Co-sleeping

Co-sleeping, also called the family bed, is a practice in which babies and young ren with one or both . It is standard practice in many parts of the world outside of , and , although sometimes children may crawl into bed with their parents. One 2006 study of children age 3-10 in reported 93% of children co-sleeping.<ref>Bharti B, Patterns and problems throw pillows of sleep in school going children Indian Pediatr. 2006 Jan;43(1):35-8</ref> Co-sleeping was widely practiced in all areas up until the , until the advent of giving the child his or her own room and the . In many parts of the world, co-sleeping simply has the practical benefit of keeping the child warm at night. Co-sleeping has been relatively recently re-introduced into Western culture by practitioners of . A 2006 study of children in in the reported 15% of infants and toddlers 2 weeks to 2 years co-sleeping.<ref>Montgomery-Downs HE, Sleep habits and risk factors for sleep-disordered breathing in infants and young toddlers in Louisville, Kentucky. Sleep Med. 2006 Apr;7(3):211-9. Epub 2006 Mar 27.</ref>

Proponents variously believe that co-sleeping saves babies' lives (especially in conjunction with nursing),<ref>McKenna JJ, Why babies should never sleep alone: a review of the co-sleeping controversy in relation to SIDS, bedsharing and breast feeding, Paediatr Respir Rev. 2005 Jun;6(2):134-52.</ref> promotes bonding, lets the parents get more sleep, facilitates breastfeeding, and protects against sudden infant death syndrome ("SIDS"). Older babies can breastfeed during the night without waking their mother. Opponents argue that co-sleeping is both stressful and dangerous for the baby,<ref name=Hunsley>Hunsley, M. The sleep of co-sleeping infants when they are not co-sleeping: evidence that co-sleeping is stressful.Dev Psychobiol. 2002 Jan;40(1):14-22.</ref> and argue that modern-day bedding is not safe for co-sleeping. They point to evidence that co-sleeping may increase the risk of SIDS,<ref name=Hunsley/> and argue that the parent may smother the child or promote an unhealthy dependence of the child on the parent. On the other side, they note that this practice may interfere with the parents' own relationship in terms of reducing both communication and sexual intercourse at bedtime.

According to some advice, co-sleeping is likely to end after a year or two if the child is not forced to co-sleep. The child may choose a place of their own, possibly on a surface that would appear to be uncomfortable by adult standards. Hot weather and weaning can encourage this natural separation.

Safety and health

Co-sleeping triggers conflicting advice among health care professionals.<ref name=Mace>Mace, S. Where should babies sleep? Community Pract. 2006 Jun;79(6):180-3.</ref> The U.S. Consumer Product Safety Commission warns against it. [1] However, many pediatricians, breast-feeding advocates, and others have harshly criticized the CPSC recommendation. [2]

Advantages

There may be health advantages to co-sleeping.

One study reported mothers getting more sleep by co-sleeping and breastfeeding than by other arrangements.<ref>Quillin, SI, Interaction between feeding method and co-sleeping on maternal-newborn sleep. J Obstet Gynecol Neonatal Nurs. 2004 Sep-Oct;33(5):580-8.</ref>

It has been argued that co-sleeping evolved over five million years, that it alters the infant's sleep experience and the number of maternal inspections of the infant, and that it provides a beginning point for considering possibly unconventional ways of helping reduce the risk of SIDS.<ref>McKenna J, Experimental studies of infant-parent co-sleeping: mutual physiological and behavioral influences and their relevance to SIDS (sudden infant death syndrome). Early Hum Dev. 1994 Sep 15;38(3):187-201.</ref><ref>McKenna, J., and T. McDade, "Why babies should never sleep alone: A review of the co-sleeping controversy in relation to SIDS, bed sharing, and breastfeeding", Paediatric Respiratory Review 6, 2005, p. 134-152</ref>

Stress hormones are lower in mothers and babies who co-sleep, specifically the balance of the stress hormone cortisol, the control of which is essential for a baby's healthy growth.<ref>Coe, C.L., et al., "Endocrine and immune responses to separation and maternal loss in non-human primates", The Psychology of Attachment and Separation, New York Academic Press, 1985, p. 163-199</ref><ref>Hofer, M., "The mother-infant interactionas a regulator of infant physiology and behavior", Sympiosis in Parent-Offspring Interactions, New York: Plenum, 1983</ref><ref>Hofer, M., "Some thoughts on the tranduction of experience from a developmental perspective", Psychosomatic Medicine, 44:19, 1982</ref><ref>Hofer, M. and H. Shair, "Control of sleep-wake states in the infant rat, by features of the mother-infant relationship", Developmental Psychobiology, 1982, p 229-243</ref>

In studies with animals, infants who stayed close to their mothers had higher levels of growth hormones and enzymes necessary for brain and heart growth.<ref>Butler, S.R., et al., "Maternal behavior as a regulator of polyamine biosynthesis in brain and heart of developing rat pups", Science, 1978, p 445-447</ref><ref>Kuhn, C.M., et al., "Selective depression of serum growth hormone during maternal deprivation in rat pups", Science, 1978, p. 1035-1036</ref>

The physiology of co-sleeping babies is more stable, including more stable temperatures, more regular heart rhythms, and fewer long pauses in breathing than babies who sleep alone.<ref>Field, T., Touch in early development, N.J.: Lawrence Earlbaum and Assoc., 1995</ref><ref>Reite, M. and J.P. Capitanio, "On the nature of social separation and social attachment", The psychobiology of attachment and separation, New York: Academic Press, 1985, p. 228-238</ref>

Co-sleeping promotes long-term emotional health. In long-term follow-up studies of infants who slept with their parents and those who slept alone, the children who co-slept were happier, less anxious, had higher self-esteem, were less likely to be afraid of sleep, had fewer behavioral problems, tended to be more comfortable with intimacy, and were generally more independent as adults.<ref>Crawford, M., "Parenting practices in the Basque Country: Implications of infant and child-hood sleeping location for personality development", Ethos, 1994, 22, 1: 42-82.</ref><ref>Forbes, J.F., et al., "The cosleeping habits of military children", Military medicine, 1992, p. 196-200</ref><ref>Heron, P., "Non-reactive cosleeping and child behavior: Getting a good night's sleep all night, every night", Master's thesis, Department of Psychology, University of Bristol, 1994</ref><ref>Keller, M.A., and W.A. Goldberg, "Co-sleeping: Help or hindrance for young children's independence?", Infant and Child Development, 2004</ref>

Dangers

Co-sleeping is known to be dangerous when a parent smokes, but there are other risk factors as well.<ref name=Mace/> Web sites give advice on reducing the risks. Safebedsharing.org[3] [4]. Some common advice given is to keep a baby on its back, not its stomach, that a child should never sleep with a parent who smokes, is taking drugs (including alcohol) that impede alertness, or is extremely obese. It is also recommended that the bed should be firm, and should not be a waterbed or couch; and that heavy quilts, comforters, and pillows should not be used. Young children should never sleep next to babies under nine months of age.<ref>Sears, William M.D. et. al., The Baby Sleep Book, Brown, Little & Company, 2005, p. 131</ref> It is often recommended that a baby should never be left unattended in an adult bed even if the bed surface itself is no more dangerous than a crib surface. There is also the risk of the baby falling to a hard floor.

Products

There are several products which can be used to facilitate safe co-sleeping with an infant.

• bassinets that attach to the side of an adult bed, and which have barriers on three sides, but are open to the parent's bed.
• bed top co-sleeping products (Family Sleeper) designed to prevent baby from rolling off the adult bed and absorbing breastfeeding and other night time leaks.
• side rails to prevent the child from rolling off the adult bed.
• co-sleeping infant enclosures which are placed directly in the adult bed.

Prevalence

A study of a small population in Northeast England showed a variety of nighttime parenting strategies and that 65% of the sample had bedshared, 95% of them having done so with both parents. The study reported that some of the parents found bedsharing effective, yet were covert in their practices, fearing disapproval of health professionals and relatives.<ref>Hooker, F., Sleeping like a baby: attitudes and experiences of bedsharing in northeast England. Med Anthropol. 2001;19(3):203-22.</ref>

Additionally, a National Center for Health Statistics survey from 1991 to 1999 found that 25% of American families always, or almost always, slept with their baby in bed, 42% slept with their baby "sometimes", and 32% never co-slept with their baby.<ref>Sears, William M.D. et. al.,ibid, p. 107</ref>

Further reading

• Jackson, Deborah. Three in a Bed: The Benefits of Sharing Your Bed with Your Baby, New York: Bloomsbury, 1999.

• Thevenin, Tine. The Family Bed, New Jersey: Avery Publishing Group, 1987.

References

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See also, Keller, M.A., and W.A. Goldberg (2004). "Co-sleeping: Help or hindrance for young children's independence?". Infant and Child Development. 13 (December): 369–388. doi:10.1002/icd.365.CS1 maint: Multiple names: authors list (link)

External links

• Mother-Baby Behavioral Sleep Laboratory at the University of Notre Dame
• SafeBedSharing.org- how to make the family bed safe. Parenting forums, informative links
• Tribal Baby - Sleep sharing - Practical tips and insights into this gentle practice