Should You Practice Co-Sleeping?

should-you-practice-co-sleeping

Co-sleeping has been a rather controversial topic. On one hand, you feel safe when your little one is close to you, while on the other hand, you’re worried that it could be a hazardous practice that will put your baby at risk. If you’re in a serious dilemma, then you’ve come to the right place!

Let’s explore the argument for and against the practice, and look at how to do it properly by following some proven guidelines, and when you should abandon the idea of co-sleeping…

What Is Co-sleeping?

Co-sleeping essentially refers to parents sleeping in close proximity to the child, or what some termed as “within sensory range” so that they can detect and respond to sensory signals and cues of each other (in the forms of smells, sounds and whisperings, movements, touches, heat).

There are a few ways of doing it:

  • Room sharing or separate-surface co-sleeping

Parents can do so by attaching a co-sleeper or sidecar crib (which is like a crib with only 3 walls leaving the 4th side open) to one side of the parents’ bed, so that the mother and baby are within arm’s length without sharing the same bed.

It can also refer to having the baby sleep in a separate bassinet or crib in the same room. For older kids, they may be sleeping in a mattress on the floor, next to the parents’ bed.

  • Bed sharing

Bed sharing refers to parents and child sleeping in or sharing the same “family bed”.

There are also parents who are not strictly in either one of the categories of co-sleeping with their child. The baby/child has his/her own bedroom, but they are also welcome into their parents’ bed.

To Co-sleep Or Not: Yes, No, Sometimes?

The majority of parents would agree that one size does not fit all babies. The most important thing at the end of the day is to do what is necessary to help your child sleep better and safely. So there’s no right and wrong answer to the question of where does your baby sleep.

You may have read up a lot on this controversial topic and be of the opinion that you’re well covered. But just be prepared that you may well have to change your game plan to suit your child when the time comes.

Even if you don’t plan to co-sleep with your baby, there may be times when you bring your baby to your bed or bedroom out of sheer exhaustion, or if it’s easier to comfort or feed him. Similarly, if you plan to bed-share, you may find that your baby prefers more space for himself in his sidecar crib.

With this in mind, it’s still a good idea for you to know when is co-sleeping unsafe and how to make sure that your bedroom is safe for co-sleeping if the need arise.

“Co-sleeping is dangerous”

This is probably the number one reason for the opponents of co-sleeping. It is however important to make the distinction that this claim is mainly directed at bed-sharing rather than co-sleeping as a whole.

Of note, both the American Academy of Pediatrics (AAP) and the U.S. Product Safety Commission (CPSC) advise against bed-sharing due to the risks of suffocation and strangulation.

Professor James J. McKenna, a world-renowned expert on infant sleep, in particular the practice of on mother-infant co-sleeping in relationship to breastfeeding and SIDS (Sudden Infant Death Syndrome), argues that “co-sleeping for the breastfeeding mother is normative human behavior” and it is inappropriate to simply claim that bed-sharing is a SIDS risk factor without mentioning other independent risk factors associated with infant dying (such as the infant being placed prone, or in bed without supervision).

In fact, it is very common in many non-Western or traditional cultures for parents (especially breastfeeding moms) to bed-share with their babies, and the number of SIDS in these cultures appears to be lower than in the west.

The AAP does, however, recommend the practice of room-sharing (or separate surface co-sleeping) without bed-sharing, as it is thought to help lower the risk of SIDS.

The reality is that sleeping alone can be a very dangerous thing for a baby. Newborn’s physiology is not able to function optimally yet. Their nervous, digestive, cardio-respiratory and thermo-regulatory systems are immature and not fully developed, and periodic apnea (not breathing) are common for babies.

Benefits Of Co-sleeping

Many research and sleep studies on co-sleeping mother-infant pairs have shown that their sleep cycles become in sync with one another.

For example, a mother may arouse a few seconds before her baby and she would lay a comforting hand on the child just as the baby starts to squirm. Both will then drift and resettle back to sleep. Both may display more frequent and more synchronous arousals, without being fully awake, compared to mother-infant pairs who sleep in separate rooms. As a result, both parents and babies get to sleep more.

There’s a lot of mutual touches and interactions going on at night between the co-sleeping infant-mother pair which promote emotional bonding and give reassurances to the infant in the form of a familiar presence. This helps the baby to resettle themselves back to sleep without full awakening.

Benefits Of Co-Sleeping

Hence, there is no night-time separation anxiety compared to a baby who awakens from deep sleep feeling startled and frightened to find himself/herself alone in a crib in the nursery. Infants at this stage of development is not able to think of their mother as existing somewhere else and soothe himself back to sleep.

With only 25% of the human brain developed at birth, infants depend a lot on the proximity and contact with the body of its caregiver (usually the mother) for some form of physiological regulation and support. For example, the mom’s body warmth can help to keep the infant warm as he is not yet able to shiver to keep its own body warm. Infants sleeping near their parents have been found to have more stable body temperatures, breathing, and heart rhythm.

Because of the in-sync sleep cycles, increased proximity and increased interactions (especially for breastfeeding moms) at night, co-sleeping mothers are able to better detect and respond to an infant in distress, for example during an apnea episode.

The ongoing sensory exchanges between the infant and mother also means that infants spend more time in lighter sleep rather than deep sleep, which is actually a safer form of sleep as it is more difficult for infants to arouse from deep sleep to terminate apnea episodes (pauses in breathing).

There is no scientific evidence that concludes that co-sleeping is bad. Accidents, unfortunately, do happen as there are risks, just like everything else. But it is often unsafe sleeping practices and conditions that lead to many of the deaths associated with co-sleeping.

As mentioned earlier, co-sleeping is more common in other non-western cultures, yet the number of deaths associated with co-sleeping in these cultures is lower. This could be due to differences in practices, beddings and mattresses that lower the risk.

Here are some general guidelines for a safe sleeping environment, which should be followed irrespective of where the baby is sleeping:

  • Infants should sleep on their backs. Never place them prone on their tummy!
  • Absence of smoke (including secondhand smoke).
  • Make use of light blanketing.
  • The head of the infant should never be covered.
  • Sleep only on firm mattress. Never use waterbed, air bed, beanbag mattress or a sagging mattress.
    • A soft or sagging mattress poses a higher risk of suffocation or overheating. Even if the baby is sleeping on his back, he/she may flip face-down and suffocate if the mattress is too soft.
    • Waterbed, air bed and bean bag mattress may form deep crevices where the baby could get trapped and suffocate.
    • Here is a simple test you can do to check if the mattress is firm enough for a baby: http://cosleeping.nd.edu/links/
  • There should not be sheepskins, fluffy material, stuffed animals or pillows around the infant. The infant should not be placed to sleep on top of a pillow or soft beddings, as he may roll off the pillow and get smothered.
  • Bedding should be tight fitting to the mattress.
  • The mattress should fit snuggly in the crib. If bed-sharing, make sure that the mattress fit tightly into the bedframe/headboard or against the wall.
    • There should be no gaps between the mattress and the frame or adjacent wall that the baby could wriggle into, get trapped and suffocate.
  • Do not use crib bumpers as they pose a risk of suffocation, strangulation or entrapment.
  • Never leave your baby to sleep alone or fall asleep with your baby on a sofa, couch or armchair. These are the most dangerous place for co-sleeping as the infant can slip face down and get wedged between the cushions or back of the couch where they may get suffocated.

When Should You Not Co-sleep?

Alcohol And Smoke

You should never co-sleep with your baby if:

  • You or your partner have been drinking alcohol, or have taken medication/drugs that make you drowsy.

Alcohol and drugs may affect your memory and awareness such that you forget the presence of the baby in your bed. You may sleep so soundly and deeply that you don’t realize that you have rolled onto your precious baby.

By the same reasoning, it is recommended you do not bed-share if you are extremely tired.

  • You or your partner smokes (even if you don’t smoke in bed or at home) or if the mother have smoked during pregnancy.

Smokes will affect the brain development, making it more difficult for babies to arouse.

When bed-sharing, it is important to be aware that adult beds are not designed to assure the safety of infants. Hence parents have to understand what are the risks and unsafe co-sleeping practices, and take the necessary precautions to make sure that they are co-sleeping safely.

How To Ensure That You Are Co-sleeping Safely?

  • Abide by the abovementioned guidelines.
  • Do not smoke.
  • If bed-sharing, breastfeed your baby.
    • Research has shown that breastfeeding moms instinctively adopt a “C” sleeping position.Breastfeeding mothers tend to lie on the side facing the baby with the body curled protectively around the baby, with their lower arm placed above the baby head and knees drawn up under the baby’s feet. This sleeping position creates more safety as it prevents the mother from rolling forward or backward and keeps pillows away from the baby’s head.
    • Similarly, breastfeeding babies instinctively stay close to the mother, typically lying level with the mom’s breasts for ease of feeding. Hence, they tend not to “roam’ around the bed and risk getting entrapped somewhere. They also tend to sleep on the back or on their side facing the mother, which reduces the risk of sleeping on their tummy and SDIS.
    • Breastfeeding mother-infant pairs also tend to be more sensitive to each other due to the breastfeeding interactions, arouse more frequently to each other, and spend more time in light rather than deeper stages of sleep compared to bottle-feeding mother-infant pairs. This C-shaped sleeping instinct is also not seen in bottle-feeding moms. Hence, bed-sharing is safer for breastfeeding mother-infant pairs.
  • For bottle-fed babies, it may be safer to adopt separate-surface co-sleeping rather than bed-sharing, i.e. have the babies sleep alongside the mother at arm’s length but not on the same bed. This involves the use of a co-sleeper (or sidecar crib) securely attached to the adult bed.
    • One such product is The Arms Reach Co-sleeper, which attaches tightly and firmly to the parent’s bed, preventing the bassinet to shift away from the bed and creating any gaps for the baby to slip into. Other safety designs include a drop of about 4 inches from the adult to infant mattress, as well as a rail on the parent-facing side. These help to prevent the parent’s ody or blankets from draping over the infant, yet allow the mother to reach out to the baby at night.
  • If bed-sharing, it may be best to pull the bed off its frame and place the mattress on the floor in the centre of the room.
    • This remove the risk of having any gaps between the bed frame/headboards and the mattress.
    • It also reduces the risk of the baby getting injured if he rolls off the bed.
    • Even if you’ve pushed the mattress against the wall, never assume that it is totally safe as the mattress might move away from the wall without you realizing, and creating a space big enough for the baby to slip into.
    • Similarly, it is best to remove any end tables or lamp tables next to the adult bed as the space between the bed and table is a risk.
  • Keep your bedding light and minimal.
    • Keep bedding and pillows away from the baby’s head, to avoid him getting smothered or overheated
    • Use light sheets and blankets instead of a duvet. Alternatively, use a well-fitted baby sleeping bag.
  • Parents with long hair should tie it back to avoid unfortunate accidents of entanglement around baby’s neck. Likewise, do not wear lingerie with string ties longer than eight inches or any dangling jewellery.
  • Do not leave your baby in an adult bed alone, even if it’s for just 5 minutes.
  • Do not let your toddler/older children sleep next to your baby. In fact, it is best not to have other children in the same bed as your baby as they do not understand the risk nor have the same awareness.

  • Keep your baby warm, but not hot.
    • When bed-sharing, do not swaddle the baby as he may overheat and he will not be able to effectively use their limbs to alert the parents close to him. As a rule of thumb, if you’re at a comfortable temperature, your baby probably feels the same too.
  • Extremely obese parents may wish to have the baby in a co-sleeper or bassinet beside the bed rather than bed-share as they may have difficulty feeling exactly where or how close the baby is, relative from their own body.
  • If bed-sharing, both parents have to agree, be comfortable and committed to this decision. They should both view themselves as the primary caregiver, feel equally responsible and aware that the infant is present in the bed space.
  • Do not bed-share in an overcrowded bed. A king-size bed should have enough room to accommodate you, for your partner and the baby. However if your bed is too small, one of you may have to sleep elsewhere or you may want to have your baby sleep in a bedside co-sleeper.

“If My Baby Sleeps In My Bedroom, Will He/She Ever Learn To Sleep On His/Her Own?”

Co-sleeping With Older Kids

Image source Fatherly

Some parents are afraid of co-sleeping out of the fear that perhaps at 8 years old, the son/daughter will still be in their bedroom…

The truth is, as much horror stories you have heard about transitioning babies/toddlers to their own bed and eventually their own room, there are probably just as many families who have gone through it without any hassle.

Transitions are part of growing up. Just like potty training, there will come a time when your child decides to learn to sleep on their own.

Yes, a toddler who has co-slept as an infant may do so later than an infant who has always been sleeping alone. But you may have also heard many stories of parents who continue to have trouble getting their toddler to sleep through the night even though they had been sleeping in their own room from the very beginning.

The key to helping your child develop good healthy sleeping habits is consistency, and certainly not sleeping location. Transitioning your child to their own room – the specifics of when and how, will depend on your child’s personality.

Your child will be able to make a confident transition if you do so gently, matter-of-factly, stress-free, and reassure them that their needs will be met day and night, no matter where they are sleeping.

“Baby Who Co-sleeps Will Not Be Independent.”

Sleeping arrangement alone would not be able to determine the dependency or independence of a child, though it may serve to re-inforce certain attributes.

In the long term, it has been observed that babies who’ve co-slept with their parents, thrive better – emotionally, physically and intellectually. When babies sleep close to parents, they feel constantly reassured, grow up forming stronger family bonds and feeling more confident.

Recent studies are starting to show that co-sleeping (rather than solitary sleeping) helps to promote independence, feeling of high self-esteem, strong sexual identities, social competence and increased ability to handle stress.

Every parent should be empowered to make their own informed decisions whether to co-sleep or not, as well as how to do it. It is important to understand what makes co-sleeping unsafe in order to avoid them and what safe co-sleeping practices are.

For more information and resources on co-sleeping and safe co-sleeping guidelines, you can refer to:

Should You Practice Co-Sleeping? was last modified: March 15th, 2017 by Evangeline

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