Every parent, paediatrician, and coroner wishes SIDS and accidental suffocation were things of the past.
After all, we have tons of information and research to help parents make informed decisions about baby sleep.
Unfortunately, unexpected infant death still occurs. In some situations, these deaths are preventable. In other situations, no known cause is found.
Although many potential causes exist, the media tends to focus only on deaths related to cosleeping.
Media Reports Against Cosleeping Missed Vital Message
The message put out to parents is they can avoid unexpected deaths by avoiding all cosleeping, in all situations.
This sends an unbalanced message; it also leaves out discussion of other risky sleeping situations.
A report regarding the death of a 5-month-old in 2016 was released recently. It was determined the otherwise healthy baby had died due to bedsharing with his mother and older sibling. The overall message was to warn parents never to cosleep with their infants.
Media reports involving cosleeping miss a vital message. Human mothers and babies are wired to be near each other. Infants, especially newborns, don’t sleep well alone. This leads parents who weren’t planing to cosleep, to make last minute decisions to cosleep while missing critical information about how to do so safely, or know when it must be avoided.
It isn’t that cosleeping is inherently dangerous – after all, it’s what dependent human infants are wired for. It’s that our modern lifestyles aren’t conducive to safe cosleeping. But parents aren’t given all the information to help them get rest while also ensuring their babies are safe.
What happens when exhausted and desperate parents decide to cosleep at 2am? They might make decisions that are inherently risky – like bedsharing with an infant and older sibling, cosleeping on a couch, or bedsharing after a couple of glasses of wine.
What Are SIDS And Accidental Suffocation?
Many parents bring home their newborns and spend a lot of time living in fear of SIDS. Few parents, however, are given the proper definition of SIDS, and information about accidental suffocation.
Although it’s important to be aware of both SIDS and accidental suffocation, a lack of proper information can lead to either excessive fear or a failure to take proper precautions. The way in which the media reports on cosleeping can result in parents being extremely fearful of SIDS and not having the right information.
Early parent educator Yvette O’Dowd writes:
“Sudden infant death syndrome (SIDS) is a term that was first used in 1969 to describe a sudden and unexpected death of a baby under 1 year of age, while asleep.
“Another term, ‘Sudden Unexpected Death in Infancy’ (SUDI), is also quite commonly used. SUDI is a research classification which includes both SIDS and fatal sleeping accidents”.
When the media focuses only on cosleeping deaths, several details are missed. A lack of extra detail can lead parents to assume their baby is safe, as long as they don’t cosleep. Parents might also avoid cosleeping in bed at all costs, and end up cosleeping on a couch, which is far riskier.
There are several situations that increase the risk of SIDS and SUDI. Some of them are:
- Babies sleeping with the head or face covered (this includes wearing a hat)
- Smoking during pregnancy, or babies being exposed to second and third hand smoke
- Formula feeding
- Using bumpers, blankets or stuffed items in crib or cot
- Tummy or side sleeping
- Bedsharing with pillows or puffy blankets near baby, bedsharing with siblings or pets in the bed, or with a parent who has consumed any medication or alcohol.
The overall risk of SIDS and SUDS is quite low. However, we should still make informed decisions. O’Dowd says:
“Life is full of risks, right from conception. By informing ourselves about risks and making informed choices in all aspects of raising our children, we can reduce risk where possible”.
Be sure to read What Is SIDS? 6 Things Families Need To Know to learn more about SIDS and SUDI.
Is Cosleeping Inherently Dangerous?
Based upon media reports, cosleeping is deemed inherently dangerous. However, what does the evidence show?
Professor James Mckenna of the Mother-Baby Behavioral Sleep Laboratory of Notre Dame says, “It’s scientifically fallacious to say that co-sleeping increases the chances of SIDS, especially in light of the fact that hundreds of different co-sleeping patterns exist, which vary in degrees of safety and/or benefits and outcomes associated with them.
“Room-sharing is a form of co-sleeping, and it’s known that room-sharing decreases an infants chances of dying by up to 50% compared with babies sleeping alone.
“But perhaps more importantly, no human infant (meaning no present living human beings) would or could be alive today had our ancestral mothers not have slept next to their infants for physiological regulation, management, protection, and to breastfeed throughout the night”.
A major piece of information missing in media reports is infant sleep decisions come down to weighing up benefits and risks when parents have access to all the evidence-based information related to sleep.
We rarely hear about the risks associated with not cosleeping (either room sharing or bedsharing). Some evidence exists to support the benefits of cosleeping, as well as the risks associated with not cosleeping.
A pair of Harvard researchers found there are overall societal risks associated with not cosleeping. Study author Sarah LeVine said:
“We place an emphasis on being an individual in the United States. After all the work we’ve done, we’re not at all sure that’s the best way. In every country I’ve worked, my assistants—privileged, intelligent university graduates—all slept with their children.
“The proven benefits of mother-infant co-sleeping far outweigh the largely imaginary risks. Putting a baby in a separate room at night encumbers parents and leads to their exhaustion without guaranteeing the safety or future character development of their children.
“In Japan—a large, rich, modern country—parents universally sleep with their infants, yet their infant mortality rate is one of the lowest in the world—2.8 deaths per 1,000 live births versus 6.2 in the United States—and their rate of sudden infant death syndrome, or SIDS, is roughly half the US rate”.
Perhaps most surprisingly, even the first president of the SIDS foundation said bedsharing wasn’t necessarily dangerous.
His newer research, published in 2013, was largely ignored by the media. This was possibly because the evidence contradicted current guidelines. Unfortunately, it often takes many years from the time of new research to the time guidelines change.
Bedsharing can be dangerous – but only when established safety guidelines are ignored. Infants also die unexpectedly in cribs, which is why SIDS is sometimes referred to as cot death. Regardless of where baby sleeps, there are risks in not following established safety guidelines.
Dr. Abraham B. Bergman (the original president of the National SIDS foundation) published ‘Bed Sharing per se Is Not Dangerous’ in the Journal of the American Medical Association (JAMA). In response to healthcare professionals strongly discouraging any and all bedsharing, Bergman said:
“I find the report disquieting because evidence linking bed sharing per se to the increased risk for infant death is lacking”.
Research professionals now realise the effort to discourage bedsharing to keep infants safe could potentially be linked to parents making riskier choices. When desperate parents avoid bedsharing at all costs but fall asleep in a glider chair, they’ve actually put their infants at more risk.
When parents over-swaddle (too many layers), place a sleep positioner, or use baby gear not designed for sleep, in an effort to get baby to sleep solo for longer stretches, they are putting babies at an increased risk of death, when compared with cosleeping while following safe sleep guidelines.
UNICEF UK recognised this imbalance of parent education and published Safe Co-sleeping Guidelines For Health Professionals to help educate their patients properly.
Bedsharing is not safe for all infants and all parents; neither is it safe on every type of sleep surface. Providing parents with all the information helps them make the safest choice for their babies. Making generalised statements without proper information does not help parents make safer choices.
How Can Bedsharing Be Done Safely?
Even parents who choose not to bedshare should be made aware of safety guidelines. Why? Because it helps them make informed decisions at times when they might be feeling desperate.
Co-sleeping parent and parenting expert, Kelly Winder, wrote:
“When sleeping with your baby, make sure:
- You put babies to sleep on their backs; although they generally tend to sleep on their backs, some co-sleeping babies will turn to face their mothers
- Your baby does not have a pillow; pillows are not required for babies under 12 months
- There are no soft toys or fluffy pillows on the bed
- The bed doesn’t have thick or heavy blankets
- The surface is firm and flat
- There is no loose bedding or other potential hazards on the bed which could smother or choke your baby
- You don’t overheat or over swaddle your baby. Dress your baby lightly for sleeping.
- Keep the room at a temperature that is comfortable for an adult who is lightly dressed. Baby should not feel hot or sweaty to the touch”.
She also shared these risk factors. Bedsharing is not safe for you and your baby, if:
- You are a smoker
- You are excessively fatigued
- You have consumed alcohol, prescription medications, or any substance that might cause sedation (e.g. some allergy medications or heavy pain relievers)
- There are any siblings also in the bed
- Your baby is asleep on your chest on her tummy
- You are sleeping on a couch, arm chair, glider or waterbed.
Most research also shows that bedsharing between an exclusively breastfed baby is the biological norm, compared with bedsharing with a formula fed infant, which might have risks.
Be sure to read Sleeping With Baby – Safe Co-Sleeping Tips to learn more.
Should I Bedshare With My Baby?
This article is not intended to persuade parents into bedsharing. It is meant to provide information to encourage parents to make fully informed decisions regarding how and where their babies should sleep. Parents should not make decisions based on media reports that aren’t likely to share all vital information.
Few new parents are provided with up to date, evidence-based sleeping information that is vital to making safe sleep choices.
Why do we share information about bedsharing? Because research still shows many parents choose bedsharing. And if parents are going to bedshare, they need the proper information to do so in the safest possible way.
Parents also need to know why bedsharing can be risky, and why simply placing a child in a crib or bassinet will not eliminate all sleep related risks. Sleeping close to an infant isn’t the risk; risks lie in medications, alcohol, excessive fatigue, unsafe bedding, unsafe bed frames, etc.
Simply removing baby from the family bed doesn’t guarantee safety. Research shows many parents still take unnecessary risks when putting their baby to sleep, whether it be bedsharing or in a crib.
Be sure to read SIDS And Safe Sleep – Many Parents Still Practise Unsafe Infant Sleep Arrangements to understand more about the importance of making fully informed decisions.