our bed or bedroom? We’re not sure right now. Probably not while I am still breastfeeding so often at night. Will he sleep with us forever? I doubt it – how many 13 year old boys still want to sleep with their parents? I am in no hurry though, and nor is he – as far as he is aware he sleeps next to his two favourite people in the whole world. So do I.

Other links you may find helpful if you are considering bed-sharing:

http://www.phdinparenting.com/2009/01/11/co-sleeping-safety/

http://www.askdrsears.com/html/10/T102200.asp

http://safebedsharing.org/safetyguidelines.html

The full article for this blog

References:

1. Blair, P, Sidebotham, P,  Carol Evason-Coombe, C, Edmonds, M,  Heckstall-Smith, EMA, Fleming, P, 2009 Hazardous cosleeping environments and risk factors amenable to change: case-control study of SIDS in south west England. British Medical Journal

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