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The Family Bed

Why is sleeping with your baby controversial?

Deciding whether or not to bring your baby into your bed isn't controversial, it's individual. We believe that there's no "right" or "wrong" place for infants to sleep and that every family needs to formulate a nighttime arrangement that works for them. Sleep-sharing (the term we prefer to "the family bed," which conjures images of a jumble of kids on the bed, with Dad and the family dog perched precariously on the edge) certainly isn't for everyone. Many babies sleep just fine on their own from the start. Others need the security of sleeping with their parents while they make the transition to life outside the womb and can be comfortably eased into solo sleep after a few months. Still others are perfectly content to sleep on their own early on and need the added security of sleep-sharing only when they're older. The point is, wherever parents and babies get the best night's sleep is the right place for them.

Mothers and fathers who do choose to sleep with their baby, however, can rest assured that this isn't some strange new invention. In fact, sleeping apart from an infant is a relatively new concept. In industrialized countries, the majority of babies slept with their parents until about 100 years ago, and in many traditional cultures the practice never stopped. A book on childcare written in the 19th century, for instance, states that "there can scarcely be a doubt that... a child will thrive better if allowed to sleep beside its mother and cherished by her warmth than if placed in a separate bed."

William Sears is a contributing editor of BabyTalk. His wife, Martha Sears, is his frequent coauthor.

Why did you start sleeping with your babies?

Our first three children slept fine in cribs, so we had no reason to consider any other arrangement. Then came our fourth, Hayden. When she was a few weeks old, Hayden began waking every hour at night. Martha would nurse her back to sleep, only to be summoned again by an anxious cry. Out of sheer exhaustion one night, Martha and Hayden fell asleep together in our bed, and we all awoke refreshed the next morning. The same routine occurred during the next few nights. In her own way, Hayden was telling us that she needed to sleep next to us.

We initially had to get over a long litany of "you'll be sorry's" -- warnings about marital interference and terminal nighttime dependency. But we were tired, we needed some sleep, and it worked for us. After that, our next four babies joined us in bed (one at a time, of course!), and the rest is history.

When we first stumbled on this arrangement, parents either kept their baby in his own bed or kept his presence in theirs a secret. One evening, for example, we were at a party and the subject of sleep (or the lack of it) came up. In a whisper, we confided to a friend, "We sleep with our baby." She looked around to be sure that no one could hear her and whispered, "Me, too." These days, however, as rules about parenting become less rigid and parents grow more comfortable experimenting with different arrangements, sleep-sharing is reemerging from the cultural closet.

What are the benefits?

It promotes bonding. Three actions encourage the mother-child bond: sleeping nearby, touching the baby, and breastfeeding. By bringing her infant to bed with her, a mother takes advantage of all three. Sleep-sharing is particularly valuable for a mother-baby pair who had a slow start due to the baby's prematurity or a medical condition that required separating them after birth.

It helps babies go to sleep easier. In the early months, an infant needs to be parented to sleep, not just put down to sleep. This relaxes him more easily -- and less traumatically -- than leaving him alone or letting him cry. It also creates a healthy attitude toward sleep. A baby learns to regard sleep as a pleasant state to enter and a fearless state in which to remain. We believe that one reason sleep disorders have become such a problem in this country (witness the appearance of sleep-disorder clinics in most major cities) is that so many children develop unhealthy attitudes about sleep that plague them for life.

It helps many babies sleep better. It's a myth that young infants can be "trained" to sleep through the night. In the first six months, babies wake up every couple of hours, regardless of where they sleep. For many, it's difficult to resettle after these periods of night waking. If Baby is sleeping next to his mother, her very presence conveys that it's safe to go back to sleep. Feeling calm, he either doesn't fully awaken or resettles easily and quickly with the help of her touch and perhaps a few minutes of nursing.

It helps many parents sleep better. Martha, in particular, found sleep-sharing to be a lifesaver. After a bit of practice, she developed a wonderful level of nighttime harmony with our babies. Often without waking up herself, she'd lay a comforting hand on the baby's back when he or she started to squirm and help the baby drift back to sleep. Night feedings also became much less of a chore. If a hungry infant can reach for the nipple and suck immediately, he won't fully awaken, and both Mom and Baby can quickly fall back into a deep sleep.

The separate sleeper, on the other hand, wakes up alone and behind bars. Anxiety sets in, and Baby cries. In time, his wails rouse his mother, who staggers down the hall. By the time she reaches him, he's wide-awake and agitated. She's wide-awake and exhausted. It takes longer to settle a crying, angry baby than it does a half-asleep baby, so when he's finally dozing again, Mom may have trouble getting back to sleep herself.

It helps working parents reconnect with Baby. For mothers and babies who are separated during the day, sleep-sharing allows them to be reunited at night. Lisa, the mother of 2-month-old Madeline, confided to us: "Sleeping with my baby allows me to make up for the time we both miss during the day." It's also particularly beneficial for a mother who wants to continue breastfeeding after returning to work. Frequent nighttime nursing will keep up her milk supply and ensure that her baby gets plenty of nutritious breast milk. In addition, the act of sucking stimulates hormones that have a relaxing effect on the mother, helping her unwind and enabling her to get a better night's sleep (and do a better day's work).

It helps babies thrive. In fact, one of the oldest treatments for a newborn who's not gaining weight fast enough is taking him to bed and nursing him. Now that sleep-sharing studies are being conducted at several universities, science is beginning to confirm what experienced baby watchers have long suspected: Something good and healthful happens when babies sleep with their parents.

Will it make him overly dependent?

The push for solo sleep in previous generations was prompted by the great American desire for independence. Both experience and research, however, have shown that the more attached infants are to their parents, the more they learn to trust. In the first years of life, your child is a little person with big needs. He trusts that you'll meet his needs at night just as you do during the day. This trust, in turn, fosters healthy independence. Indeed, some of the most secure and independent children we've seen are those who've shared a bed with their parents.

What's the danger of rolling over on the baby?

Even with millions of babies sleeping with their parents, this rarely happens, especially when certain precautions are taken (see "Safe Sleep-Sharing"). The same subconscious awareness of boundaries that keeps people from falling out of bed prevents them from rolling onto their baby. A mother who sleeps with her infant is so physically and mentally aware of his presence, even while sleeping, that it's extremely unlikely she'd roll on top of him. Even if she did, her little one would put up such a fuss that she'd awaken in an instant. A father, on the other hand, doesn't usually enjoy the same keen awareness, so we advise that younger babies sleep next to their mother, not between parents.

Does sleep sharing interfere with sleep?

It can, but as most new parents know, just having a baby interferes with intimacy. What's important is that both parents are willing to make the commitment. If you decide to try the arrangement, discuss the details ahead of time and have periodic "are you okay with this?" chats. While a tiny baby isn't aware of lovemaking, parents may be inhibited by his presence, so consider one of the following alternatives when the mood strikes: Temporarily move the sleeping baby into another room; put him to sleep in a crib and then bring him to bed only after he awakens for the first time (many sleep-sharing parents do this anyway); forgo nighttime sex for love in the morning, afternoon, or any other time Baby is napping elsewhere; finally, be creative when it comes to choosing your lovemaking locale -- after all, any room in the house is a potential love chamber.

When is sleep-sharing not a good idea?

No sleeping arrangement works for all families all the time. Connie, a mother in our practice, once explained her decision to have her baby sleep in a crib: "Quite honestly, I don't want the baby in our bed. We have four other children, and by the time evening comes, I've had enough of kids. I want some time alone with my husband." Connie recognized that this was what she needed for her well-being, and her whole family benefited.

Some other situations in which sleep-sharing probably isn't a good idea: First, it should never be practiced reluctantly. Sometimes when a baby sleeps poorly, his parents take him into their bed without really wanting him there. Second, it's not wise to embark on this arrangement unless both parents wholeheartedly agree to it. Otherwise, it can trigger tension between partners instead of attachment between parents and Baby. Third, it may be difficult to adjust to if parents and child have already gotten used to sleeping on their own, because then they may be ultrasensitive to one another's presence and wake up more often. Last, some babies and parents have a critical sleeping distance; having another body too close increases their nighttime waking. And some older babies kick, squirm, and turn "360s" during the night, frequently disturbing Mom or Dad.

In any of these situations, an alternative arrangement can work just as well. One is to set up a "sidecar": remove one side rail from your baby's crib and place the crib adjacent to your bed. Adjust the mattress height to the level of yours, and make absolutely sure that there's no crevice between your bed and the crib in which Baby could get stuck (remove the crib's wheels so it doesn't slide). Another option is to place the baby in a bassinet or cradle next to your bed during the early months. Doing this allows you to be in close contact for nursing and touching but gives Mom, Dad, and Baby their own space.

How can you ease an older child out of your bed?

Many mothers and fathers worry that once the baby gets used to sleeping in their bed, he'll never want to leave. He will eventually sleep in his own bed -- we guarantee it. But he may not be ready to separate as soon as you are. After all, he's been in first class, so he may not take kindly to being bumped to coach. That's why weaning Baby from your bed is like weaning him from the breast -- do it gradually. You could try a sidecar arrangement, and as your baby gets used to his crib, replace the side rail and slowly move it away from your bed and eventually into another room. For a toddler, first try a mattress or a futon at the foot of your bed, then after a few months move him into his own room (a "big kid" bed with sheets emblazoned with his favorite fictional character may help stoke his enthusiasm for the transition). But keep his old mattress in your room for a while so he has a place to go if he wakes up.

Meanwhile, remember this: The time your child spends in your arms, at your breast, and in your bed will be over before you know it, yet the memories of love and trust will last you both a lifetime.

Sleep-Sharing and SIDS

Many parents and experts are confused about whether sleep-sharing increases or decreases the risk of sudden infant death syndrome (SIDS). Indeed, there's conflicting evidence, but we believe that as long as it's done safely, sleeping with your baby can help prevent this tragedy.First, some history: In 1992 researchers in New Zealand cited sleep-sharing as a factor that increases the likelihood of SIDS. This finding quickly made its way into medical teaching and public perception, although it was greeted with skepticism by sleep-sharing parents and some researchers. On closer analysis, it became apparent that the authors of the study had included parents who slept with their babies yet smoked and went to bed intoxicated - both unsafe practices that contribute to the risk of SIDS or of rolling onto the baby. Once this group of parents was separated out, the study showed that sleep-sharing, in fact, did not increase the risk of SIDS. In addition, James McKenna, Ph.D., of the University of Notre Dame, and Peter Fleming, M.D., of Bristol University in England, later reanalyzed the data and concluded that sleep-sharing can, under appropriate conditions, actually decrease the likelihood of SIDS.Despite these clarifications, however, fears linger on, and the medical establishment remains cautious about recommending sleep-sharing to new parents. In fact, the American Academy of Pediatrics recently stated that it's not convinced that sleep-sharing helps reduce the risk of SIDS. Still, we believe that sleeping with your baby can help keep him safe, for the following reasons:

  1. The incidence of SIDS is lower in sleep-sharing cultures such as Japan, where the rate is one-tenth that of the United States.
  2. Research by McKenna and Sarah Mosko, Ph.D., a sleep specialist at the University of California at Irvine, found that babies who slept with their parents had shorter periods of deep sleep (when SIDS is more likely to occur) than did those who slumber alone.
  3. A major part of the sleep-sharing and SIDS-prevention theory is that Mom acts as a breathing "pacemaker" for her baby. Because of their mutual sensitivity, the mother's presence heightens Baby's ability to be aroused, making him less likely to experience the pauses in breathing that have been associated with SIDS.

In addition to sleeping with five of our babies and educating many of our patients' parents about this practice, we've studied it firsthand. In 1992, a new baby, Lauren, entered the Sears' bedroom laboratory. After borrowing $80,000 worth of equipment, we were able to study sleep-sharing's effect on Lauren's breathing in a home environment.We monitored 2-month-old Lauren's pulse, breathing motions, and blood-oxygen levels while she slept next to Martha, and while she slept alone. The results, which we presented at an international SIDS conference in 1993: When Lauren slept with her mother, her breathing and heart rate were more regular, and there were fewer dips in her respiration rate and blood-oxygen level. Our findings were similar with a second infant whose parents generously allowed us into their bedroom. We monitored Lauren and the other baby again when they were 5 months old. As expected, the differences between shared and solo sleep were less pronounced than they'd been when the babies were younger.Although this research was obviously done on a very small scale, we feel that it adds credibility to our belief that sleep-sharing helps prevent SIDS.

Safe Sleep Sharing

If you decide to sleep with your little one, take these precautions:

DO

  • Place Baby on his back to sleep.
  • Prevent him from rolling out of bed by putting him between Mom and a guardrail (available at infant-product stores) or between Mom and the wall. Be sure that the guardrail or wall is flush with the mattress.
  • Keep Baby well away from pillows and heavy comforters.
  • Give everyone more space by using a king-size bed.

DON'T

  • Sleep with your baby if you've used alcohol or medications that dull your sensitivity to his presence.
  • Bring him to bed if either parent smokes in the bedroom.
  • Allow fathers or older siblings to sleep next to an infant under 9 months old (neither one has a keen awareness of tiny babies).
  • Sleep with Baby on a couch, waterbed, or any other soft surface in which his body could become trapped or his head buried.
  • Wear dangling necklaces or nightclothes that have ties longer than seven inches or buttons; these can get tangled around an infant's neck or cause him to choke.
  • Place quilts, blankets, pillows, or comforters under the baby.
  • Wear pungent hairspray, deodorant, or perfume, which can irritate Baby's sensitive nasal passages.
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