So the following video is making the rounds on the interweb as a means of discouraging parents from bedsharing. Take a moment and watch it yourself (I recommend staying away from hard things you might bang your head on, causing injury):
Hello Ms. Cop. Might I first ask what your qualifications are to talk about infant sleep and safety? Are you a researcher on the side? Do you know the circumstances of the babies that have died? Did you do the autopsies? No, I imagine you are used here to instill a sense of fear and authority. After all, a cop tells you not to do something, you’d better think twice before doing it because the implication is it’s illegal and you can go to jail. Great start.
Onto the first comment – that over half of babies die in unsafe sleep environments. I would love the actual stat, but I’m not arguing against this because I’m sure it’s true in the sense of what we conceptualize as an “unsafe” sleeping environment. The problem is that if it’s close to 50%, we also need to know how this compares to the percentage of people who have babies in these same sleeping environments. The reason this matters is that we need this to understand the actual risk – if 50% of families have babies in unsafe sleep environments (and according to a recent finding, 55% are in this category for bedding alone, like soft blankets and comforters) and 50% of babies are dying in these environments, is the environment that unsafe or are we looking at red herrings?
I know there have been studies on many of these factors (like bumpers and pillows and comforters in cribs) and they do show an increase (though the relative increase is one that families may accept or not, depending on the benefit that’s associated with it, but we’ll get to that later), but the problem is that the actual risks aren’t being given here to allow families to understand the individual risks they may or may not be taking. Instead, we’re clearly getting a fear-mongering campaign.
So we have the ABC of safe sleep, but unfortunately there’s a little problem with A. You see, I want to say I “know” it means babies should be sleeping by themselves, on their own sleep surface, not next to anyone else; HOWEVER, it also reads that they should be alone. As in, in another room alone. Which is ridiculous and increases the risk of SIDS. As much as I want to give them credit that they mean the former, I just can’t give them that credit because they haven’t earned it.
Now comes the focus on bedsharing. Although this started as a generalized “safe sleep” video, the main intention becomes clear: Bedsharing is, as put in the video, “very dangerous”. Did you know babies have died while bedsharing?!?! (They clearly omit how many and how many have died in cribs.) Ms. Cop manages to discuss all the problems that can exist in family bed situations are mentioned without a single discussion of how to make it safer. Instead, the focus is on fear and what a dangerous, horrible thing bedsharing is (even though it’s not).
If the voice over wasn’t enough to scare you, the video of a woman sleeping certainly should. Here we see a woman who is sleeping without the baby in her bed, moving around all over the bed. First, the sleep of people alone versus with children is different. In fact, sleep is so varied that we have identified differences in bedsharing sleep between breastfeeding and formula feeding mother-infant dyads. To suggest that sleep is the same for parents who bedshare, those who do not bedshare, and non-parents is just plain ignorant. However, has anyone else noticed the time stamp on this video is just crazy? Goes up then down then up – frankly it seems like it was cut together to make the most frantic, roll-around, crazy sleep ever. If it’s truly from one night then they have flat-out lied to make it look as bad as it does based on the times given.
Second, the situation in the video is quite possibly not a safe place to put a baby – especially not in the middle of the damn bed like they do in this video, with knees into the baby’s stomach and blankets crumpled up everywhere. However, the video does suggest something most people ignore (and doesn’t make sense with the timeline in the video, but alas, that’s what we’ve got) – the mother is sleeping and has to get up to get baby, she doesn’t rearrange the bed at all and is presumably doing it in the middle of the night when she’s tired, meaning the bed isn’t prepared to bedshare safely. The situations in which women find themselves bedsharing unintentionally are also ones that can lead to even more dangerous situations. In fact, one of the biggest problems with campaigns like this is that they may actually be putting more babies at risk as parents engage in riskier practices in order to avoid bedsharing.
Now the video moves onto the crib safety tips… oh wait, there aren’t any. Which is awesome because, really, why do parents need to know about the many unsafe sleep environments that can happen when sleeping in a crib? Where’s the discussion of toys, pillows, blankets, bumpers, etc. that claim the lives of infants sleeping in cribs each year? When that discussion and associated visual is absent, it makes bedsharing seem like the only contributing problem when in fact it’s not. Researchers in Alaska examined each infant death from SIDS or suffocation where bedsharing was involved and guess what they found? Only 1 death over the span of 13 years was found to have NO risk factors for bedsharing. ONE.
Where should the focus be? Teaching families how to safely bedshare because despite all these anti-bedsharing campaigns, bedsharing continues to rise. Why? It works. It helps breastfeeding, gives moms more sleep, and is a great way to facilitate touch with infants who direly want that closeness. It may not be for every family, but we have evolved as humans to keep our babies close – they expect it and we expect it. Violating that norm is something we should think long and hard about advocating against, especially when there are clear guidelines about how to bedshare safely.
I want to address the issue of risks and benefits here too. The focus on bedsharing in the safe infant sleep environments discussion is remarkable because it’s the one area in which there is a consistent benefit to contend with. What I mean is that when you speak of pillows or bumpers or extra blankets and toys in cribs, there’s very little or no benefit to their presence (there may be certain exceptions here, but speaking by and large) yet they get far less attention than bedsharing. With bedsharing the benefits are tangible: Breastfeeding increases, mothers get more sleep, and infants receive precious and much-needed touch that is lacking in Western cultures. With these benefits, it’s no wonder that bedsharing has been said to not “be a modifiable infant-care practice that can be influenced by risk-education and simple recommendations” (Ball & Volpe, 2013).
If you want to help families, you have to realize that you’re asking people to change something that isn’t going to change for many, many reasons that are all valid. Instead, focus on teaching people how to bedshare safely and make sure their bed is safe at all times in case they end up tired and wanting to breastfeed in bed. There really should be no other plan at this point.