Co-sleeping Info

I encourage expectant parents to read the following article, even if they are not planning to bedshare or co-sleep with their infant.  The process of breastfeeding actually creates a hormonal influence on mothers initiating sleep.  Mothers may find themselves inadvertently cosleeping/bedsharing and feeling guilty about it the next day. I believe the following article clarifies the studies behind the differing beliefs about the safety and risk of co-sleeping, the interesting discoveries about how co-sleeping can actually benefit some families, and how to co-sleep safely.

Article from Mothering Magazine:  Sleeping with your Baby

cosleep pic

Safe Co-Sleeping Check List

#1: Babies should sleep on their backs

  1. Babies love to sleep on their bellies, and tend to sleep more deeply in this position.  This might sound good, however, having your baby sleep on her/his back is considered safer. “Light stage sleep is thought to be physiologically more appropriate and safer for babies, because it is easier to awaken to terminate apneas (episodes where one stops breathing), than it is when babies are in deeper stages of sleep.” (Sources: Our Babies, Ourselves p 134, An Overview of the Benefits of Co-Sleeping).I do have a concern about back sleeping, though.Too much time in any position can mold baby’s soft cranial bones into an unnatural shape, as can excessive use of car seats, swings and other devices. To prevent this, alternate the way baby’s head faces while they sleep when you put them down and limit their time in car seats.

    #2: Breastfeed

    According to Dr. James McKenna, head of the University of Notre Dame’s Mother-Baby Behavioral Sleep Laboratory, formula feeding disrupts the biological feedback loop between mother and baby in two ways: sleep position and sleep awareness.

    Sleep Position

    Breastfed babies instinctively stay close to their mothers at night.  “Data from Consumer Product Safety Commission indicate that the greatest risks to a baby sleeping in a bed with an adult is not, as many would assume, from an adult overlaying or rolling over onto the baby, but from the infant strangling or becoming wedged or trapped between a wall, a piece of furniture, the bed frame, headboard or footboard and the mattress.”

    Also, breastfed babies tend to sleep at chest level with their mother, while formula fed babies tend to be placed further up on the bed near the pillows (=higher risk for accidents).

    Sleep Awareness

    Formula-fed babies tend to sleep more deeply and wake less often. Because the sleep patterns of mothers often synchronizes with the baby’s this can lead to decreased awareness of one another in the sleep environment and may result in a sleep-related injury. For these reasons Dr. McKenna strongly that formula-fed babies sleep in a sidecar/nearby crib arrangement rather than bed share. (source)

    #3: Create A Safe Sleep Environment

    Avoid toxic substances in your sleep environment.  This includes: cigarrettes, alcohol, mold, toxic chemicals and fumes sometimes found in mattresses, air fresheners etc

    #4: Secure The Perimeter

    This simplest way to do this is to move all furniture and possible entrapment hazards away from your bed and sleep on a matress on the floor. If your bedroom has wood/tile/concrete floors it might be a good idea to cushion a bit with a yoga mat or carpet pad.

    If you would prefer to keep your mattress off the floor, Dr. Sears recommends that you

    “place baby between mother and a guardrail or push the mattress flush against the wall and position baby between mother and the wall. Guardrails enclosed with plastic mesh are safer than those with slats, which can entrap baby’s limbs or head. Be sure the guardrail is flush against the mattress so there is no crevice that baby could sink into.”

    For more information from Dr. Sears, click on this excellent link:

    http://www.askdrsears.com/topics/health-concerns/sleep-problems/sleep-safety/cosleeping-safely

    Note: If you can fit your fingers between the rail and mattress there is a risk of entrapment. To create a safer setup simply roll up a towel or blanket and stuff it between the rail and mattress until it’s so snug you can’t reach in.

    #5: Make Sure Everyone Has Their Place In Bed

    Dr. Sears recommends that you “Place baby adjacent to mother, rather than between mother and father. Mothers we have interviewed on the subject of sharing sleep feel they are so physically and mentally aware of their baby’s presence even while sleeping, that it’s extremely unlikely they would roll over onto their baby. Some fathers, on the other hand, may not enjoy the same sensitivity of baby’s presence while asleep; so it is possible they might roll over on or throw out an arm onto baby. After a few months of sleep-sharing, most dads seem to develop a keen awareness of their baby’s presence.”

    He also suggests that toddlers never be allowed to sleep in bed with babies.  Another good trick is investing in a king mattress, or pushing two twin mattresses together to create the largest bed possible.  (if using twin mattresses, take measures to ensure baby cannot fall between).

    #6: Pay Attention to Temperatures

    Keeping the room cool (around 65-68 degrees) is recommended for lowering the risk of SIDS. Sleeping next to your baby will raise her body temperature, so keep that in mind when you’re gauging the room temperature. In fact, cooler environments make for better adult sleep as well, so a lower temperature is better for everyone.  Also, remember to wear long sleeve pajamas and put your baby in a sleeper.  Wearing pajamas allows you to keep your covers a bit lower, and also keeps you warm when you have to sit up in bed for a diaper change or burp session

    # 7: Do Not Sleep With Your Baby If . . .

    • You or your partner smoke or are under the influence –  If you or your partner drink, smoke or take medications at night, don’t bring your baby into bed.  Instead, use a bassinet beside your bed
    • You are extremely obese. There is some controversy about this, so I’m including it so you can decide for yourself.  Obesity may pose a smothering danger because it is linked to sleep apnea, which makes a parent difficult to rouse.   However, a mother with obesity without who does not suffer from apnea, would appear to be able to co-sleep without this risk
    • You are exhausted from sleep deprivation and don’t believe you would rouse if your baby needed you at night
    • You are breastfeeding a baby on a cushiony surface, such as a waterbed or couch. Basically, cosleeping in waterbeds and couches is very unsafe, as these surfaces have shape (and lack of shape) that can lead to baby getting stuck or smothering.
    • You are the child’s baby-sitter, as a baby-sitters awareness will not be as acute as a mothers

    Also, don’t . . .

    • Allow older siblings to sleep with a baby under nine months, as they do not have the same awareness as their parents
    • Fall asleep with baby on a couch, as baby may get wedged between the back of the couch and the larger person’s body, or baby’s head may become buried in cushion crevices or soft cushions.
    • Sleep with baby on a free-floating, wavy waterbed or similar “sinky” surface in which baby could suffocate.
    • Overheat or overbundle baby. Remember, your body next to your baby’s will generate heat
    • Wear lingerie with string ties longer than eight inches. Also avoid long jewelry and tie up long hair

National Recommendations for SIDS Prevention

About 2,100 infants in the U.S. die yearly from SIDS. The American Academy of Pediatrics recommends:

  • Placing babies on a firm mattress to sleep, and not using pillows or bumper pads in cribs.
  • Staying current onall recommended immunizations.
  • Making sure a baby does not get too warm while sleeping.
  • Not smoking, drinking alcohol, or use drugs while pregnant, and avoiding exposing baby to secondhand smoke.
  • Breastfeeding, if possible.
  • Putting a baby to sleep with a pacifier (But if a baby rejects the pacifier, don’t force it.)
  • Putting babies to sleep in the same room, but not the same bed, as parents.

Breastfeeding and Co-Sleeping

Excerpt from the amazing article:ABM Clinical Protocol #6: Guideline on Co-Sleeping and Breastfeeding

Breastfeeding and Cosleeping PDF

BACKGROUND The terms co-sleeping and bed sharing are often used interchangeably. However, bed sharing is only one form of co-sleeping. Co-sleeping, in reality, refers to the diverse ways in which infants sleep in close social and/or physical contact with a caregiver (usually the mother).1 This operational definition includes an infant sleeping alongside a parent on a different piece of furniture/object as well as clearly unsafe practices such as sharing a sofa or recliner. Around the world the practice of co-sleeping can be very variable, and, as such, all forms of co-sleeping do not carry the same risks or benefits.2 Some forms of parent-child co-sleeping provide physical protection for the infant against cold and extend the duration of breastfeeding, thus improving the chances of survival of the slowly developing human infant.1,3–5 The human infant, relative to other mammals, develops more slowly, requires frequent feedings, and is born neurologically less mature.1,3–5 In malaria settings, co-sleeping is recommended as the most efficient use of available bed-nets, and co-sleeping may be necessary in other geographic areas where available bedding or housing is inadequate. Bed sharing and co-sleeping have also long been promoted as a method to enhance parenting behavior or “attachment parenting” and also to facilitate breastfeeding.1–13 Bed sharing and some forms of co-sleeping have been rather controversial in the medical literature in recent years and have received considerable negative comment.6–10 Some pubABM Protocols 38 lic health authorities have discouraged all parents from bed sharing.11,12