The short answer to the title is —- not really, and the risk varies. But I sure get why so many parents want to co-sleep despite most pediatricians urging against it.
I was up early yesterday morning listening to NPR when a story about parents’ love and desire to sleep with their babies grabbed my attention. The headline reads: “Is sleeping with your baby as dangerous as doctors say?” I mean, parents (like me) want(ed) to co-sleep and bond with their babies, of course, especially when their babies fuss and cry and especially when parents are exhausted. Every pediatrician hears and understands the parent who says something like, “By 3am I was just so tired I plopped her in bed with me after feeding and gave up on the bassinet.”
Parents ARE tired and want to make that crying, noise, and a baby’s sadness go away. The piece opened up the challenge in parents feeling judged or insecure about sharing truths with pediatricians who have strongly advised them to separate sleeping spaces. Many parents may feel that if they continue, in overwhelm, or instinct, or in love to bed-share and co-sleep, they have to keep it from their pediatrician.
The rub here is pediatricians want what is best for families and what’s best for the bond between babies and their parents. But they also want to protect babies as best they can with the evidence fueling guidelines and advice. How we’re talking about this may miss some salient points in American family lives.
Putting babies on their back in safe sleep environments has proved so helpful for protecting babies. But the guidelines may have focused too little on the risk that comes with over-tired parents who just can’t follow the advice and the risks co-sleeping may pose particularly when a tired, working mom co-sleeps out of desperation. Sleep experts have helped me understand that sleep deprivation changes arousal and it may be riskier for an over-tired parent to co-sleep than a better rested one.
Science and data have guided pediatric policies to say that co-sleeping and bed-sharing are not safe and should be avoided. The American Academy of Pediatrics states that “it should be avoided at all times.” Bed-sharing and co-sleeping can put babies at risk for SIDS, accidental suffocation, and/or accidental strangulation. About 3,700 babies die each year in the U.S. from sleep-related causes. These numbers and policies have urged pediatricians to help parents find ways to have babies sleep near-by, in the same room, but on a separate surface. But when parents can’t follow-through on the advice or don’t agree with it, they may just be staying quiet.
Parents are tired! Parents want to enjoy their babies! Parents want their babies to thrive! Pediatricians do, too.
But maybe it’s not as cut and dry as this. Maybe there are some co-sleeping scenarios that may be lower risk than others. Maybe we need to acknowledge this and help guide families to some of the nuance in the data and the risks. Eliminate all risks we can but take into account how families want to live (and will live) outside the exam room walls.
This morning, after the story I immediately got on the phone with my friend, colleague, and sleep expert, Dr. Maida Chen to discuss the topic. The guidelines, the need for them, and ways that we might consider supporting families and helping them understand all she does about sleep, risks, family, working parents fatigue, a lack of great maternity leave support, etc.
“Sleep deprivation makes co-sleeping unsafe. I consider full-time, working moms and frankly any mom with obligations beyond their newborn at high risk for sleep deprivation, and I would not recommend they bed-share with their babies. If you’re back at work, or taking care of other children, or going to school, or taking care of family members, you’re probably sleep deprived. In an ideal world we would have 1 year of paid maternity leave, but that’s just not the case.” ~Dr. Maida Chen
Other risk factors that increase dangers with co-sleeping include: having a premature baby, parents who consume alcohol, smoke and/or use drugs that would change their level of arousal or movement in bed.
Oftentimes our maternal drive, love, and bond with our child are what drives us to want to soak up baby snuggles. Or the fact that most babies just sleep better when being held. Or nighttime feedings are easier this way. Or all of the above.
This isn’t a comprehensive post – rather a post to acknowledge how complex sleep guidance can be when the advicde isn’t taken and the truths aren’t then heard. I want all parents to do the best they can and also always eliminate all the risks they can. Dr. Chen and I are thinking of building some digital tools to help families understand the data more, mitigate risk, and incorporate their real-life decisions and realities into decision-making. But we want to start by understanding where we find you, even today. Help us by first just answering this question? We’ll be back with some more (questions, and information). Stay tuned. And please share.
CHristina Marchion says
I’m a family physician. I have lost patients to unsafe sleep practices, 2 months before my first child. I was fired by a family for giving them AAP handouts on why cosleeping is unsafe in my first year in practice. Yet I still struggled with falling asleep breastfeeding in a rocker with my son on a breastfeeding pillow. This is despite setting alarms, trying tv, audiobooks, Facebook, anything to keep myself awake.
Now my 2nd son, despite knowing first hand risks, looking at all these studies, knowing about sleep deprivation from training, current job, my 2 kids- I still struggle. I have a Snoo bassinet. I doubled my maternity leave. And there’s still a time between 4 am and 9 am where if I can’t get my son back swaddled in the snoo- I make cosleeping as safe as possible knowing fully about the controversy of “safe cosleeping” being an oxymoron. And I often times kick myself for doing it ever but am so desperate knowing my only option is unsafe falling asleep from exhaustion or minimizing risk. (I never have smoked, don’t use sedative drugs while cosleeping, there’s no pillows near my infant who is full term, it only happens between hours of 4-9 am while side position breastfeeding with my arm outstretched so I can’t roll over, infant is put down on his back, mattress is firm though not on floor, no other living being is in bed with us, etc). And as I write this, I’m also so grateful nothing tragic has happened. But I literally could not fight it and still struggle. Even during the day being fully awake and after coffee, there is something about breastfeeding that sometimes lulls me to sleep.
I’m a doctor- if I knew my doctor would just use scare tactics and berate me for cosleeping, I wouldn’t tell them. I now ask my patients with deliberate, careful wording. “When and how often do u cosleep?” Because most would answer “bassinet” if asked where their child sleeps. Before I changed how I asked, maybe 3% of my patients co-slept. Now I would suspect it’s 60-80%. When asked where their infant slept, in their mind it wouldn’t include the other times, when they are tired, when it’s a nap, etc. If I normalize it with that other way of asking, then we can at least talk about the recommendations and risk reduction. Because I’ve now been there. I wish I could say I never have and never will cosleep.
Karen Deitrick says
I really feel for parents of newborns who struggle to settle down after a feeding at night. How challenging for a working parent who cannot get enough sleep to function well and safely the next day. Our WWII era parents told us to use cardboard boxes lined with a blanket which didn’t feel right but worked like a charm. Our son graduated to a dresser drawer until breastfeeding was at a point in which he was able to get to sleep fairly quickly then off to his own bed in his own room! It was a little scary having the little one so far away but what a good nights sleep!
Amy Herrera says
My first son I coslept quite a bit for survival. Second son very little but I was terribly sleep deprived for about 18 months.
My 3rd baby is 3.5 months old. I don’t remember cosleeping once but she slept swaddled in a Graco swing till 2 months old. Since 2 months old she only wakes up once a night and she falls asleep on her own, swaddled in her crib, and self-soothes pretty well. I am so glad I don’t plan on having another and having to make these agonizing sleep vs safety trade offs again.