Although the image of a baby and
parent dozing off together is not an uncommon one, the practice of cosleeping
is controversial in the United States. Cosleeping, or sharing a bed with an
infant, claims the lives of 64 children under age 2 each year, according to the
U.S. Consumer Product Safety Commission (CPSC). This organization cautions
parents against sharing beds with their babies, but supporters of cosleeping
believe that a parent's bed is just where an infant belongs. But is it safe?
What Is
Cosleeping?
Cosleeping is the act of having your infant in your bed with you during sleep.
There are many reasons why parents choose to cosleep. Some find that it makes
nighttime breast-feeding more convenient, or that it's easier to soothe an
infant back to sleep in the middle of the night.
William Sears, MD, a cosleeping proponent,
says that it also helps babies fall asleep more easily, especially during their
first few months, as well as stay asleep longer.
In addition, Dr. Sears says that
cosleeping makes it easier for a nursing mother to get her sleep cycle in sync
with her baby's. Cosleeping mothers often awaken just before their babies start
to cry for a feeding and can nurse them back to sleep before they both fully
awaken.
Some parents who are separated
from their babies during the day believe that cosleeping helps them regain the
closeness with their infant that they missed during the day.
What are the downsides of
cosleeping? Having a baby in bed sometimes prevents both parents from getting a
good night's sleep. And infants who cosleep typically become dependent upon
being in a parent's bed in order to sleep, says Mary McCord, MD, MPH, an
associate clinical professor of pediatrics and public health at Columbia
University.
"They become habituated to
it, and emotionally, they come to want it," Dr. McCord says. "There isn't
anything wrong with this, but the parents have to accept that their sleep is
more likely to be disrupted." Eventually, the cosleeping routine will be
broken at some point, either naturally because the child wants it or by the
parents' choice.
Is Cosleeping
Safe?
Despite the potential benefits of cosleeping, the CPSC warns parents not to put
their infants in adult beds, stating that the practice puts young children at
risk of suffocation and strangulation. The CPSC found that at least 515 infant
deaths occurring during January 1990 to December 1997 were linked to sleeping
in adult beds. Most of the deaths involved babies who were under 3 months old.
"Our recommendation is that
the safest place to put an infant to sleep is in a crib that meets current standards
and has no soft bedding," says Ken Giles, a CPSC spokesperson. "We
recommend against having an infant sleeping in an adult bed because there are a
number of hazards, many of which can lead to death."
The CPSC identifies four primary
hazards:
Of the 515 deaths, the CPSC
reports that 121 were due to an adult or sibling rolling on top of a baby,
whereas the other 394 resulted from entrapment of a child's head.
But despite the statistics, some
people dispute the commission's findings. Dr. Sears says that cosleeping is not
inherently dangerous and that the commission went too far in recommending that
parents never sleep with children under age 2. According to him, parents will
not roll over onto a baby because they are conscious of the baby's presence
even during sleep. However, Dr. Sears recommends that a baby not be put
to bed between two parents, but rather between a parent and a wall or
guardrail. He also says that parents should not cosleep if they are under the
influence of alcohol or any drug because it could diminish awareness of the
baby.
The American Academy of Pediatrics
(AAP) is in agreement with the CPSC about cosleeping. Although the AAP notes
that cosleeping is a widespread practice in many cultures, it highlights the
fact that families in other countries almost never sleep in beds with soft
mattresses and bulky covers that could smother a child. As a result, the risks
are lower in these countries compared to the United States.
Cosleeping and
SIDS
The connection between cosleeping and sudden infant death syndrome (SIDS) is
unclear and research is ongoing. An AAP policy statement says that although
cosleeping may have benefits (such as promoting breast-feeding), there are no
scientific studies suggesting that it reduces SIDS. In fact, the opposite may
be true. The AAP says that some studies suggest that, under certain conditions,
cosleeping may increase the risk of SIDS.
The AAP also published in its
journal, PEDIATRICS, a study of infant deaths in New Zealand, concluding that
cosleeping environments involving mothers who smoke are associated with an
increased risk of SIDS.
Safe Sleeping
Recommendations
To reduce the risk of SIDS, babies should always be placed to sleep on
their backs, whether they sleep in a crib or a bed. Pillows, comforters,
quilts, and other soft or plush items are also a risk factor for suffocation
and should not be in a crib or a bed where a baby sleeps.
Follow these recommendations for
infants and toddlers when putting your child in a crib:
According to the CPSC, a safe crib
has:
If you choose to share your bed
with your infant, follow these precautions:
|
Northeast Indiana Pediatric Specialists, PC |
|
Dr. Michael Dick & Dr. Todd Dillon nips@med-web.com |