Sleep: Talking With Your Doctor About Bedsharing

Sleep: Talking With Your Doctor About Bedsharing

Some parents choose not to discuss their sleeping arrangements with medical caregivers, even if asked. If you do choose to, here are some points you may find helpful.

  • I really do appreciate your willingness to listen. It’s one of the reason’s we came to you.
  • Although the public health campaigns suggest that all bedsharing with babies is dangerous, the research shows that the issue is complex, and not a one-size fits-all.
  • Most of the research mixes up SIDS and suffocation. There are ways to make bedsharing safely comparable to a crib’s.
  • SIDS is linked to smoking, formula-feeding, alcohol, a baby sleeping on his stomach, an overheated baby, a premie or baby with significant health issues, and a baby left alone. That’s not us.
  • Suffocation and other breathing risks are linked to an impaired adult or a soft or cluttered or otherwise hazardous surface. That’s not us.
  • Like other breastfeeding mothers, I sleep with my baby in a specific, protective positi8on, away from pillows, and he stays there to be near my breast. A bottle-feeding mother doesn’t sleep in that position wand her baby is less likely to stay put.
  • I make sure my baby sleeps next to me and not next to someone else.
  • No studies have found an increased risk for babies when all those other risks are accounted for. The 2013 Carpenter meta-analysis that says otherwise is based on studies with poor definitions and missing data.
  • Research studies have found no increased risk with bedsharing after about four months.
  • Like other breastfeeding mothers, I wake up frequently to tend him and feed him, and often don’t even know I’m doing it. If he were across the room, he wouldn’t be tended nearly so carefully.
  • He doesn’t need a pacifier. I’m right there to nurse him.
  • If a mother doesn’t bedshare, she’s less likely to nurse as long as medical organizations recommend, with big health consequences.
  • Publications say my baby shouldn’t sleep on a chair or a recliner or a sofa or bed to nurse at night. He sleeps when we nurse. Where, exactly, am I supposed to go at 3 .m. if I’m really tired?
  • Sleep training isn’t something we’re comfortable with. The research that promotes it doesn’t look at the internal changes or the long-term outcomes. Sleep training raises his cortisol level and keeps it high even after he stops crying. And it’s not good for breastfeeding.

References

  1. Ball, H.L. Breastfeeding, bedsharing, and infant sleep. Birth 30 (2003): 181-188.
  2. Mosko, S., Richard, C., McKenna, J. Maternal sleep and arousals during bedsharing with infants. Sleep 20, no. 2 (1997): 142-150.
  3. Richard, C., Mosko, S., McKenna, J., et al. Sleeping position, orientation, and proximity in bedsharing infants and mothers, Sleep 19, no. 9 (1996): 685-690. Baddock, S. A., Galland, B. C., Bolton, D. P. G., et al. Differences in infant and parent behaviors during routine bed sharing compared with cot sleeping in the home setting. Pediatrics 117, no. 5 (2006) 1599-1607.
  4. Mosko, S., Richard, C., McKenna, J. Maternal sleep and arousals during bedsharing with infants. Sleep 20, no. 2 (1997): 142-150.
  5. McKenna, J. J., Ball, H. L., Gettler, L.T. Mother-infant cosleeping, breastfeeding, and sudden infant death syndrome: what biological anthropology has discovered about normal infant sleep and pediatric sleep medicine. American Journal of Physical Anthropology 134, suppl. 45 (2007): 133-161.
  6. Ball, H. L. Breastfeeding, bed-sharing, and infant sleep. Birth 30 (2003): 181-188. Ball, H. L. Bedsharing practices of initially breastfed infants in the first 6 months of life. Infant and Child Development 16, no. 4 (2007): 387-401. Ball, H. L. Reasons to bed-share: why parents sleep with their infants. Journal of Reproductive and Infant Psychology 20, no 4 (2002): 2017-221. Kendall-Tackett, K., Cong, Z., Hale, T.W. Mother-infant sleep locations and nighttime feeding behavior. Clinical Lactation 1, no. 1 (2010): 27-30. Lahr, M. B., Rosenberg, K. D. Maternal-infant bedsharing: risk factors for bedsharing in a population-based survey of new mothers and implications for SIDS risk reduction. Maternal and Child Health Journal 11, no. 3 (2007):277-286. Blair, P. S., Ball, H. L., The prevalence and characteristics associated with parent-infant bed-sharing in England. Archives of Disease in Childhood 89, no. 12 (2004): 1106-1110.
  7. Moore, E. R., Anderson, G. C., Bergman, N., et al. Early sking-to-skin contact for mothers and their healthy newborn infants. Cochrane Database of Systematic Reviews 5 (2012), CD003519.
  8. Montgomery-Downs, H. E., et al. Normative longitudinal maternal sleep: the first 4 postpartum months. American Journal of Obstetrics and Gynecology 203, no. 5 (2010):465e1-7.
  9. Parmelee, A. H. Jr., Wenner, W. H., Schulz, H. R. Infant sleep patterns: from birth to 16 weeks of age. Journal of Pediatrics 65 (1964): 576-582.
  10. Kent, J. C., Mitoulas, L. R., Cregan, M. D., et al. Volume and frequency of breastfeedings and fat content of breast milk throughout the day. Pediatrics 117, no. 3 (2006): e387-e395.
  11. Ball, H.L. Breastfeeding, bedsharing, and infant sleep. Birth 30 (2003): 181-188.
  12. Volpe, L. E., Ball, H. L., McKenna J. J., Nighttime parenting strategies and sleep-related risks to infants. Social Science and Medicine 79 (2012): 92-100.
  13. Kendall-Tackett, K., Cong, Z., Hale, T. W. Mother-infant sleep locations and nighttime feeding behavior. Clinical Lactation 1, no. 1 (2010): 27-30.
  14. Blair, P. S., Fleming, P. J., Smith, I. J., et al. Babies sleeping with parents: case-control study of factors influencing the risk of the sudden infant death syndrome. CESDI SUDI Research Group. BMJ 319, no. 7223 (1999): 1457-1461. Carpenter, R. G., Irgens, L. M., Blair, P. S., et al. Sudden unexplained infant death in 20 regions in Europe: case control study. Lancet 363, no 9404 (2004): 185-191. Tappin, D., Ecob, R., Brooke, H. Bedsharing, roomsharing, and sudden infant death syndrome in Scotland: a case-control study. Journal of Pediatrics 147, no. 1 (2005): 32-37. Vennemann, M. M., Bajanowski, T., Brinkmann, B., et al. Sleep environment risk factors for sudden death syndrome: the German Sudden Infant Death Syndrome Study. Pediatrics 123, no. 4 (2009): 1162-1170. Ruys, J. H., De Jonge, G. A., Brand, R., et al. Bed sharing in the first four months of life: a risk factor for sudden infant death. Acta Paediatrica 96, no. 10 (2007): 1399-1403.
  15. Ball, H.L. Breastfeeding, bedsharing, and infant sleep. Birth 30 (2003): 181-188. Ball, H. L., Besharing practices of initially breastfed infants in the first 6 months of life. Infant and Child Development 16, no. 4 (2007): 387-401. Ball, H. L. Reasons to bed-share: why parents sleep with their infants. Journal of Reproductive and Infant Psychology 20, no. 4 (2002): 207-221. Kendall-Tackett, K., Cong, Z., Hale, T. W. Mother-infant sleep locations and nighttime feeding behavior. Clinical Lacatation 1, no. 1 (2010): 27-30. Lahr, M. B., Rosenberg, K. D., Lapidus, J. A., Maternal-infant bedsharing: risk factors for bedsharing in a population-based survey of new mothers and implications for SIDS risk reduction. Maternal and Child Health Journal 11, no. 3 (2007): 277-286. Blair, P.S. The prevalence and characteristics associated with parent-infant bed-sharing in England. Archives of Disease in Childhood 89, no. 12 (2004): 1106-1110.
  16. Blair, P. S., Sidebotham, P., Evason-Coombe, C., Edmonds, M., Heckstall-Smith, E., and Feming P. Hazardous cosleeping environments and risk factors amenable to change: case-control study of SIDS in south west England. BMJ 339 (2009): b3666. doi:10.1136/bmj.b3666.
  17. World Health Organization, United Nations Children’s Fund Global Strategy for Infant and Young Child Feeding. Geneva: World Health Organization, 2003; 30. American Academy of Pediatrics, Breastfeeding and the use of human milk. Pediatrics 129, no. 3 (2012): e827-e841.
  18. Hauck, F. R., Thompson, J. M., Tanabe, K. O., et al. Breastfeeding and reduced risk of sudden infant death syndrome: a meta-analysis. Pediatrics 128, no. 1 (2011): 103-110.
  19. Emde, R. N. Early emotional development: new modes of thinking for research and intervention. Pediatrics 102, no. 5 suppl. E (1998): 1236-1243.