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Ask Dr. Sears: Co-Sleeping a SIDS Danger?

Q. I've heard that sharing a bed with your baby poses a danger for SIDS. Is this true? We've been co-sleeping with our 3-month-old since he was born, and I'm worried that I could be putting him in danger.

A.
Don't worry; continue co-sleeping. Because I have thoroughly researched this common concern and written two books on the subject, The Baby Sleep Book and SIDS: A Parent's Guide to Understanding and Preventing Sudden Infant Death Syndrome, I feel that I can confidently advise you on this subject. In the SIDS book, you'll find more than 250 scientific references to support the information provided on sleep and breathing patterns, and safe sleeping arrangements.

Also, my wife and I co-slept with every one of our eight babies and I have advocated the practice throughout my 35 years of being a pediatrician. I've come to the conclusion that co-sleeping, if practiced wisely and safely, can actually lower the risk of SIDS, and here's why:

Co-sleeping helps your baby rouse himself: New research has shown that in most cases, SIDS is caused by a baby's inability to arouse himself from sleep. Normally, when something occurs that threatens your baby's well being, such as difficulty breathing, he will automatically wake up. For reasons that are still unknown, in some babies, this protective mechanism does not go off, and so these babies are more at risk for SIDS.

This is where the positive aspects of co-sleeping come in. Dr. James McKenna, director of the Mother-Baby Sleep Laboratory and Professor of Anthropology at the University of Notre Dame, has conducted numerous studies of mothers and babies who were co-sleeping and night nursing. His group of researchers found that mom and baby share similar patterns of sleep arousals, what we call "nighttime harmony." They drifted in and out of sleep stages in a similar, but not always identical, pattern. Some SIDS researchers believe that this is a factor in baby's protective arousal mechanism. This harmony may also be related to a psychological synchronicity between co-sleeping mothers and their babies: The co-sleeping mom is more likely to subconsciously sense if her baby's health is in danger and wake up.

Researchers also believe that the carbon dioxide you exhale when you sleep close to your baby may help stimulate her breathing. Plus, co-sleeping infants tend to automatically sleep on their back, in order to have easier access to nighttime feedings. Back sleeping has proved to be one of the top risk-reducers for SIDS. Meanwhile, babies who sleep separately from their moms have been shown to experience a decrease in the amount of REM sleep, the state of sleep in which protective arousal is the most likely to occur.

Co-sleeping is a common practice worldwide: The rate of SIDS is lowest in cultures that traditionally share sleep, such as Asian. While there could be many other factors contributing to the lower incidence of SIDS in these cultures, all the population studies I've seen have come to the same conclusion: Safe co-sleeping lowers the SIDS risk.

Co-sleeping warnings are based on imprecise science: I began my pediatric career in academic medicine and teaching in university hospitals. At that time, I learned an important lesson about scientific research: When the conclusions of a scientific study and common sense don't match, suspect faulty science. Both Dr. McKenna's writings and my two books mentioned above contain information that proves the original studies that triggered the "alarm" about co-sleeping were flawed.

In addition, scientists have yet to come to a universal agreement on the definition of co-sleeping. I've always considered co-sleeping to mean bed-sharing or sleeping within arm's reach of mother; however, it can also be defined as simply being close to mom or sleeping in the parents' bedroom. No matter your interpretation, you will find general agreement among all SIDS researchers, pediatricians, and the American Academy of Pediatrics that sleeping in the same room with parents lowers the risk of SIDS.

Co-sleeping is as safe as the conditions you practice: For obvious reasons, parents under the influence of alcohol, drugs, or medications that interfere with normal sleep patterns should never have their baby in their bed. Other safeguards to employ:

  • Sleep in a king-size bed if possible, to give everybody enough room.
  • Be sure there are no wide crevices between the mattress and the guardrail or headboard that your baby's head could sink into.
  • Never allow infants to sleep in the same bed with siblings or caregivers - they may not have the same awareness of a baby's presence that parents do.
  • Don't fall asleep with your baby on a surface that isn't firm, such as a couch or a beanbag chair; she could suffocate by getting wedged between the cushions.

Many parents have resolved co-sleeping worries by using a bedside co-sleeper: a crib-like bed that attaches securely to the side of your mattress. This allows you to have your own sleeping space on your bed, while your baby sleeps within arm's reach for easy nursing and comforting.

I hope you continue to enjoy co-sleeping with your baby, practice it safely, and reap the rewards of feeling more connected with each other. Just remember  -- wherever you and your baby get the best night's sleep is the right arrangement for your family.

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