Co-Sleeping With a Baby

Before many new parents bring their baby home, they are often warned by pediatric experts to never sleep in the same bed with their infant. The recommendation comes from the American Academy of Pediatrics (AAP) who suggests this practice may contribute to Sudden Infant Death Syndrome (SIDS) and other sleep-related deaths.
But James J. McKenna, Ph.D. has another opinion. In the San Francisco resident’s new book Safe Infant Sleep (Platypus Media, 2020), he challenges the AAP’s position by saying that co-sleeping can be done safely. Plus, it is better for the infant and the mother’s ability to breastfeed. In fact, he says, telling parents they shouldn’t co-sleep puts infants in more danger. For example, a parent may end up falling asleep on a couch or recliner with their baby, where they are more likely to be crushed because they fear co-sleeping in a bed.
McKenna is the founder and director of the Mother-Baby Behavioral Sleep Laboratory at the University of Notre Dame, a pioneer in the study of co-sleeping. As a biological anthropologist, he has also studied parenting with non-human primates such as monkeys. 
His studies, as well as his personal experience with his own child, has led McKenna to conclude that there are many benefits to bed-sharing. His studies indicate that it regulates the baby’s heart rate, hormonal levels, body temperature and blood pressure. He also found that mothers who co-sleep breastfeed much more than those who don’t. 
Many parents are bed-sharing with their infants and not telling their pediatricians for fear of being reprimanded or worse, McKenna says. A 2018 report from the United States Department of Health and Human Services showed that 61.4 percent of families in the country co-sleep some or all of the night, according to his book. McKenna argues that the best way to ensure infants are sleeping safely is to provide safety recommendations to fit the individual needs of each family.
Bay Area Parent spoke with McKenna:
What is the key message of your book?
Parents alone have the responsibility and ability to make a decision as to where their baby will sleep and whether or not they are able to do it in a safe manner. … Listen to your pediatrician but don’t be afraid to share with them what you do with your baby. We have to stop lying about bed-sharing. The more we lie about it, the more we uphold the idea that it’s bad and negative. We have to start saying, “Thank you, Dr. so and so, I’ve read about how to safely bed-share with my baby, and that’s what I will be doing.”
There is a lot of information out there and they [parents] should understand how this whole debate [about co-sleeping] happened. This idea came out of the heads of some people who meant well, but had no training or understanding who babies are. The best teacher for parents in understanding their baby is the baby itself. Trust your lead as to what your baby needs and wants. Parents need to be empowered and entrusted to do the best for their babies. … Minimally, more than half of new mothers are bed-sharing with their babies, but they are not feeling free enough to discuss it with their pediatricians. Even pediatricians are probably afraid to vary from the American Academy of Pediatrics’ message.
What are the benefits of co-sleeping?
Because they are getting more minutes of sleep, babies are happier. They cry less. … They drink more breast milk – twice as much [his studies showed]. The more the better is the case with breast milk. Breastfeeding provides more protection from Sudden Infant Death Syndrome and all kinds of diseases including cancers. … It [breastfeeding] gets the uterus in shape faster from her pregnancy status. The mothers feel more settled themselves. The attachment to the mother and baby increases. Some forms of co-sleeping reduce the chances of a baby dying. Even just room-sharing with the baby cuts death from SIDS in half. It permits mothers and babies to communicate more frequently through the night. …The closer the baby is, the more the interactions, the more the engagement, the more the strength of that physiological regulation. In a sense, you’re providing the infant with opportunities to grow the proper kind of brain it needs to grow. After babies are born, there is a regression period where neurons are shed. Part of that was related to the fact that they [neurons] weren’t being used by the intensity of the engagement that occurs with co-sleeping. …There’s a whole new line of research that shows more than we suspected – that early experiences of the baby really matter for lifetime achievements, happiness and self-resiliency.
What are the risks of co-sleeping? How can they be avoided?
Separate surface co-sleeping is still co-sleeping. Having your baby alongside your bed is a more stable environment. …If you smoked during your pregnancy, we know that it damages the arousal mechanisms of a baby. If you smoked during your pregnancy, you certainly wouldn’t want to bed-share with your baby, but you could certainly co-sleep with your baby on a separate surface. 
Using drugs or alcohol is another risk factor for co-sleeping. If you are using drugs and alcohol, you certainly shouldn’t bed-share on the same surface. Babies have died because a toddler didn’t know they couldn’t just lie on them [the infant]. Formula drinking babies and cows’ milk drinking babies don’t have the same protective mechanisms operating to protect them. They move around in bed a lot more than breastfeeding babies. Breastfeeding babies lie under their mother’s arm all night long. Sleeping on recliners or couches with your baby is dangerous. Putting babies on their bellies is a risk. 
Would you suggest using co-sleepers that can be placed on the bed?
There are some good in-bed structures for co-sleeping. They are helpful but if you use them you still have to be cautious. You still have to maintain a good alertness to your baby. 

Teresa Mills-Faraudo is an associate editor at Bay Area Parent.
Editor’s Note: These views are not meant to replace the advice of your child’s pediatrician. Consult with your medical professional when making decisions about your child’s sleeping arrangements.



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