Sleep

The other night as my husband and I were getting ready for bed, our dog, Trey, who was in his kennel, started barking. We thought this was unusual because he had just gone out to potty and he is used to sleeping in there.  Jokingly, I told my husband, we should just let him "bark it out" tonight.  Of course, we went to check on him and let him out of his kennel, and he came upstairs and got in bed with us (being a small dog, he easily fits at the foot of the bed).

After I made the joke about letting him cry bark it out, I started thinking about the way we treat our babies.  I wouldn't keep my dog locked in his kennel barking, even though I knew he was fed and had just gone potty, why would I ever keep my baby locked in his crib crying? (Ever notice how much cribs look like cages?)

Yet, I hear parents, frequently talking about how their babies eventually learned to sleep after they were left to cry it out in their cribs.  How much more do we love our children than our pets?  It was unthinkable to me to leave my dog in his cage barking, even if for purely selfish reasons-that I wanted to get some rest and not listen to him barking.  How many parents who have listened to their child cry, have been able to rest themselves?

I have tried to let my babies cry while I waited outside the room.  I felt terrible.  I wasn't at peace, and everything inside of me was also crying, "Go pick him up and hold him!"  It wasn't a quiet voice inside of me, but my instinct, my intuition was shouting at me, that this was not right.

And so, as I reflect on my apparently, lonely dog, and about to give birth to my 4th baby, I think back to those early days with my other children.  Granted, I have my share of some sleepless nights, but overall the majority of our nights were very calm and peaceful.  When my baby woke, I also woke to sounds of movement, thumb sucking and lip smacking, not crying.  My babies didn't need to cry to wake me, for they were sleeping right next to me.  Usually, all I had to do  was roll over and start nursing, before drifting back to sleep.  My husband and my dog slept through the whole exchange.  In the morning, was I always ready to jump up and start my day?  No, but I wasn't sleep deprived, I was ready to face another challenging day as a mommy.

Kangaroo Care

http://opinionator.blogs.nytimes.com/2010/12/13/the-human-incubator/?emc=eta1

co-sleeping

http://pages.uoregon.edu/icds/Evolution_FG_files/McKenna_Cosleeping.pdf

My personal experience with co-sleeping

When you are pregnant for the first time. You think of all the things you want to do different than your parents did. You want to be a great parent or "the cool mom". You start listening to advice from everyone who offers it. And no one is shy about telling you how you should raise your baby. I think everyone would be better off if they just listened to their heart and to their baby.

I heard many people say things like: that you shouldn't sleep with your baby, you shouldn't nurse the baby to sleep, don't hold the baby too much, he needs to learn to soothe himself, and on and on and on....
Since this is my blog, I'm going to give my own advice and if you don't like it-don't read it! I read about attachment parenting when I was pregnant and this theory seemed to make the most sense to me.  Babies want to be held and I believe they need to be held, often!

It just seems natural that since babies need to breastfeed often, as much as every 2 hours or more, they also need to be held this often. Breastfeeding also allows mom to get rest that she needs in those early days.  Speaking of rest or sleep, most new parents are often asked how much (or how little sleep they are getting).  And while I cannot claim to have gotten 8 hours of sleep every night, I feel I got more than many other new moms I talked to.  What was my secret?  Co-sleeping or bedsharing. 

That's right my babies slept in bed with me and my husband.  Nursing in the side-lying position is great for nighttime feedings.  None of my babies even had to cry to let me know they were hungry at night, I would wake when they woke because they were sleeping right beside me.  Crying is a late sign of hunger, babies have a rooting reflex when they are hungry.  This rooting reflex includes lip smacking, licking, or sucking on fingers.  I would wake when I heard the baby rooting. I did not have to get up out of bed, walk to my baby's room, calm him down from crying and then feed him.  No, I only had to lift my shirt and pull him close.  My babies did not sleep through the night at 6 weeks, but it didn't matter because we were getting plenty of sleep together.

There are many objections to this style of parenting and I do believe that this is not the solution for everyone.  But it worked for our family and allowed every to meet their needs for sleep, feeding, holding, etc.
Co-sleeping is safe, if you look at the statistics it is safer than a baby sleeping alone in a crib.  The AAP has recently changed their recommendations as well, that baby should sleep in the same room as his parents.  The AAP however does not endorse co-sleeping.

I never feared that I would roll over onto my baby.  There is an awareness of the baby being present in bed, just as you are aware of the edge of the bed or of your partner sleeping next to you in bed.  The risk comes for parents who are bottle feeding, obese, smoke, using drugs or alcohol.  See article in earlier post for references and recommendations for safe co-sleeping.

The other criticism I often encountered was that my children would never want to sleep in their own bed.  Speaking only from personal experience, this has not been the case.  As my babies weaned and no longer needed to feed often during the night, they also seemed to need more space for sleeping they would perhaps fall asleep in my bed but then we would move them to their own bed where they seemed more comfortable.  My children, despite being nursed to sleep for the first year or so of their lives have all learned to fall asleep on their own and rarely wake up at night and come into my bed.  I believe this to be so because I met their need for shared sleep, holding, and feeding when they were babies.

What about intimacy and privacy with your partner?  Again, this was not a concern with our babies, as they were too young or sleeping to be aware of anything else going on in the bedroom.  I heard someone say once, that it would be better for a child to walk in on his or her parents making love than to witness them fighting.  I think the reverse is probably more often the case.

Listen to your heart, listen to your baby and find the solution that works for your family.  Don't worry about what others might think or say.  Parenting requires you to make many decisions that not everyone else is always going to agree with.  You need to do what is best for your baby. 

I like Dr. Sears' book, The Baby Sleep Book for more information or see www.askdrsears.com

Bedsharing

Shunning the Family Bed. Who Benefits Most?

December 08 2009

According to Dr. Jay Gordon, babies sleeping on a safe surface with sober, nonsmoking parents respond to their parents, and the parents respond to them. The chance of SIDS occurring in this situation are close to zero. Babies in a crib or in a room away from their parents, on the other hand, will breastfeed less and are at greater risk of infections, including life-threatening ones.

The medical profession, as it often does, is approaching the entire idea of the family bed backward. A baby in the same bed with his or her parents is surrounded by the best possible surveillance and safety system. It must be the responsibility of the manufacturers and proponents of cribs and separated sleep to prove that such disruption is safe, not the other way around.

Newborn babies breathe in irregular rhythms and even stop breathing for a few seconds at a time. To put it simply, they are not designed to sleep alone.

Sources:

Peaceful Parenting October 15, 2009

Dr. Mercola's Comments:

Back in 2002, the Consumer Product Safety Commission (CPSC) and the Juvenile Product Manufacturers Association (JPMA, the crib manufacturers' lobby) launched a campaign to discourage parents from sleeping with their infants.

They also warned about allowing babies to sleep alone in adult beds.

Both warnings were based on data that, presumably, showed infants had a small risk of dying in adult beds.

The Dangers Infants Face When Sleeping in an Adult Bed

For example, an article in the Archives of Pediatric and Adolescent Medicine stated that, based on records from the CPSC dating from January 1990 to December 1997, there were a total of 515 deaths of children younger than 2 years who were placed to sleep on adult beds.

Of those, 121 were caused by a parent or sibling lying on top of the child, and 394 were due to entrapment in the bed structure, causing suffocation or strangulation.

In conclusion, the authors stated:

“Placing children younger than 2 years to sleep in adult beds exposes them to potentially fatal hazards that are generally not recognized by the parent or caregiver.

These hazards include overlying by a parent, sibling, or other adult sharing the bed; entrapment or wedging of the child between the mattress and another object; head entrapment in bed railings; and suffocation on waterbeds.”

However, the recommendation to avoid co-sleeping with your infant has been heavily criticized by many child health experts who believe bedsharing is the healthiest alternative.

And some who have taken the time to review the data further have come to an entirely different conclusion than the CPSC, raising the question whether perhaps this recommendation was more about benefitting the juvenile products industry than promoting the safest sleeping habits.

Statistics Show Co-Sleeping is Likely Twice as Safe as Sleeping in a Crib!

In an article for Mothering magazine, Tina Kimmel dissected the statistics from an 18 year period (1980-1997), showing how co-sleeping with your infant may actually be twice as safe as letting them sleep alone in a crib.

Interestingly, the CPSC never actually presented the relative risk of each sleeping scenario, which may lead parents to think that letting their child sleep alongside them is the more dangerous alternative.

However, when the relative risk of each is assessed by dividing the measure of danger for each situation by the prevalence of that situation, and then comparing them, it turns out that infants are more than twice as safe in adult beds as in cribs.

In fact, using the CPSC’s own data for measuring the danger of each situation, and data from the CDC's Pregnancy Risk Assessment Monitoring System (PRAMS) to ascertain the prevalence or frequency of each sleeping scenario, Kimmel found that crib sleeping had a relative risk of 2.37, compared with sleeping in an adult bed.

Clearly, looking at the relative risk of each situation makes more sense than basing your decision on an arbitrary assumption that bedsharing is dangerous. Especially since it’s not necessarily true.

Bedsharing May Be a Safer Option for Breastfed Infants

Interestingly, in one British study, breastfeeding mothers who shared their bed with their infants were found to sleep in a characteristic manner that promotes safety for the child, whereas mothers who bottle-fed their babies did not.

The researchers explained:

“The mother spontaneously adopted a distinctive lateral position facing the infant, with her knees drawn up under the infant's feet and her upper arm positioned above the infant's head. This position facilitates the baby's easy access to mother's breasts, and babies orient themselves towards their mother's breasts for most of the night.

It also provides several safety benefits:

• the baby is flat on the mattress, away from pillows

• the baby is constrained by the mother's knees and arm so that it can't move up or down the bed

• the mother controls the height of bed covers over the baby

• it is very difficult for the baby to be rolled on by either parent, as the mother's elbow and knees are in the way

• the mother is close enough to monitor the baby's temperature and breathing continually ·

Bedsharing families who did not breastfeed slept together differently, particularly with respect to the physical orientation to the infant.

Mothers who had never breastfed did not curl up around their infants for sleep and did not, therefore, use their own bodies to make a constrained space in the bed for the baby.

These mothers primarily positioned their infants at face height in the bed, either between or propped up on the parents' pillows. Mothers also spent a much smaller proportion of the night facing their infants, and although infants were still oriented towards their mothers for the majority of the night, the mother's position meant there was less face-to-face orientation.

It seems that the mothers who didn't breastfeed slept with their infants as if they were sleeping with another adult (faces at same height, no protective sleeping position, less persistent orientation towards infant).”

Safe Bedsharing Guidelines

Naturally, no single sleeping arrangement is 100 percent safe as there are many factors that can play a role. For example, as the study above discovered, whether or not you breastfeed your child may influence the instinctive positioning of your baby in relation to yourself, making bedsharing more or less safe.

Alcohol consumption and whether or not you smoke would also be factors to take into consideration. But overall, according to the research of James McKenna, Director of the University of Notre Dame's Mother-Baby Sleep Laboratory, infant deaths are far more common in cribs than in beds shared with parents.

The single most dangerous thing you can do is to leave your child alone during sleep, he says.

There are a number of studies, several of which are discussed in McKenna’s paper “Why babies should never sleep alone: A review of the co-sleeping controversy in relation to SIDS, bedsharing and breastfeeding,” that show bedsharing, or sleeping in close proximity, actually protects against SIDS rather than cause it.

That said, there are certain common sense guidelines to keep in mind if you decide that bedsharing is right for you and your child.

Safebedsharing.org offers these sensible safety guidelines:

• Never leave an infant or toddler unattended on an adult bed. Co-sleeping or family bed sharing consists of an adult and a child. Babies can roll off of beds (even when using a co-sleeping device), can become tangled in blankets, or otherwise need the attention of an adult. We recommend babies not be left unattended in the early months.

• Never sleep with your baby on a water bed or on a couch. Water beds and couches are associated with suffocation of babies.

• Avoid adding railings or putting furniture next to the side of your bed. Baby could become lodged next to railing or furniture and suffocate

• Avoid pushing your bed against a wall. Baby could also be lodged between the bed and wall causing suffocation.

• Never let another sibling sleep next to your baby. Children sleep deeply and may roll over on baby. Baby is best placed next to Mom or Dad only.

• Never sleep next to your baby if you are intoxicated or have been using drugs, are taking medications, are overly tired or in any other way feel that your ability to be aroused could be affected.

• It is not recommended that you bed share if are currently smoking. This has been associated with higher incidence of S.I.D.S.

• Use a firm mattress for bed sharing. Soft mattresses can allow baby to accidentally roll over causing suffocation.

• Make sure all bedding fits snuggly on the mattress. Fitted sheets that come loose could cover baby's face.

• Make sure mattress is flush against head- and footboards. If there are any gaps baby could become lodged between head or footboard and mattress and cause suffocation.

• Always place baby to sleep on her back. This has been shown to reduce the risk of S.I.D.S.

• Avoid over-dressing your baby. Overheating is also associated with an increased risk of S.I.D.S.

• Avoid strings or ties on night clothes or blankets. These could cause strangulation. Be sure to remove toys or other objects from bed before sleep time, to avoid suffocation.

• If you have long hair tie it in a pony tail or braid it. Long hair could cause suffocation or strangulation.

Other Options, if Bedsharing is Not for You

For some people, the idea of sleeping with a baby beside them is just too worrisome. But there’s no reason to despair. The choice to share your bed with your child or let them sleep on their own is yours, and yours alone. There’s no one-size-fits-all solution.

However, avoiding sharing your bed for fear that it’s a more dangerous choice is most likely unwarranted. The research points to the opposite being true.

If you want your baby close but are still worried about accidentally laying on her, you could remove one of the side rails and place the crib level with your mattress. This way, your baby will have a space of her own, but you’ll still be in close proximity. Just take precautions to secure the crib to your bed so your baby can’t fall through the crack.

In addition to the benefits already mentioned, another one is psychological, as co-sleeping tends to enhance bonding and feelings of safety and comfort. Another option to achieve enhanced bonding is to wear your baby in a pouch or sling for several hours during the day.

Babywearing International is an interesting resource to learn more about the many benefits of cradling your baby close during those first few months of life. They also offer helpful tips on how to choose a suitable baby sling or carrier.

Related Links:

Why Where You Sleep Matters If You Want a Healthy Baby

Breastfeeding Reduces Risk of SIDS

Seven Reasons to Breastfeed Your Child That You Need to Know