Conscious Co-sleeping

What is Co-Sleeping?

Co-sleeping is the practice of having your baby sleep in your bed or in a bed that is adjacent to your bed. The practice of “separate surface” co-sleeping provides many of the same benefits.

Co-sleeping, when done correctly, is safer than having your baby sleep in a separate room. Co-sleeping promotes bonding, and makes breastfeeding a more easily achieved practice.

In writing this I hope to address some frequently asked questions that concerned parents often have about co-sleeping. The answers are from my personal experience as well as the research of Dr. James McKenna of the Mother-Baby Behavioural Sleep Laboratory of the University of Notre Dame.

Why co-sleep in “western” cultures which often do not approve of the practice?

The short answer to this is because it is safer and healthier for your baby. Being within close reach during sleep enables the mother and baby to each respond to the cues of the other (smells whispering, touch, heat, breathing patterns).

Co-sleeping is a cross-cultural, species-wide practice which is a behaviour designed to maximise infant survival rates.  It is humankind’s oldest and most successful mother-baby sleeping and breastfeeding arrangement.

Apart from the obvious convenience of breastfeeding, are there any other health benefits to co-sleeping?

When a baby sleeps close to their mother or another adult caregiver, where they periodically exchange sensory stimuli and share touch, vision, sounds, smells, movement cues, breathing sounds, CO2 gas, as well as breast-milk, it cuts the chance of the baby dying from SIDS (about a third to half).

A newborn baby’s respiratory system is not fully developed, they benefit from hearing the pattern of the parents breathing as they sleep. As they hear the pattern they naturally copy it preventing breathing abnormalities.  As with the breathing, the baby’s internal heating regulation is not fully developed either and when sleeping use the parent’s body heat to keep warm in a way that works better than heavy blankets which can be a SIDS risk.

The frequency with which the baby is touched is also of great value to the baby’s developing immune system and growth. Being in arms reach for a pat or cuddle helps to promote the release of  growth hormones and promotes elasticity in the intestines to help the baby’s absorption of nutrients.

In addition to the above, sleeping in the shelter of the parent promotes neural and psychological development.  Remember, most mammals are born ready to walk, but ours are born when they are still 1 year away from walking. Our evolutionary design has us birthing our babies early so that we can walk upright and be better able to run from predators, but in order to develop properly our babies need more time in our arms.

What makes the safest possible bed-sharing environment?

There is no one risk or benefit factor which guarantees the safety of the bed, but a combination of factors.

To begin with, a safe bed-sharing environment is when the bed is shared with non-smoking, responsible, committed and sober parents or close family members.  An emotional bond is very important as well. Tobacco or other substances should not be smoked anywhere in a house where children are living. The dangers of second hand smoke should not be underestimated.

The baby should sleep on their back on a clean, flat firm surface, unencumbered by pillows, sheepskins, bean bags, fluffy materials  and toys that can smother the face. The baby should have light blanketing , kept away from the face. Use sleep suits to keep warm in colder weather.

The baby should never be left on a bed alone but should be between the two adults, or in a crib next to the bed. Breastfeeding mothers tend to fall asleep with the baby cradled between her arm and body. This is one of the safest positions for baby.

It goes without saying that a baby should never be left to sleep on a couch or sofa or on any other surface where they can become lodged between the cushions or fall into a crevice, or roll off onto the floor. Babies can roll from the time they are born.  Waterbeds are not safe for family bed-sharing.

I am concerned about the possibility of SIDS and I have heard that a baby can be smothered if they sleep in bed with the parents.  How can SIDS be prevented and still gain the benefits of co-sleeping?

Babies are not smothered if they sleep with emotionally attuned, healthy, non-smoking and sober parents. The parent adjusts their sleeping space to protect the baby. It goes without saying that this includes never taking desensitising medications when sleeping in bed with your child.

If you feel insecure about having the baby in your actual bed, you could invest in a crib such as the Arms Reach which is a cot/crib which can be attached to the side of the parent’s bed.

I have heard some experienced mothers say that if I allow my baby to sleep in my room or bed then they will not develop independence and my baby will grow up to be emotionally clingy and won’t be able to sleep in their own room when they get older. Is this true?

Interestingly, when a child’s inherent need for reassurance contact and proximity to the parent is met, the child grows up more self-assured and independent than those who are supposedly “trained” to sleep in their own rooms and “self-soothe” as infants.

Some parents confuse the ability of an infant to “soothe” themselves back to sleep with independence, autonomy and a lifelong sense of confidence.  The age at which a child learns to put itself back to sleep has little to do with its eventual confidence I itself as a human being. All children eventually learn to go to sleep by themselves, but the ones who have a sense of trust from knowing that you will be there when they need you, will have the confidence to later spread their wings at the appropriate time.

Unfortunately parents often feel pushed into going against their instincts by societal pressures which have their basis in false claims which suggest that if a child cannot put themselves back to sleep or “self-soothe” by a certain age then something is wrong with them or wrong with the parents.

No other cultures in the world, aside from the “western” cultures worry about such “milestones”.

Western culture has constructed a version of “normal”, in which there is an assumption that a baby sleeps in their own room and “self-soothes” so that the parents can keep to a rigid schedule and normal sleep pattern.

As most parents can attest, leaving a baby to cry it out in his/her room until they give up and fall asleep from exhaustion is not soothing to anyone. It goes against everything that your parental nature tells you to do.

Psychologists Keller and Goldberg from the University of California found that the capacity for self-sufficiency as well as the capacity for full engagement with others and “problem solving skills” were enhanced by routinely co-sleeping from birth. Keller and Goldberg(2004) conducted the first systematic studies of “independence”  starting out with a definition of what they meant by “independence” which was the first of its kind. Their study found that non-bed sharing toddlers were the ones less likely to be able to be alone, and less able to solve the problems presented to them while alone. The opposite of what is frequently assumed.

Does sleeping arrangement alone determine a child’s level of independence?

Human beings are complex creatures, so it seems obvious that sleeping arrangements are only a part of the bigger picture. A co-sleeping arrangement likely enhances the positive personality attributes of the child as well as enhancing the psychological and social skills acquired from the child’s relationship with his or her parents and other social experiences and relationships.  But it will be the relationship that child and parents develop with each other over the 24 hours of each day that plays an important role in the child’s development of independence. Is the child loved and cared for emotionally all of the time, including the night time hours of sleep? The sleeping time is only part of the give and take interactions which develop the child’s character in the long-term.

Why is it less safe for bottle-fed babies to bed-share?

Bottle-fed babies and their mothers engage in different behaviours from those who breastfeed. This can lead to risk factors being introduced. A breastfeeding mother will naturally keep her baby under her arm and close to the chest area, and the baby will gravitate towards that area also to look for the nipple and because they like the good smell of mothers milk. By contrast a bottle feeding mother may not have a habit of holding her baby this way and the baby may gravitate higher in the bed towards the pillows. Breastfeeding changes the mothers sleep physiology also making them awaken when the baby stirs and adjust their sleep pattern to the child’s. This is an added safety factor that may be missing from the bottle feeding mother’s sleep pattern.

While there are concerns about actual bed-sharing with a bottle fed baby that does not mean that you cannot co-sleep in the same room, or using a separate surface co-sleeping crib, so that you and your child can partake of the bonding experience of co-sleeping. For your child’s sake, please consider breastfeeding so that your child can get the full species-specific benefits which come from breastfeeding.

Why do we hear about babies dying from bed-sharing?

Coroners rarely report the cause of the death of a SIDS baby in bed sharing cases.

Bed-sharing deaths are preventable if all the risk factors are removed and only breastfeeding babies share a bed with their breastfeeding mother.

Let’s review the preventative measures for SIDS with bed-sharing:

-share a bed with your small baby only if you are breastfeeding

-be knowledgeable about what the risks are

-do not share a bed if you or your partner have been smoking, drinking alcohol or taking drugs (including de-sensitising prescription medication)

-never smoke in the house where a child lives

-babies must sleep on their backs not the tummy or sides from which they can roll onto their tummy

-the sleeping surface should be firm, clean and free from sheepskins, pillows, doonas, puffy quilts, fluffy toys and materials

-warmth should be obtained from light blanketing, preferable of breathable material and sleep-suits for the baby

-bed should be low to the ground and in the middle of the room not against the wall

-baby should never be left to sleep alone on the parent’s bed

-other children should not be in the bed with the baby

-never place the baby on top of or in between pillows

-never bed-share in a waterbed

-babies of mothers who smoked during pregnancy  or routinely breathed in second-hand smoke are at risk in any situation but a separate surface for sleep is advisable as they may be unable to wake up when they are low on oxygen which may occur because of sleep apnoea (they child stops breathing during deep sleep)

The experts who recommend bed-sharing agree that no two bed-sharing arrangements are alike and it’s up to each set of parents to make sure that all the proper preventatives are practiced.

 

What other baby care practices protect and contribute to their health and well-being including their safety at night?

Hold and respond to the child as much as possible. The overuse of hard surface carriers and plastic car seats, or other carriers contributes to the development of flat head syndrome as well as not allowing the baby to develop neck muscles that are strong enough to move the baby’s face away from a suffocating surface while asleep.  Body to body upright carrying in the arms is excellent for developing the muscles of the neck and spine as well as allowing hand-eye co-ordination to develop as the baby’s head can swivel around and his eyes can track what’s going on.  The next best thing to arm carrying, is carrying the baby in a baby-wearing wrap or with the head free and legs in a frog position so as not to put undue pressure on the spine.

Supervised tummy time on the floor a couple of times a day is also advisable to help the development of the back and neck muscles for sitting, crawling and later walking.

If I begin this practice of co-sleeping when should my child move out of our room and into their own room?

This is a question which should be answered by each parent in their own way. The question which you should ask yourself is this: Is it safe for them to be on their own at this stage of their development?

My six children all moved into another room between the ages of 2-3. I felt they were ready to move out when they could speak to communicate their needs, when they could walk well, and when it seemed like they were giving me cues to indicate that they wanted to have a room of their own (or shared with a sibling, which they were usually excited about). They would still come to my bed if they awake from a nightmare till around 4 years old but we often took them back to their room and re-settled them, so that we could all sleep better. My youngest child continued to fall asleep during story time on our bed till she was 7 years old, and we would transfer her to her bed for the night. She continued this till one day she made up her mind to just go to sleep in her own bed and she has done that ever since.

So it really is a personal decision based on your experience, and what cues your child is giving you. Follow your parental instinct.

Resources on co-sleeping found at:

www.cosleeping.org

www.naturalchild.org/james_mckenna/cosleeping.pdf

 www.cosleeping.nd.edu

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