What's Up, Doc

2 good reasons not to cosleep

merrie7 — Wed, 04 Feb 2009 21:24:19 GMT

I used to watch those Nanny 911 shows. Every single one of these families had trouble getting their kids to sleep in their own beds. I can see the appeal of sleeping with a newborn while your nursing. But, apparently it often leads to sleeping with a 5 year old who has a temper tamptrum when you try to put him in his own room.

The second and far more important reason not to sleep with your baby is that accidents happen. I know, because it happened to my best friend. She had her son in the bed with her and took care to place him away from her so she wouldn't roll over on him. But he moved during the night and smothered. As if this horror wasn't bad enough, she was subjected to a police investigation and lost most of her friends and her husband.

Freak accident? Sure. Million to one shot? I certainly hope so. But for all you mothers out there going "Yeah, but...." why would you even want to risk it?

need to do more research!

mountainlake — Mon, 10 Aug 2009 08:37:04 GMT

This study did not take into account whether parents were taking drugs, overtired, obese, etc.

A study in Britain that did take into account these factors found that sharing a bed with an infant did not increase the risk of SIDS: http://www.themedguru.com/articles/sharing_a_bed_with_infants_does_not_increase_sids_risk-86117932.html

In addition, the article did not address the benefits of cosleeping. There are long-term social and psychological benefits as shown through research:

http://www.nd.edu/~jmckenn1/lab/longterm.html

I'm not jabbing a pitchfork at anyone. I'm just saying that all the research should be acknowledge, not just those that are against cosleeping.

Highest Cosleep Lowest SIDS Hong Kong

sethbscott — Mon, 06 Apr 2009 20:56:34 GMT

When I became a new parent, I was concerned about this issue. When I researched it, I found that comparisons to other countries are more useful than simply looking at America. That's how I found this amazing statistic:

The country with the least accounts of SIDS or infant death: Hong Kong

The country with the highest percentage of cosleeping: Hong Kong

This would indicate that there is no correlation whatsoever between the two. In fact, Asian countries almost exclusively cosleep with their children. Due to crowded and expensive real estate, they don't have children's rooms like Americans do. And yet infant deaths are almost unheard of.

Anecdotally, my wife and I have been co-sleeping with our infant son for the last year and a half. It's been more dangerous to us than him. The only recurring hazard we ever had was getting kicked in the face in the middle of the night.

Bed sharing served ancient humans

Margaret27 — Thu, 05 Mar 2009 19:37:57 GMT

Bed-sharing might well be what nature intended for babies. After all, for most of human history, babies were at risk from carnivorous animals. Keeping the baby close at night (and all day) helped the babies survive.

In Europe during the Ice Age, it must have been pretty cold at night too, so co-sleeping helped keep the babies warm enough. And in those days, overstuffed mattresses and feather comforters didn't exist. A few skins on the ground made a pretty firm sleeping surface.

A study of the side-car sleeping arrangement sounds like a good idea.

the problem with Sydney Spiesel's argument is...

theagallas — Sun, 01 Mar 2009 15:08:12 GMT

It's not substantiated by the research. Did Dr. Spiesel even read the study he cites? I did. In over 50% of the death scene reports, the site of the incident-- crib, bed, couch, sofa was not specified!Even the study authors didn't conclude that we shouldn't share beds with our babies. They said we need more information on safe sleep to prevent needless infant deaths. There isn't a mother out there who disagrees with that. Oh yeah, mothers, that reminds me: the study doesn't specify who was sleeping with baby....was it mom or, say, grandpa? I think that matters. I guess Dr. Spiesel doesn't think so.

And Dr. Spiesel warns us not to drink or take meds when we sleep with our babies. Good point. Too bad information on the involved adult's sobriety status was not included in the study. That might be really helpful information.

See that's the thing: the other problem with Dr. Spiesel's article is it's not helpful.Sleeping in very close proximity with baby is built in to breastfeeding. Babies have a round the clock need to get with mom and fill their little tummies. Mom's have a need for sleep. It's the physiological norm that babies would sleep next to mothers. Here's what's dangerous for babies in the sleep environment: couches, sofas, waterbeds, pillows, heavy comforters, sedated adult, adult other than mother, obese adult and prone positioning.

And Dr. Spiesel? Taking a "position" on breastfeeding is about as relevant as taking a "position" on in-utero gestation vs. extra uterine gestation. Who cares what anyone's position is? It's irrelevant what anyone's position is and here's why: breastfeeding is infant feeding.

It infuriates me that Slate published this without doing some fact-checking first. I mean come on, this is the best Slate has to offer?

Are people really this inhumane?

penguin15 — Mon, 09 Feb 2009 21:08:02 GMT

1. When you're asleep, you cannot bond with your child. There is no hormone, chemical, brain wave, heartbeat, etc. connection with your child. NONE. Yes, it is comforting to be next to your child, but you aren't connecting with them. They are asleep, and so are you.

2. When you're asleep, you don't know what's going on around you. Everyone sleeps through things, including thunderstorms, alarm clocks, break-ins, parties, wind gusts, whatever. How can you possibly hear every breath your child takes? You'd like to think you're that connected to your child, but you're not.

3. The fact that you can't hear everything during sleep means that even if your child starts to have problems, you may not hear it, or you may hear it, but it's too late. The lack of a child breathing makes no sound. It doesn't take too long for a child that small to be deprived of oxygen for long enough to kill it.

4. You outweigh the child by at least 10 times. If a massive person 10 times your weight sat on you, could you alert that person or would he/she not even feel you, especially when asleep?

5. These suffocation incidents don't just happen when drugs or alcohol are involved. A VERY small percentage might, but the "routine" accidents happen without these substances.

6. Cribs are designed for comfort. Yes, crib deaths occur, but they are not mostly due to suffocation / strangulation, as co-sleeping deaths are.

7. If you want to sleep with your child, it is not to comfort them, it is to comfort you. You could rock your baby to sleep, then place them asleep in the crib. To sleep with it to try and bond is just selfish. You could easily hear everything from a few feet away in the crib, but to comfort your feelings about your parenting ability, you'll keep the child in bed with you. It is not a doll or a teddy bear, this is a living, breathing human. To treat it like a toy is just inhumane and terrible.

8. The risk of strangulation / suffocation is just too great to continue the co-sleeping thing. Much like in breastfeeding, the child needs to be weened away. If it cannot sleep on its own, it won't be able to when it grows up. Meaning more night-time visits by your 8-year old because you never taught him to sleep on his own (oh yeah, there's scientific proof on that one).

We'd all love to have "family bonding time". But when you're asleep, none of it matters, because you're all ASLEEP! If you wanted to bond more, you shouldn't have watched three hours of CSI while your kid was in the playpen. The bedroom is no place for risking your child's life to comfort yourself. To all those who've lost kids in this way, I'm sure you'll agree that it is absolutely devastating to wake up with an unconscious child. For those of you who continue this practice, I pity you. You don't continue to drive drunk even if you've never hurt anyone before. It's just too risky and unsafe. Any minute of the night, a sheet or blanket could turn the wrong way, and boom, you've just killed an infant. Stop playing with your child like it's a toy, and put it to sleep in a crib or bassinet. Yes, it's "colder" than the bed. But isn't an alive child better than a dead one?

I co-sleep!!!!

JudyMcNeil2004 — Sat, 07 Feb 2009 03:59:31 GMT

With both my children, I co-slept with them the day they were born. It's easier to breastfeed and promotes bonding. Here are things to remember when considering co-sleeping.

You shouldn't if:

You are overweight

On medication

A deep sleeper.

Make sure the mattress is firm and no fluffy blankets. Do not co-sleep with the baby between two parents. The father does not have the natural instincts the mother has. This is not an insult to men. Mothers carry the baby for nine moments and our bodies tend to be in sinc.

This article is one-sided and insulting

kat.don — Thu, 26 Mar 2009 18:47:49 GMT

While the author says there is no evidence that co-sleeping is beneficial to parents and child, that is simply not true. There are a deluge of studies that support co-sleeping, not to mention the fact that SIDS is unknown in cultures where co-sleeping is the norm. Further, the author sites only this one recent study to support his sweeping suggestion that co-sleeping is bad. From the little he tells us about the study, it doesn't seem very sound. An analysis of death certificates?! How rigorous. There is good evidence that "rolling over on your infant" is the most common cover-up for killing your own infant.

It would be nice for the author to at least acknowledge the controversy here. This is terrible journalism. Shame on you, Slate.

Arms Reach Co-Sleeper Basinette

jposey — Fri, 27 Feb 2009 22:06:06 GMT

There ARE alternatives that allow parents and baby to be close!

There's a product that allows co-sleeping without the roll-over danger called Arms Reach Co-Sleeper Basinette. It is basicaly a 3 sided basinette that is attached to the side of the parental bed -- right up against the side of the mattress. My grandson was 5-1/2 weeks premature and co-slept in this bassinette (after 3 weeks in NICU), then went straight to a big bed with rails. My daughter also nursed him (she pumped while he was in NICU), and he is ahead of his age group, physically and developmentally.

Most parents I know...

pollyannacowgirl — Sat, 21 Mar 2009 17:17:28 GMT

Wind up co-sleeping, even if they're against it at first.

This is totally anecdotal and I claim no scientific proof of anything.

Now, I know all kinds of moms; ones that had epidurals, ones that did natural, ones that formula-feed, ones that breastfeed. The moms I know are college-educated, mostly white or Asian city-dwellers and rather affluent. They all love their children very very much. As far as I know they are not drug or alcohol abusers.

In my casual conversations with neighbors, folks in the playground, other parents at my kids' school, whenever the topic comes up, it's a vast majority who admit to having the children sleep in the marital bed. Usually people will be very hesitant to admit it. It usually starts out as a complaint. When I say that I've co-slept my kids (and they've transitioned well to their own beds on their own schedule) and that I understand, the truth comes pouring out. They admit that it's nice to snuggle their babies/children and that it's not forever and they never thought they would tolerate it.

Just an observation.

Bed Sharing with Children

joyfuljennifer73 — Fri, 06 Feb 2009 15:44:49 GMT

This is a subject I feel VERY strongly about. I was raised all over the world, and ONLY in the United States is this such a taboo concept. Parents have been (and continue to enjoy) co-sleeping with their children forever, very successfully, in all areas of the world.

I have two children who both slept with my husband and myself. At first my husband was a little nervous about the idea; even though he is not from the US, he also slept with his parents when he was young. He was worried that he would roll over on the baby, that the baby would suffocate, or that something could happen. We decreased the amount of blankets on our bed, and our children slept up toward the top of the bed (we used no headboard that they could get their heads caught in.) We made sure they weren't extra fluffy, and we kept nothing in the bed but a pillow for each of us, and our blanket and sheets. Parents LEARN not to roll over and squish their kids, and any parent knows that once they have children, they wake up more easily and are "more aware" of noises when they are normally sleeping. Neither of us rolled on our children.

The benefits of this were that we successfully breastfed on demand, which leads to the child having a better self esteem, and is linked to a higher IQ, in fact. Nursing also is beneficial for the mother, in that the longer she breastfeeds, the more her chances of developing breast cancer decreases.

Research shows that co-sleeping infants virtually never startle during sleep and rarely cry during the night, compared to solo sleepers who startle repeatedly throughout the night and spend 4 times the number of minutes crying. Startling and crying releases adrenaline, which increases heart rate and blood pressure, interferes with restful sleep and leads to long term sleep anxiety.

Notre Dame anthropology professor and leading sleep researcher, James McKenna, has long held that babies who sleep with their mothers enjoy greater immunilogical benefits from breastfeeding because they nurse twice as frequently as their counterparts who sleep alone. Studies show that infants who sleep near to parents have more stable temperatures, regular heart rhythms, and fewer long pauses in breathing compared to babies who sleep alone. This means baby sleeps physiologically safer.

In his book on Sudden Infant Death Syndrome, pediatrician William Sears cites co-sleeping as a proactive measure parents can take to reduce the risk of this tragedy. McKenna's research shows that babies who sleep with parents spend less time in Level III sleep, a state of deep sleep when the risk of apneas are increased. Further, co-sleeping babies learn to imitate healthy breathing patterns from their bunkmates.

Worldwide research shows that the SIDS rate is lowest (and even unheard of) in countries where co-sleeping is the norm, rather than the exception. Babies who sleep either in or next to their parents’ bed have a fourfold decrease in the chance of SIDS. Co-sleeping babies actually spend more time sleeping on their back or side which decreases the risk of SIDS. Further research shows that the carbon dioxide exhaled by a parent actually works to stimulate baby’s breathing.

Co-sleeping babies grow up with a higher self-esteem, less anxiety, become independent sooner (are more independent than their peers), are better behaved in school, have fewer health problems, and are more comfortable with affection. They also have less psychiatric problems. After all, who is more likely to be well-adjusted, the child who learns that his needs will be met, or the one who is left alone for long periods of time? McKenna suggests that it is confusing for a baby to receive cuddles during the day while also being taught that the same behavior is inappropriate at night.

The Consumer Product Safety Commission published data that described infant fatalities in adult beds. These same data, however, showed more than 3 times as many crib related infant fatalities compared to adult bed accidents. Another recent large study concluded that bed sharing did NOT increase the risk of SIDS, unless the mom was a smoker or abused alcohol.

Richard Ferber suggests that the best way to solve your child's "sleep problems" is to isolate them in another room, shut the door, and let them cry for ten minutes without interruption. Then parents may enter the room and verbally soothe the baby, but are warned against making physical contact with their baby. Shortly after, they are advised to leave the infant to cry for another timed interval a la "Mad About You."

Many parents argue that they tried "Ferberizing" their baby and enjoyed great success with the technique. Indeed, the infant may stop crying and learn to go to sleep on his own, but this is a short-term pay off for parents. The baby has not suddenly discovered quiet content. He simply is exhausted from his futile efforts to be nurtured. Fifteen years later, the same parents shrug their shoulders and wonder why their kids are shutting them out.

A few parents do experience difficulty sleeping with a baby in their bed. For them, a "sidecar" or bedside sleeper is an ideal way to meet their needs for rest and their baby's need for co-sleep. Keeping a crib or bassinet in the parents' room is another option. A "family bed" is not for everyone, but creative solutions for co-sleep are abundant in our consumer-friendly culture.

The most common question co-sleepers are asked is about maintaining a sexual relationship with one's partner. The answer is simple. Go someplace where the baby is not. Enough said.

For those who consider unlimited access to their sexual partner more important than meeting the needs of their baby, cat ownership is a wonderful alternative to parenthood. You can just toss a bowl of Nine Lives on the floor and frolic around the house whenever the mood hits you.

Co-sleeping is not right for everyone. Heavy drinkers and drug addicts should avoid sleeping with their babies. Of course, these folks should probably avoid parenthood altogether.

If scientific research consistently demonstrates that co-sleeping offers tremendous benefits for babies and has no deleterious effects, it's time Americans join the rest of the world and parent our babies 24 hours a day.

Finally! A sane article on this subject

From Under the Quabbin — Fri, 27 Feb 2009 03:55:37 GMT

Thanks for a sober article on co-sleeping, pointing out the risks, and mentioning the benefits (to which you should add: A breastfed newborn doesn't reach the same state of distress at night before Mom can feed it). Thanks also for sticking to medical facts and avoiding the psychobabble predictions most people throw into the discussion.

One of the hardest choices my wife and I made early on was whether to co-sleep or not. We chose to do so, and we thoroughly enjoy it, and so does our little girl. We are cognizant of the risks, especially since I sleep very heavily. But we don't tell people we do it, because there is apparently this notion that babies who co-sleep grow up dependent (Nobody mentions the risk of death except doctors).

Hmmm

janna1g — Wed, 04 Feb 2009 19:31:28 GMT

I believe I read that the reduction in SIDS and concurrent rise in strangulation/suffocation while sleeping comes out to exactly the same death rate. That is, what used to be called SIDS is now more accurately classified on death certificates.

Even the reduction in deaths attributed to back sleeping is not an actual reduction in death rates, but the result of shifting classification of causes.

I personally suspect that if you suffocate your infant by rolling over on them, you are under the influence of some kind of intoxicant or medication. My son didn't sleep with us, but across the hall. Never the less, I was awake before he began crying nearly all the time. Just the sound of him wiggling a bit more in his crib was enough to wake me.

In the same bed, I probably wouldn't have slept at all! Or very, very lightly.

Sleeping with baby in your bed

dorothy Steinbeck — Tue, 10 Feb 2009 07:43:47 GMT

Most if not all mammals sleep with their children in a den or lair. It is very, very natural for children to be nurtured through an "attachment" manner, where baby is close to mom and dad at all times for the first year, two is better. Breast feeding is a very important part of raising a baby, and so is having the whole family sleep together. It is a natural response and that is why so many parents do it.

I agree that a stoned out or drunk parent should not sleep with their children because there is a chance of the parent not waking up if he or she rolls over on the baby, but that is extreme - I mean the parent(s) would have to be passed out stone drunk and probably shouldn't be taking care of a baby anyway. Telling parents they should not sleep with their children is tantamount to telling them it is better to feed their babies formula rather than breast feeding or should let them cry themselves to sleep in a crib all by themselves. Babies should be tended to any time that they cry because there is something the baby needs - and, the need to be held and cuddled is just as important as the need for food or a diaper change or anything else. Parents should carry their babies in slings to keep them close as well. These are the things that make confident, self-assured adults. When babies' needs are not met, they get confused and frightened and feel unloved. These studies are bunk and have nothing to do with raising really productive and happy children who will grow into self-assured, confident adults who know they are worthwhile and have much to offer society.

EXCUSE ME?

ndwannabe — Sat, 07 Feb 2009 07:46:23 GMT

Is it "OK"? Gee, soon the question is going to be "Is it OK to touch your baby..."

People, that's how ALL mothers of ALL species rared their babies in ALL times, untill all of sudden we came up with a need to analyse and calculate and do "recent research studies"...

Crazy times...

Let me ask you - do you sleep so soundly that you fall of your bed when you toss and turn? Why not? There is something STILL not asleep in your brain that tells the rest of your body what is safe and what is not. This same "something" will tell your body not to roll over your baby!

Man, with all those cribs, props, swings, bottles, holders and restrictors, those poor babies are like caged animals...

I wonder how Mary managed to raise Jesus without a crib of his own.

This is the most important thing we have to worry about?

MarketingMama — Fri, 06 Feb 2009 13:47:29 GMT

What a bizarre thing to worry about in a world where children are beaten, abused, impoverished and neglected. The parents I know who choose to co-sleep do so out of love for their child and a commitment to breastfeeding. They read McKenna and Sears and make smart decisions about safety such as using an attached sleeper, getting a firm, non-pillow top mattress, putting the mattress on the floor, etc., getting rid of loose sheets and blankets, etc. Studies like this are misleading because nowhere do the researchers tell you how many of the deaths occurred in settings like this vs. someone sleeping with loose sheets or on a couch or under the influence of something.

I don’t think co-sleeping’s for everyone and I think we should support programs that provide cribs, etc., so that infants are not sleeping with parents out of poverty or lack of another option. But if a family chooses to co-sleep safely, I say Bravo for another child in a loving home with parents who are attentive and care. I was just reading an article the other day about instances of child abuse going up when parents are under increased economic stress, so in this time of economic downturn, shouldn’t we be a bit more worried about the babies who aren’t getting love and attention?

I cosleep and I haven't killed my kids yet! :)

annasoderberg — Sat, 07 Feb 2009 07:23:51 GMT

Here is an article with solid facts:

How the Stats Really Stack Up: Cosleeping Is Twice As Safe
By Tina Kimmel
Issue 114 September/October 2002 (Mothering)

The Consumer Product Safety Commission (CPSC) and the Juvenile Product Manufacturers Association (JPMA, the crib manufacturers' lobby) recently launched a campaign to discourage parents from placing infants in adult beds or sleeping with them, based on data showing that infants have a very small risk of dying in adult beds.1,2 The CPSC implies that infants in adult beds are at greater risk than infants in cribs, but as we know, and as they know, babies also die in cribs.

What we need to do is calculate the relative riskiness of an infant sleeping in an adult bed versus a crib. We can do that by dividing a measure of danger for each situation by the prevalence, or frequency, of that situation, and then comparing them. (Oddly, the CPSC never presents relative risks.) Using government figures, we can perform a rough calculation to show that infants are more than twice as safe in adult beds as in cribs. This is aside from the many other advantages of cosleeping or bedsharing, such as increased breastfeeding and physiological regulation, the experience of having slept well, parents' feeling of assurance that their child is well and happy, the enhanced security of psychological attachment and family togetherness, and family enjoyment.3

Let's begin by looking closely at the CPSC data. The anti-cosleeping campaign is based on a dataset that contains the 2,178 cases of unintentional mechanical suffocation of US infants under 13 months old for the period 1980 to 1997. CPSC-authored articles about these data reflect only the small portion of deaths that occurred in adult beds.4 However, these data also have been published with summaries of the cause-of-death codes on all 2,178 cases.5 This complete dataset is further summarized in Table 1.

Of these 2,178 infant suffocation deaths, we are certain of only 139 occurring in an adult bed. For 102 of these, we know that a larger person (presumably a sleeping adult) was present, because the cause-of-death code is "overlain in a bed." That does not tell us exactly what caused the death-that is, whether the baby died and then was lain on, or died as a result of being lain on. We can assume that the 37 deaths involving waterbeds occurred in adult beds, since few child waterbeds exist. That gives us a total of 139 infant suffocation deaths known to have occurred in adult beds in these 18 years.

The same data show that 428 infants died due to being in a crib. It is likely that there were preventable risk factors (such as using a crib in need of repair) involved in these crib-related deaths. But that doesn't change our calculations, because the deaths did occur. Similarly, our calculations do not change due to the preventable risk factors (such as intoxication) involved in adult-bed deaths (and other overlying). Note that advocates are raising public awareness to increase the safety of both these sleeping arrangements, with the hope that all these deaths will decrease.

We can't use the other 739 bed- or bedding-related cases in our analysis, because the place of death is not specific enough; these deaths may have occurred in a large adult bed, a single-size adult bed, a child's bed, or a misused crib. Nor can we include the remaining 760 deaths, as we have no idea whether they took place in a sleep situation at all. We also know nothing about the presence or absence of an adult, although a nearby, aware caretaker could have prevented many of these deaths.

So for only 567 (139 plus 428) of the deaths do we know whether they took place in an adult or infant bed. Thus, from 1980 to 1997, 75 percent of the mechanical suffocation deaths of US infants with a known place of occurrence took place in cribs, while 25 percent took place in adult beds.

While it is tempting to make the observation that three times as many babies died in cribs as in adult beds, if three times as many babies were actually sleeping in cribs as in adult beds, the risk would be the same in either place. Based only on this crude death-certificate data, we do not know which is safer. We still need to know how many babies were actually in adult beds or cribs-that is, an estimate of how common cosleeping was.

To estimate cosleeping prevalence, we can turn to the CDC's Pregnancy Risk Assessment Monitoring System (PRAMS).6 PRAMS has been surveying mothers of infants, usually between two and six months of age (but occasionally up to nine months), since 1988. Approximately 1,800 new mothers are sampled each year in each participating state. The sample is rigorously selected to represent essentially every birth in the state, and the response rates are high (70 to 80 percent). Most of the 100 or so PRAMS questions involve prenatal and well-baby care and stressors.

States have the option of adding their own questions and have asked about cosleeping. The basic question asked is, "How often does your new baby sleep in the same bed with you? Always; Sometimes; Never." (Some states add "Almost always.") PRAMS data, therefore, can be used to ascertain cosleeping prevalence in participating states and may be the only data of this kind.

Table 2 shows the results of this question on the PRAMS survey from 1991 through 1999, the most recent data available.

We see from these data that roughly 68 percent (100 percent minus the 23 to 43 percent who "never" coslept) of babies in these states enjoyed cosleeping at least some of the time. Data from the United Kingdom are similar: Helen Ball's Sleep Lab found that around 7 percent always coslept, 40 percent did so for part of the night, and 33 percent never coslept.6

Now let's try to estimate a single cosleeping prevalence rate from these data. Let's say that babies who "sometimes" cosleep do so about half the time. Over all the years of this sample, around 42 percent of babies coslept "sometimes." Let's also say that "always" or "almost always" means 90 percent of the time. Roughly 26 percent of infants coslept "always" or "almost always." Adding "always/almost always" (90 percent of the time x 26 percent of babies) to "sometimes" (50 percent of the time x 42 percent of babies), we get 44 percent of babies ages two to nine months who were cosleeping at any given time, presumably in an adult bed.

Now we can use these figures based on CPSC and PRAMS data to calculate the riskiness of these two sleep arrangements, although it's important to understand the limitations of doing so. For example, these PRAMS data are from only five states (although more will be available in the future), while the CPSC data are from the entire US. The years in which the PRAMS cosleeping data were collected are not the same as those covered by the CPSC dataset, although they overlap. The CPSC covers infants zero to thirteen months, while PRAMS asks about infants two to nine months. The CPSC collects demographic details such as state, income, race, and age of mother (as does PRAMS), as well as time of the death, but they are not easily available to do a more detailed analysis. One or both of these data sources lacks information on impairment of caretaker and other known sleep risk factors, exact sleeping and furniture arrangements during different times in the night, overcrowding and other motivation for cosleeping or crib sleeping, clinical pathology findings, previous health of the infant, etc. Plus, a complete risk analysis should include all causes of infant deaths, including SIDS.

Nonetheless, these data are important population-based sources of information on sleep risks that we would not have otherwise. So let's go ahead and use them to estimate a risk ratio for cosleeping. We take the 25 percent of the suffocation risk in the CPSC data linked to being in an adult bed and divide it by the 44 percent of babies who were actually in adult beds. Then we divide that fraction by a similar fraction for cribs, i.e., 75 percent divided by 56 percent. (If we multiplied each of these fractions by an overall infant death rate, we would have the actual risk for each group.)

This result shows that it was actually less than half (42 percent) as risky, or more than twice as safe, for an infant to be in an adult bed than in a crib. Based upon these calculations using the CPSC's own data, we can say that crib sleeping had a relative risk of 2.37 compared with sleeping in an adult bed.

Therefore, cosleep with impunity-but, of course, be sure to follow the safe cosleeping guidelines described in this issue of Mothering.

NOTES
1. "CPSC, JPMA Launch Campaign about the Hidden Hazards of Placing Babies in Adult Beds," Consumer Product Safety Commission press release no. 02-153, May 3, 2002.
2. S. Nakamura et al., "Review of Hazards Associated with Children Placed in Adult Beds," Arch. Pediatr. Adolesc. Med. 153, no. 10 (1999): 1019- 1023.
3. Summarized in M. O'Hara et al., "Sleep Location and Suffocation: How Good Is the Evidence?" Pediatrics 105, no. 4 (2000): 915-920.
4. See Note 2.
5. Dorothy A. Drago and Andrew L. Dannenberg, "Infant Mechanical Suffocation Deaths in the United States, 1980-1997," Pediatrics 103, no. 5 (1999): e59.
6. Centers for Disease Control and Prevention, "Pregnancy Risk Assessment Monitoring System," www.cdc.gov/nccdphp/drh/srv_PRAMS.htm.
7. "The Sleep Lab Awakening," University of Durham (UK) press release, April 6, 2000.

Tina Kimmel, MSW, MPH, is a PhD student in social welfare at the University of California-Berkeley and is writing her dissertation on "The Effect of Welfare Reform on Breastfeeding Rates: Findings from the Pregnancy Risk Assessment Monitoring System." Previously she worked as a research scientist for California's state health department. She would like to acknowledge the state PRAMS epidemiologists who shared their analyzed data for this article: Rhonda Stephens, MPH (Alabama), Chris Wells, MS (Colorado), Ken Rosenberg, MD, MPH (Oregon), Melissa Baker, MA (West Virginia), and especially Kathy Perham-Hester, MS, MPH (Alaska) for her valuable insights. Tina has two children, Rosie (27) and Jesse (21), and one grandchild, Eli (4)-all born at home and all cosleepers.

The safest place for a baby to sleep is a crib

KT3 — Sat, 07 Feb 2009 05:43:48 GMT

I've work in child protection/social services and although you may question the findings of the present study, I can tell you the safest place for a baby to sleep is in a crib. I've seen families emotionally ripped to shreds because their babies have been suffocated. Parents roll over babies, babies get caught between parents and pillows, thrown off the bed or wedged between couch cushions. These are not bad, neglectful parents. These were parents who loved their children dearly. These are parents, however, who did not understand the dangers of sleeping with their babies.

Co-sleeping was a fatal decision for my daughter

Deweygrrl — Fri, 06 Feb 2009 20:20:20 GMT

We did everything to make it "safe"

There were no heavy blankets, firm matress, she was not between my husband and I, I am petite, I was not under the influence of anything except love and naivete.

our daughter suffocateed because of overlay. This tragedy could have been avoided if we followed the ABC's of sleep. Alone, On her back, and in a safe Crib.

I liken it to the behavior of drunk driving. Someone doesn't die when a drunk gets behind the wheel, but it increases the risk. why would anyone take this risk!

Please listen. I do not want anyone to go through what my family has.

Damn good idea in the initial months

janani — Fri, 06 Feb 2009 14:20:06 GMT

This article was just more alarmist crap w/o any conclusive evidence to back it up.

As long as you're not drunk or stoned, it's fantastic to co-sleep. It is very conducive to breastfeeding and also very reassuring to the infant. As someone who has done it and has a healthy non-suffocated baby to show for it, I assure you, you will be aware of the baby's movements and you won't strangle him/her.

very hard to accept

Deweygrrl — Sat, 07 Feb 2009 00:23:52 GMT

I have been following this thread closely and I find it so hard to understand why anyone would still co-sleep if they knew of ANY babies that died because of it.

I try so hard to share my story. I did everything that Dr. sears bookds say to make it "safe". I was not on drugs or alcohol, she was not inbetween anything or anyone, there were no blankets, it was a firm mattress, i am not obese or a heavy sleeper and my daughter died in our bed because of overlayment.

My heartaches becuase of the "it can not happen to me" mentality. It can and DID happen to me.

I have to live with the emptiness and pain every day. I would never want anyone to go through this.

Please do not let anyone you know cosleep. PLEASE....

Do it for Corynn.

Co-sleeping

gauge2 — Wed, 04 Feb 2009 13:25:26 GMT

There are a large number of studies that show co-sleeping generates positive developmental effects, and the risks involved stem from a limited number of highly controllable risk factors (e.g., alcohol use, loose bedding, fathers). Putting the infant in another room (recommended by male physicians to this day) is just a cold-hearted experiment.

Most babies die sleeping alone

Angelica Totten — Sun, 08 Feb 2009 02:13:14 GMT

First of all, contrary to what this article says, this study does NOT link bedsharing practices with rates of suffocation/accidents (see my posting below, "doctor refutes study"). This article is the opinion of *1* doctor who, by the way, seems smugly happy that this study seems to validate "what doctors (such as herself) have been saying all along," versus parents who are "pushing" to bedshare. That alone should raise red flags about his/her biased approach to the data.

Second, according to James McKenna, national cosleeping/bedsharing expert (see link http://www.naturalchild.com/james_mckenna/cosleeping.pdf):

"Most USA and other western infants die from SIDS or
from fatal accidents during solitary sleep outside the supervision
of a committed adult.24

Moreover, the overwhelming
number of suspected accidental overlays or fatal accidents
occur not within breast feeding–bedsharing communities but
in urban poverty, where multiple independent SIDS risk
‘factors’ converge and bottle feeding rather than breast
feeding predominates. Additional adverse risk ‘factors’ associated
with bedsharing in high-risk populations are maternal
smoking, infants placed to sleep on pillows or under duvets,
with other children and co-sleeping with infants on sofas,
waterbeds or couches. Bedsharing when the infant sleeps
with an adult other than the mother, maternal exhaustion,
alcohol or drug use, or leaving infants unattended on an adult
bed also increase SIDS risks and/or fatal accidents.21,25–28

This review examines conceptual issues related to the
biological functions of mother–infant co-sleeping, bedsharing
and what relationship each has to SIDS. It addresses the
lack of definition as to what constitutes co-sleeping in
studies that argue against the practice29 and describes
reasons why in western industrialised countries the question
concerning what constitutes safe infant sleep has been
turned on it’s head. That is, solitary infant sleep in ‘baby
designed cots,’ devoid of parental contact–a novel and
biologically unexpected sleep environment for the human
infant–is regarded without qualifications by some researchers
as being inherently safer than any and all forms of
mother–infant co-sleeping.30 Moreover, mothers’ bodies,
whether offering breast milk or not and independent of
sobriety, continue to be regarded as potentially lethal
weapons–wooden rolling pins, if you will, over which
neither mothers nor their infants have control during sleep
(see Consumer Product Safety Commission (CPSC) statement
by Ann Brown, above).

The need to distinguish between safe and unsafe beds
and bedsharing is essential in clarifying under what conditions
forms of co-sleeping (including forms of bedsharing)
can be considered ‘hazardous.’"

...for more, follow the link.

Are people really this inhumane?

penguin15 — Mon, 09 Feb 2009 20:39:11 GMT

First off, please don't respond to this if you're just going to claim that "he doesn't have kids, so he wouldn't know". I've been around plenty of kids to know. The risks for co-sleeping are astoundingly high, and I can't believe that people do this. Here's what I know: 1. When you're asleep, you cannot bond with your child. There is no hormone, chemical, brain wave, heartbeat, etc. connection with your child. NONE. Yes, it is comforting to be next to your child, but you aren't connecting with them. They are asleep, and so are you. 2. When you're asleep, you don't know what's going on around you. Everyone sleeps through things, including thunderstorms, alarm clocks, break-ins, parties, wind gusts, whatever. How can you possibly hear every breath your child takes? You'd like to think you're that connected to your child, but you're not. 3. The fact that you can't hear everything during sleep means that even if your child starts to have problems, you may not hear it, or you may hear it, but it's too late. The lack of a child breathing makes no sound. It doesn't take too long for a child that small to be deprived of oxygen for long enough to kill it.4. You outweigh the child by at least 10 times. If a massive person 10 times your weight sat on you, could you alert that person or would he/she not even feel you, especially when asleep? 5. These suffocation incidents don't just happen when drugs or alcohol are involved. A VERY small percentage might, but the "routine" accidents happen without these substances. 6. Cribs are designed for comfort. Yes, crib deaths occur, but they are not mostly due to suffocation / strangulation, as co-sleeping deaths are. 7. If you want to sleep with your child, it is not to comfort them, it is to comfort you. You could rock your baby to sleep, then place them asleep in the crib. To sleep with it to try and bond is just selfish. You could easily hear everything from a few feet away in the crib, but to comfort your feelings about your parenting ability, you'll keep the child in bed with you. It is not a doll or a teddy bear, this is a living, breathing human. To treat it like a toy is just inhumane and terrible. 8. The risk of strangulation / suffocation is just too great to continue the co-sleeping thing. Much like in breastfeeding, the child needs to be weened away. If it cannot sleep on its own, it won't be able to when it grows up. Meaning more night-time visits by your 8-year old because you never taught him to sleep on his own (oh yeah, there's scientific proof on that one). We'd all love to have "family bonding time". But when you're asleep, none of it matters, because you're all ASLEEP! If you wanted to bond more, you shouldn't have watched three hours of CSI while your kid was in the playpen. The bedroom is no place for risking your child's life to comfort yourself. To all those who've lost kids in this way, I'm sure you'll agree that it is absolutely devastating to wake up with an unconscious child. For those of you who continue this practice, I pity you. You don't continue to drive drunk even if you've never hurt anyone before. It's just too risky and unsafe. Any minute of the night, a sheet or blanket could turn the wrong way, and boom, you've just killed an infant. Stop playing with your child like it's a toy, and put it to sleep in a crib or bassinet. Yes, it's "colder" than the bed. But isn't an alive child better than a dead one?

Lets bring up a new thought on this

Crystal3355 — Fri, 06 Feb 2009 18:44:39 GMT

I will start by saying my 4 month old sleeps with me. I have been pitchforked by family members already so do your best if you got one ready. So to me there are FAR too many questions around these deaths that happen. First off if your husband is a heavy sleeper why would you have your child sleep near your husband since you would know already that it is a risk. They never say what the percentage of men or women rolling over is, if they were on drugs/alcohol, and a big one to me is how heavy they were. They say that roll over deaths have increased over the years-so has obesity, so it makes me wonder whether or not that can effect the situation. There aren't enough stats.

Co-sleeping isn't a new topic and it sometimes makes me think of the 70s when women were urged not to breast feed (which is insane!)--until there is a well put together study on co-sleeping I think it is up to the parents and the pitchfork people should put it in their pocket.