Is it really OK to sleep with your baby?

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Here is a post I am most eager for you all to read. It is submitted by Vanessa Freville, a pediatric nurse practitioner at Carilion Clinic Children’s Hospital. She is a former PICU nurse, pediatric Emergency Department NP, and currently works with the hospitalist group in the in-patient area. Vanessa is very passionate about keeping our infants and children safe. She is an active member of the Roanoke SafeKids alliance. In honor of SIDS awareness week, she wrote this post to encourage conversation and exploration of the practice of SAFE SLEEP in infants. I suspect this one may engender many comments. Please let us know your opinions, positive or negative.

How many parents have shared their own bed or fallen asleep with their baby at some point?

Most people I imagine!

There has been a lot of talk recently about co-sleeping with infants in the prevention of SIDS which has brought about much controversy. Many cultures and societies believe that co-sleeping is beneficial for bonding and development despite concerns raised by the medical community. Breastfeeding advocates often argue that one of the main pros of keeping baby in bed with them or “co-sleeping” is that it makes those “middle of the night” feedings much easier. Newborns often feed very frequently if not seemingly constantly! In addition, the closeness of having baby near is thought to improve bonding and emotional development.

The American Academy of Pediatrics, however advises against co-sleeping in the prevention of SIDS or Sudden Infant Death Syndrome. They further advise that if you do choose to sleep with your newborn, avoid doing so while drinking or when “excessively tired”. I don’t know many new parents who aren’t “excessively tired” as a baseline, though! Recommendations by the AAP do encourage baby to sleep in their own crib close to or in the same room as their parents. It is agreed among all communities that bonding and closeness during the crucial newborn period is important for both baby and parents. Most pediatricians educate families routinely in the prevention of SIDS which involves numerous recommendations such as back to sleep without blankets or soft toys, avoiding the use of bumper pads and much more including the avoidance of co-sleeping.

The controversy however remains… have we gone too far in the prevention of SIDS that we are risking normal development and bonding in infancy?

I can tell my readers that I have personally seen a number of infants over the course of my career who have been smothered to death by co-sleeping. When you are exhausted, you may not recognize that you are rolling over on the infant, or that he or she has become smothered by the bedclothes or pillows routinely present in an adult bed. My strong feeling is that you should keep your baby close, but in his or her own bed. And remember, early on, they just need a safe place. They wiggle, they scoot, even at very young ages. Your infant is the joy of your life, you want them to stay alive!

This Friday, April 20, is Spring for SIDS day

In honor of the day, the SW Virginia Alliance for Safe Babies is hosting a display at the corner of Jefferson and Elm (right near Carilion Roanoke Community Hospital. We will have 2 mattresses displayed encouraging people to avoid co-sleeping and to followthe A-B-C's of SIDS prevention.

A-alone

B-back to sleep

C-own crib

We would love to hear your comments, questions, thoughts and feelings about this issue.

Recent Comments

"The controversy however remains… have we gone too far in the prevention of SIDS that we are risking normal development and bonding in infancy?"

I think we have. I believe a lot of what has once been considered normal and natural related to pregnancy, birth, breast feeding, mothering an infant...has become over-medicalized to the point of parents being fearful not only of things like SIDS but also fearful of things like "spoiling" their infants. It has led to more dis-attachment and less healthy bonding with infants.

Certainly like everything moderation and safe practice is key. I wouldn't want to see an intoxicated mother sleeping with her baby, or a mother who is known to be a very heavy sleeper...but I know many families who have safely and effectively used co-sleeping as an integral part of their parenting.

Heather, thanks for your comment. While I agree that in most situations, nothing bad happens secondary to co-sleeping, the potential is there for a mother (or a father) to fail to recognize their impairment, even if they think they are a light sleeper. We have plenty of evidence that people fail to recognize that they are "under the influence" when they go to drive a car, and can end up having a crash. Some new parents can be so tired from chronic lack of sleep, that even someone who is traditionally a "light" sleeper, such as myself, can occasionally sleep so soundly, they don't wake up with minor noises or when they roll over on the infant.

I kept my newborns in a box-like carrier with handles, that I was able to put in the bed or next to the bed as necessary. It kept them safe, was hard and sturdy, and prevented either of us from rolling over on the baby. Yet they were right there when they needed to nurse. Obviously we occasionally will fall asleep with the baby when they nurse in the middle of the night. But when I realized it, I would return my little one to the safety of her "box" and I know I was then able to sleep more soundly thereafter.

I agree and know many parents... even Pediatricians who admit to co-sleeping on occasion with their little ones. It is a controversy that I think will always exist and I too see both sides. I think that as a medical community our job is to educate families on safe and recommended practices and allow parents to make choices with sound advice. Thank you for your input!

Wow! This is a very interesting piece. I've co-slept with all four of my babies. I nursed them exclusively (none of them have ever had a bottle -- straight from breast to sippy cup) and never felt they were in danger of becoming smothered. Of course, I don't think I ever fully went into R.E.M. sleep the entire time they were infants and sleeping in my bed with me.

I didn't have a good relationship with their father and he wasn't often in the bed with us (just about enough to produce 4 babies!). I've since divorced and remarried, but was still nursing my youngest (far too long according to some people) when I met my soulmate and Dragonslayer (Duane and the wonderful, amazing stepfather of my kids).

Our new and delicious intimate relationship made co-sleeping impossible, so little Sarah had to "go it alone". ;-) Anyway, I loved loved loved co-sleeping and feel a bit sad that my own children (especially my daughter) may not co-sleep with their infants due to these studies and educated medical opinions.

Samantha
Thank you so much for your response! Your thoughts are very true! So many people have no idea that this simple act which is so loving and cherished by parents can actually cause harm to your infant. I myself did not realize it until I became a pediatric RN and later an NP and actually cared for infant's who tragically were lost as a result of co-sleeping. I admit that I still have a hard time trying to educate parents about the dangers of co-sleeping without sounding like a harsh threat. I'm sure that your little Sarah is still sweet and loving despite not getting to share time in your bed with you! Thank you again.

The article is great and I will admit I co-slept with both of mine but drugs and alcohol aren't an issue. I cheated and turned up the heat so heavy covers would not be an issue. Both of my boys nursed, sleep was premium but I am a very still sleeper and they are sleep in the arms snuggle bugs. My oldest child was 5 weeks premature and had wimpy white boy so by the time I got him away from the hospital I was told not to let him cry. The only way we slept for the first couple of weeks that he was home was in a recliner. He was held non-stop so he didn't sleep until 5 months old unless he was held and then we discovered the swing. In fairness I was always envious of friends who had children who slept in cribs.
A friend would have lost her child if they had not co-slept. Her daughter had apnea and her husband heard her stop breathing. She stayed on a monitor for months to include in swings and car seat.
I think it's a double edged sword. If babies didn't die of SIDS in their own cribs I think there would be less people who co-slept but without enough info regarding what causes the actual deaths. When I see actual see a break down regarding the health of the parents I think it would mean more.

I'm a firm believer in co-sleeper beds for the little ones. I'm not as "violent" of a sleeper as I used to be but I just feel safer with the baby not in the same bed.

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About Dr. Ackerman

Alice Ackerman, MD, MBA, FAAP, FCCM is the Chair of the Department of Pediatrics at Carilion Clinic and Professor and Founding Chair of Pediatrics at the Virginia Tech Carilion School of Medicine. Dr. Ackerman is recognized nationally as an expert in pediatric critical care.

She has been at Carilion Clinic since June of 2007. Her primary goals are to enhance the health care of children in the Roanoke Valley and Southwest Virginia, and is actively working to do this both as physician in chief of the children's hospital, as well as through involvement with many state-wide initiatives.

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