Co-sleeping/bed sharing

Dear Mr. Dad: My wife and I are looking into “co-sleeping” with our new baby girl. When I told a neighbor of mine, she shook her head and said it was too risky and would “spoil” her, causing later behavior problems. What are the risks, the benefits, and what should we do?

A: Co-sleeping, or sleeping with an infant in your adult bed, is one of the many parenting ideas that has passionate advocates and just-as-passionate detractors. The two sides are usually framed in extremes, as if you’re evil if you do it – or evil if you don’t. Obviously, it’s not that simple. As you noted, it’s best to learn the risks and benefits so you can make an informed decision.

Although it has only recently re-entered the conversation in North America, co-sleeping is not some newfangled idea. Outside of the English-speaking world it’s the norm, and before the 20th century it was standard pretty much everywhere (although it’s worth mentioning that in many countries, people share a bed with their children because the entire family lives in a single room).

Advocates of co-sleeping cite good studies that show that co-sleeping helps sync the sleep cycles of mother and child, facilitates nighttime breastfeeding, reduces stress hormones, and encourages closer attachment between parent(s) and child. But the U.S. Consumer Product Safety Commission (CPSC) advises against it, saying babies are at risk of suffocation if an adult rolls over on the child (which is extremely unlikely unless you’re obese or drunk), or the child becomes wedged between bed and wall, for example. The American Academy of Pediatrics also recommends against co-sleeping, going so far as to suggest that it increases the risk of Sudden Infant Death Syndrome (SIDS). As you might expect, many prominent experts including Dr. William Sears, have a completely different view, saying that co-sleeping may actually prevent SIDS.

When expert opinion is divided in this way, it often indicates that the evidence is so sketchy that neither extreme is justified. The CPSC estimates that about 64 children die each year as a result of sleeping with adults. Each of these is an unthinkable tragedy, of course, but it indicates a very rare occurrence, and probably included extenuating circumstances. Controlling these factors should eliminate most of the associated risks:

  • Never leave an infant unattended on the bed.
  • Never co-sleep on a waterbed or couch.
  • Don’t add railings, put furniture next to the bed, or push the bed against a wall, all of which can lead to the baby becoming wedged against the mattress.
  • Never let a sibling sleep next to the baby. Children sleep more deeply and are more likely to roll over on the baby without waking.
  • Never co-sleep under the influence of drugs or alcohol, since this may prevent you from waking when necessary.
  • If you’re a smoker, don’t co-sleep, as parent smoking has been associated with a higher incidence of SIDS.
  • Use a firm mattress and make sure all bedding fits snugly.
  • Don’t do it if you have lots of pillows and blankets on the bed.
  • Make sure the mattress is flush against head and footboards.
  • Avoid strings or ties on night clothes or blankets.

As far as the “spoiling” question goes, the jury is in: You cannot spoil a child under the age of eighteen months with attention or physical closeness. Attachment parenting research has demonstrated that proximity and responsiveness leads to a greater sense of security in a child, which makes her more likely, not less, to venture out from parental protection when the time comes.

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