I recently posted an article on the do’s and don’ts of co-sleeping, an article I hoped would be helpful for those who want to co-sleep or bedshare with their baby. I imagined the article would simply be a quick guide on some of the safety concerns that mothers need to be aware of that aren’t always obvious, and for some, the article seems to have done its job. However, it also had the effect of raising the ire of those who believe bedsharing can never be safe, drawing me into a debate I realize is more passionate than I had ever anticipated.
Let it be known that I bedshare and have since my daughter was first born. I intend to continue until she chooses to leave the bed. I also did my research prior to bedsharing as I admit I was hesitant. But what sealed it for me was when my daughter was finally born and I held her, my overwhelming instinct was to sleep with her. I couldn’t imagine putting her away from me and intuitively realized I could do this so long as I was safe about it. So we did all we could to make our bed as safe as possible and she came to bed with us. I will add that she was also a baby who would not go down on her own. If she fell asleep in my arms for a nap and I tried putting her down, she was awake within a minute, even with my hand still on her belly. She simply refused to sleep on her own, and my firm refusal to do any type of cry-it-out routine meant that she really had to sleep with us in order to get any sleep whatsoever. But regardless of her temperament, sleeping with her felt right.
This is not a unique experience and many women have said they feel the same overwhelming urge to sleep with their child and protect them. But there are those who say that that very urge is actually placing our babies at a greater risk of death. Indeed, the topic of safe bedsharing is murky and while the two sides are separated by a large, vast chasm, they are each equally certain that only they are correct. On one side, we have those who believe bedsharing allows for greater infant arousals, increases mom’s awareness of her baby, helps babies by providing them with close comfort during the night, allows for easier breastfeeding, allows everyone in the family to sleep better, has long-term social and emotional benefits for baby, and can be done safely for baby. On the other, there are those who say that bedsharing is not safe and cite research showing an increased risk of SIDS for babies who bedshare. In fact, I’ve heard of people going so far as to say it’s a “myth” that one can safely bedshare, and that those who support it do so out of a need to push their own agenda and don’t care about babies’ lives.
Let’s first put to rest the idea that there are people who are a part of this debate who don’t care about the welfare of babies because that is simply ridiculous. No parent decides to bedshare because they don’t care about their baby’s life and no medical professional or researcher is out there promoting something without the utmost consideration of these little beings. Some will argue that parents are simply ignorant of the research that demonstrates a “clear” link between SIDS and bedsharing and once made aware of it would never bedshare. And I would be remiss not to mention this research because it truly does exist. There are a plethora of articles by respected scientists in North America, New Zealand, and some parts of Europe that have found a higher incidence of SIDS (which often includes deaths by suffocation or overlay because it is too difficult to disentangle the manner of death) in infants who bedshare (for a review, see [1]). It is this evidence that has lead agencies such as the American Academy of Pediatrics to have an official policy against bedsharing. And yet, despite what could be seen as overwhelming evidence, many people, myself included, read these articles and remained skeptical about the link between SIDS and bedsharing. But why?
As a researcher myself, I am always interested in both the quality of studies that I read, but also of the logic that stems from research. You pose a question, you design a study, and hopefully if all goes well, you’ve at least gotten closer to answering that question. But to do this, you must make logical assumptions. For example, suppose I want to see if A causes B. Inherent in this is the believe that it is A per se that causes B, not a correlate of A or some aspect of how A is done that leads to B, but A in and of itself. This is important because one must be aware of factors that can affect these relationships and account for them in one’s research whenever possible. It is this issue that allowed me to remain skeptical of the aforementioned research and the notion that bedsharing per se is not safe.
As previously mentioned, many individuals who believe bedsharing to be unsafe believe that it can never be safe, and proponents have written opinion pieces saying as much[2]. The first red flag for this point of view is that there is ample anthropological evidence that we have evolved as a species (as other mammals have) to co-sleep with our offspring[3][4]. Why does this matter? Because evolution doesn’t build features into our system that harm us, we can only remain neutral or be helped by what we have evolved to do when done in the way evolution intended. Those opposed to bedsharing have commented that we wouldn’t accept the infant mortality rate of our ancestors, and while true, it also is irrelevant as the vast majority of those deaths had nothing to do with bedsharing, but rather infection, malnutrition, etc. Another common response is that other mammals will overlay or suffocate their offspring. While I am willing to accept that this happens on occasion, I have yet to see a single piece of evidence that this is a significant problem amongst other mammals. I have searched for scholarly articles on the topic and found nothing which leads me to believe that while it may happen, it is not an epidemic and we need to weigh the times this might happen against what might happen if infants are not sleeping with a parent. What is often ignored by those who are opposed to bedsharing is that there is substantial evidence that children left in a crib in a room separate from their parents (the new ‘norm’ in Western society) is associated with a large increased risk for SIDS, even when bedding and mattress and temperature are taken into account[5][6][7]. At the very least, I hope people see the need to keep babies close to their parents, even if not in the same bed.
Importantly, though, one aspect of the evolutionary argument is often ignored; “the way evolution intended” suggests we also need to be cognizant of how our environment has changed because changed it has and in a dramatically short span of time (evolutionarily speaking). Big, soft beds and fluffy pillows with duvets have hardly been the norm over the history of mankind and thus must be considered when we think of the safety of babies when bedsharing. This brings us to red flag number two –the studies that have found an increase in SIDS associated with bedsharing have failed to control for all of the known safety factors that affect safe bedsharing[8][9]. While many have controlled for smoking and alcohol use (and once these are controlled for, the results with respect to SIDS and bedsharing are equivocal), they do not account for room/infant temperature, type of bedding, presence of pillows or duvets, overcrowding in the bed, etc., all of which have been implicated as risk factors for SIDS or suffocation when bedsharing. One study that examined these myriad factors with respect to bedsharing and SIDS found that bedsharing was a non-significant factor in predicting SIDS[10]. In other words, it seems to be the way in which we now bedshare that poses an increased risk to infants, not bedsharing per se.
There’s a third red flag though, and one that is particularly salient. In order for individuals to claim that bedsharing is never safe, it has to hold across cultures and different practices, and yet today we have Japan. Japan boasts some of the highest rates of bedsharing (close to 40% bedshare on a regular basis[11]) and yet some of the lowest rates of not only infant mortality, but SIDS specifically[12][13]. The only rebuttal to this that I have found from anti-bedsharers comes from a quote in an article on SIDS and weather, done by researchers in Taiwan, and it is as follows:
Together SIDS and suffocation account now for 20% of the total infant mortality in Taiwan, representing a yearly rate of close to 1 per 1000 live births, a figure similar to infant mortality from SIDS alone in western countries. SIDS as a distinct diagnosis has recently been introduced because suffocation seemed an inappropriate diagnosis for the majority of sudden unexplained infant deaths. Suffocation as cause of death is now rarely recorded in western countries. The situation in Asia is essentially different. Taiwan and Japan both record suffocation rates that are higher than SIDS rates, and together these two causes of death sum up to values similar to those for SIDS in western countries. We include accidental suffocation diagnoses in SIDS, taking the view that from a western perspective both terms would be synonymous.[14]
If this were the whole story, we might have to accept that there is something wrong with the Japan argument, but there are a couple major flaws in this statement. First, the separation of suffocation and SIDS may have previously occurred in Japan, but that has changed in recent times, as has been reported by SIDS researchers and educational advocates[15]. In fairness, this article was written in 1995, but 16 years later, the understanding and diagnosis of SIDS is much better understood and utilized in Japan. And the rates continue to be low. The second flaw is that the statement that the rates in Japan are similar to those in Western countries is factually inaccurate. A study out of Japan on SIDS rates in the late 90s addressed the issue of suffocation vs. SIDS and included the rates of both of these forms of death from 1980 to 1999[16], as shown below:
By simply combining the numbers for the two, you still have lower rates of death than those in Western countries. For example, in 1990, the combined rate for Japan would be approximately 0.35 per 1000 live births compared to the US rate of approximately 1.3, a number much lower than Western countries. Furthermore, comparisons of rates that include both suffocation and SIDS continue to be much lower in Japan. Below is a graph from the National Sudden and Unexpected Infant/Child Death and Pregnancy Loss Resource Centre on 2005 rates of SIDS by country:
As you can see, the rates for Japan are at most half of many Western nations. If one is going to say that bedsharing per se increases the risk of SIDS, then we have a logical dilemma with the data from Japan.
I’ve also read statements from anti-bedsharing advocates that there is research showing bedsharing to be a factor in SIDS even in Japan, but with no citations to back that up. As I could only find one article stating anything remotely like this, I can only assume they refer to an article by Mukai and colleagues in Legal Medicine from 1999 which reports in its abstract: “In addition, the co-sleeping habit, which was not uncommon in Japan, seems to contribute to certain deaths of infants whose causes of death were controversial.”[17] I can also only assume those who use this article to make any statement on bedsharing have yet to actually read it in full. First, there was no analysis conducted on co-sleeping as a factor, but rather a discussion of the potential role of co-sleeping in three particular cases. Second, these three cases all included elements of bedsharing which are considered unsafe – one mother was drunk and her leg was over two infants’ faces when they were found dead and in the third case the infant was found under an older sibling. Furthermore, the rates of bedsharing in the SIDS and control groups were comparable and the rate of SIDS for infants in the same bed as parents or next to the parent bed, but on their own bed, was virtually identical with rates of 23.4% and 21.4%, respectively. (It is worth noting that this study also included both SIDS and suffocation deaths together under the umbrella of “SIDS”.) Outside of this one study, I have yet to find any research suggesting bedsharing is an issue pertaining to SIDS in Japan, and in fact, one study found the opposite – that sleeping alone was a significant risk factor[18].
So we must now ask ourselves, what does Japan do that is different?
For starters, they have lower rates of maternal smoking and alcohol consumption than Western nations and that alone will significantly contribute to lowering the risk of SIDS while bedsharing. But their bedroom also contains fewer risk factors. Here’s an example (though stereotypical) of a traditional Japanese bedroom:
Note the important part is that the bed is low to the floor with few sheets, and nothing large and fluffy. There are few pillows, none large, and the mattress is firm. We can hope that the temperature remains at or near the optimal 68oF (though I’m sure it varies). Moreover, more Japanese women give up their jobs to stay at home to raise their children[19], meaning they aren’t juggling work and childrearing and thus are not as sleep-deprived as their Western counterparts. Compare this with Western nations where women smoke and drink in larger proportions, our beds are soft and high off the ground, we use duvets and lots of pillows, we set temperatures that are much hotter than they need be for sleep, and we have people back at work after just weeks after giving birth. In fact, many mothers in the US decide to bedshare to get more sleep because they are exhausted. The very fact that they are overtired is one reason why they should not be bedsharing at that particular point and poses a problem in research as it is a factor that is often overlooked. It is also for these reasons that larger agencies, such as the American Academy of Pediatrics, speak out against the practice. It’s not that all doctors believe bedsharing to be unsafe period, but rather there’s the proverbial covering their asses that has to take place, and as long as we live in a society whereby our norms remain distinctly different from what is necessary to bedshare, how can they be expected to make blanket statements in support of it? From a policy point of view, you have to do both what is best for the masses and easiest to implement, and with the list of don’ts that accompany bedsharing, is it any wonder these groups oppose the practice publically?
If we take all of this together, I hope a clearer image starts to appear. Namely, that the claim that bedsharing is never safe is rather disingenuous. It can and has and continues to be done safely around the world. But – and there is a ‘but’ – there is a problem in Western countries in that safe bedsharing is not being practiced by many. Women are sleeping with their babies on sofas (one of the largest contributors to infant sleeping deaths in one UK study[20]), sleeping while overtired, drinking, smoking, etc. and these are all putting their infants at greater risk for death. It is a problem that we need to take seriously, but as I have stated before, I do not believe we simply abandon the practice of bedsharing altogether or threaten families with criminal action for parenting in a way that is responsive to their baby biologically and historically. I liken it to safe sex education: If you only preach abstinence then those who will do otherwise (for many reason) will not have the information to keep themselves and others safe, but if you speak of the benefits of abstinence and acknowledge it won’t work for everyone and then teach safe sex on top of it, well, you’re making sure more people are safe. (And of course the fallacy in this analogy is that cot sleeping is “risk-free” like abstinence, but we know that’s not the case either. SIDS used to be known as cot-death and babies in their cots in their parents room still die of SIDS.)
It may not be for everyone, and there are those who simply should not bedshare (like smokers), and in these cases, we need to be promoting room-sharing over the now common practice of placing a baby in their own room, separate from mom. Indeed, some people room-share for the first few months where the SIDS risk is greatest and then bedshare once the infant is old enough and strong enough to move around better whereas others just never bedshare. But for those who want to bedshare from the start or who have an infant who will not sleep without mom, learning how to safely bedshare is a must, and an area in which more education is sorely needed. Safe bedsharing is not a myth and it is not out of reach, but it does require education and work.
[Photo/Image credit: Gioia Albano]
[1] Trifunov W. The practice of bed sharing: A systematic literature and policy review. Prepared for the Public Health Agency of Canada (2009).
[2] http://www.facebook.com/notes/parents-against-co-sleeping/a-deadly-disservice-why-safe-bedsharing-is-a-myth/179657638749881
[3] Ball H. Bed-sharing and co-sleeping. NCT New Digest (2009); 48: 22-27.
[4] McKenna JJ, Thoman EB, Anders TF, Sadeh A, Schechtman VE, & Glotzbach GT. Infant-parent co-sleeping in an evolutionary perspective: Implications for understanding infant sleep development and the sudden infant death syndrome. Sleep (1993); 16: 263-282.
[5] Blair PS, Fleming PJ, Smith IJ et al. Babies sleeping with parents:case control study of factors influencing the risk of the sudden infant death syndrome. CESDI SUDI research group. British Medical Journal 1999;319: 1457–1462.
[6] Mitchell EA, Thompson JM. Cosleeping increases the risks of the sudden infant death syndrome but sleeping in the parent’s bedroom lowers it. In: Rognum TO, ed: Sudden Infant Death Syndrome: New Trends in the Nineties. Oslo, Norway: Scandinavian University Press, 1995. pp. 000–000.
[7] Carpenter RG, Irgens LM, Blair PS et al. Sudden unexplained infant death in 20 regions in Europe: case control study. Lancet 2004; 363:185–191.
[8] Hauck FR, Herman SM, Donovan M et al. Sleep environment and the risk of sudden infant death syndrome in an urban population: the Chicago Infant Mortality Study. Pediatrics (2003);111:1207-14.
[9] Carpenter PR, Irgens PL, Blair PS, England PD, Fleming PJ, Huber PJ, Schreuder P. Sudden unexplained infant death in 20 regions in Europe: case control study. Lancet (2004);363:185-191.
[10] Blair PS, Fleming PJ, Smith IJ, Ward Platt M, Young J, Nadin P, Berry PJ, Golding J and the CESDI SUDI research group. Babies sleeping with parents: case-control study of factors influencing the risk of sudden infant death syndrome. BMJ 1999;319:1457-1462.
[11] Trifunov W.
[12] http://en.wikipedia.org/wiki/List_of_countries_by_infant_mortality_rate
[13] http://www.sidscenter.org/Statistics.html
[14] Knobel HH & Chen C-J. Sudden infant death syndrome in relation to weather and optimetrically measured air pollution in Taiwan. Pediatrics (1995), 96, 1106-1110
[15] http://www.sids-network.org/experts/bedshare.htm
[16] Fujita T. Sudden infant death syndrome in Japan 1995-1998. Forensic Science International (2002); 130: 71-77.
[17] Mukai T, Tamaki N, Sato Y, et al. Sleeping environments as risk factors of sudden infant death syndrome in Japan. Legal Medicine (1999); 1:18-24.
[18] Watanabe N, Yotsukura M, Kadoi N, Yashiro K, Sakanoue M, & Nishida H. Epidemiology of sudden infant death syndrome in Japan. Acta Paediatrica Japonica (1994); 36: 329-332.
[19] http://www.mfj.gr.jp/web/wp/WP-L-04-IFRJC-Hashimoto-09-03.pdf
[20] Blair PS. Perspectives on bed-sharing. Current Pediatrics Reviews (2010); 6:67-70.
Amazing work.
Great post!
It is irrational and misguided this pronouncing of things as safe or unsafe. Research normally studies risk and there is normally some risk in everything. Being able to compare and reduce risk enables informed and better choices but research will not normally speak in terms of safe or not safeand I have found the people who do are often basing their opinions on the opinions of organisations. A lot of the advice organisations give risks making things worse because of what you mention – they have to cover their asses. Unfortunately this normally makes them try to present things in concrete and without real information.
One thing I have wondered, and often felt is missed, is controlling for feeding method. I have often thought that whether a baby is breast or formula fed would affect both the parent and the baby’s sleep and could be a very important factor in the safety of bedsharing over and above the affect of formula feeding as a stand alone risk factor for SIDS. There will be loads of things like that though. Probably even parenting style – whether you are babyled or scheduled for example… Logically the things that affect bedsharing would be to do with the awareness of the baby in the bed once you take out thermal stress factors, that is effectively what the drinking risk is…
Kat – there is some research that is starting to look at the method of feeding and bedsharing risk factor for SIDS. At the moment it’s pretty murky, but the belief by some researchers (including Dr. James McKenna) is that those who formula-feed are at higher risk of problems when bedsharing because you aren’t as in tune with your baby’s schedule. I didn’t include it in this article, though, simply because it’s very inconclusive at the moment, but worth keeping an eye on!
I’m kind of surprised you didn’t mention Dr. McKenna’s work at all.
As for bed sharing not being safe, all I can say is neither is crib sleeping. I would have 2 less children if I hadn’t slept with them as babies. My oldest started choking in his sleep and since I was right there, I was able to help him right away. My third had serious apnea issues for his first few months and he didn’t always start breathing again on his own. I’ll never forget the terror of waking from a sound sleep KNOWING he wasn’t breathing. It took awhile to get him started again (felt like forever, but was probably less than 30 seconds). If he had been in a crib, he would have been dead. As it is, I now have perfectly healthy kids ages 2-10 who all slept with me from birth.
Hi Lisa,
I think people really do forget that sleeping your baby can also save his or her life. I had a similar experience with my little girl who started vomiting in her sleep silently and it was me who woke up and got her upright to get it out. It terrified me and yet I was so thankful I had her right next to me.
As for Dr. McKenna, there are a couple reasons I didn’t all out talk about him in this post. First, I talked about him extensively in another post on co-sleeping (The Do’s and Don’ts of Co-Sleeping) and I wanted to avoid being redundant. But secondly, I found in my experiences with those who are anti-bedsharing, they immediately dismiss anything that comes from McKenna’s work and I had hoped to have an article that just might find its way to those people and not have them dismiss it out of hand because of a mention of his work. Furthermore, I want people to also realize that there are plenty of other researchers who believe in the safety of bedsharing outside of McKenna and Dr. Sears! I hope that makes sense, but I personally love his work and find it both scientifically rigorous and fascinating!
Cheers,
Tracy
Thank you. Excellent piece, and timely.
I would also have thought a paragraph on the link between feeding methods and SIDS (and the work of Dr Helen Ball of Durham in particular) might have been appropriate? However thank you very much! Sharing.
Really good article. Thanks, Tracy.
I’m interested in your explanation for not specifically mentioning Jim McKenna’s work and views. Wondering if you feel the same applies to mention of Helen Ball, ie that mere mention of her is enough to cause some anti-cosleepers to turn off? She’s also done and/or doing interesting work around feeding method. I agree that this is a variable that has been insufficiently studied up until recently (could write an essay speculating about WHY that is) and which could well reveal some really important information once sufficient research is done.
🙂 I just wrote that the whole feeding method deserves a post unto itself – and will get that!
My experience has been that Ball’s work isn’t as controversial yet because the findings aren’t as clear. But I fully expect her to fall into that camp if it starts to seem that the research all points to the important role breastfeeding plays in safely co-sleeping!
Good article, BUT – how on earth could you write such an essay on co-sleeping and NOT include anything on the method of feeding of the baby?
Meryl, because I wanted to focus exclusively on what is available in the scientific literature to back this up, I didn’t go there. There is work out there that supports the notion that method of feeding does affect the safety of co-sleeping, but it’s actually rather equivocal at the moment and so opening up that can of worms was not part of the intent! However, it’s an important enough topic that I plan to do a article outlining what is known in the future – a post all to its own 🙂
Good article. It always amazes me, regardless of topic, when people can look at something that is anthropologically normal and that the vast majority of humanity throughout the vast majority of human history practiced and survived and call it unsafe, abnormal, or weird/creepy.
Fabulous article! I really love finding well-researched and cogently written information on attachment parenting issues. I have 16 month old twins, with whom my husband and I bedshare now, but it was a long journey getting there (http://attachedatthenip.blogspot.com/2010/12/evolution-of-sleep.html). I will never forget the dull sense of horror mixed with relief at escaping what could have been when I began researching safe bedsharing AFTER committing many of the no-nos. Parents need to be educated on besharing because they never know when they’ll just “give in” and take the fussy baby to bed with them in an effort to get sleep. Knowing enough to make the sleep space safe before it gets to that point is so important! Thank you for giving us an eminently sharable article!
I hear you on getting people to know the information before they start unsafe bedsharing! One of the biggest problems I have with the anti-bedsharing view is that they also seem to be against sharing information on how to do it safely, meaning people remain uneducated and then place their children at risk every time they take them to bed. One researcher has noted that he encountered many parents who said they had heard bedsharing wasn’t safe, so they slept with their babies on sofas instead, which are even less safe than the bed. I find it tragic that we’ve become so litigious as a society that the idea of simply offering information on safety no longer registers for health professions because they risk getting sued if something goes wrong.
This is probably one of the most articulate, well informed, and well rounded posts I have read on this subject. As a pediatrician and mom, when my first child was born, I went through the same instinctual urges but fought them for obvious reasons. We did end up co-sleeping and I agree the studies do not elucidate the whole truth.
I hope public health officials can focus more on safe sleep practices, which include crib and bed environments instead of making the blanket statement that bed sharing is universally unsafe.
A just wrote a post on this, begging these questions. However, as a pediatrician, I am receiving a lot of heat for it.
Infant safety is paramount, education is key.
Thank you for this wonderful article.
Thank you Melissa! I just saw your post and comments (particularly those from Dr. Dad) and I can see the grief you get. It’s amazing how much mis-information exists surrounding the topic of bedsharing and safety, even amongst those professionals we expect will know it all. It’s especially harmful when no two kids are made alike. My daughter is like your son – she just would not go down in anything other than my arms. And she still cuddles insanely at night, like she can’t get close enough, but she obviously needs that comfort and touch and I’m happy to provide it.
It’s true. At the doctors office, W.I.C. and other (especially) low income government aid offices they tell you how unsafe co-sleeping or bed sharing is. I totally disagree and think most who put their babies in a crib to put themselves to sleep are just lazy, selfish or ignorant and tend to follow the “norm” as they see it.
Just the word SIDS raises the hackles on my neck. Firstly, why in the world are we including accidental suffocation deaths in the SIDS rate?! This makes NO sense. Secondly, I FIRMLY believe SIDS is caused by a genetic condition or predisposition that we have yet to identify, therefore making the sleeping arrangements a null point. Babies have died in beds, cradles, co sleepers, car seats, strollers, slings, couches, floors, playpens, etc, and I believe that MOST of those were cases of suffocation.
Why is it that when the baby of a smoking, formula feeding mother dies in a crib that is full of stuffed toys and bumpers no one ever accuses her of taking a risk with her child’s life, yet parents who make educated, informed decisions to co sleep and lose a child are lamb basted? I co slept with all three of my babies and if I have another, I will co sleep again. I cannot fathom giving birth and then sticking this new tiny, helpless little person into a crib, all alone. Infants are not meant to be isolated! As a doula, I recommend co sleeping and give the family all of the information they need to do it safely.
I agree it’s weird to include SIDS in with suffocation, but from the practical standpoint, I understand. It’s simply that by the time an infant is discovered, it’s nearly impossible to tell the difference most of the time. So we have to lump it together. However, obviously it was possible to tell them apart sometimes as Japan and other Asian countries did that on a regular basis! I just don’t know if they made assumptions about one mode of death versus another based on sleeping location (e.g., if co-sleeping, assuming it was suffocation over SIDS).
right on!
A fantastic well referenced article, thank you so much for posting this!
Tash
Beautifully written!
I believe that everyone has their own reasons for bed sharing. When my son was born (9 years ago almost exactly), my husband and I were not planning on bed sharing, but he would nap with us, usually sleeping on our chests. When he was eight days old, he was asleep on my husbands chest and stopped breathing. There were no blankets, no clothing, nothing around that caused it. My husband was able to get him breathing again, and he spent a few days in the hospital under going observation. They never figured out what caused it, but his doctor actually commended us for sleeping as we did, knowing it was that reason that my son survived. Needless to say, he did not leave my bed until he turned two and was ready to.
After that, my daughter (10 months now) has bed shared since birth. We bed shared in the hospital, and have done so since here at home. I love that she is there. We bedshare safely, although she does like her blankets!
THank you for writting this. I have learned that many people bed share but would never admit to it!
I slept with all three of my children. We got rid of the crib we used for only a few months after the first. But a bit off topic — I have to admit that I was amused when I saw the photo you have for a Japanese bedroom. That is the most luxurious Japanese bedroom I’ve ever seen! Certainly I didn’t see more than maybe 15 bedrooms in various houses we visited in 1983, but I was in homes and high cost apartments in the Tokyo Prefecture and none of them came close to this. No bath in the room and certainly not all that space!! And the futon (combination of bottom mattress and top bedding) was not so thick. The pillows were filled with buckwheat. And are flatter than US pillow. Also, we, in our three room apartment, took the bedding out of the futon closet at the end of the day since the room was used for other purposes in the daytime.
Unfortunately when we were there in the 80s the trend was starting for those with good salaries was to provide western style beds for the children. But most mothers still slept with the infants. Now a days there is much more formula use in Japan. A sad development.
I know this blog is a bit old but I came across this while I was doing some mindless net trawling I am absolutely appalled that these people have no idea aabout the benefits of bedsharing
http://perezitos.com/2011-11-20-posters-of-babies-and-knives-warn-against-cosleeping
It’s awful, I know. I’m actually writing something on it all as I type this 🙂 I wish there were a way to instill logic in everyone, but apparently not!
Great! Id love to hear what other people have to say. I hope you found a better link though lol 🙂
i am vietnamese and in my culture bed sharing is the norm. i was a single mother with my first child and i was bed sharing with her with no problems..i dont move around much when sleeping and i wake easily and am not a deep sleeper..we had such peaceful nights and no fussiness and baby slept well and woke up happy.my baby always slept on her back. i always had the bassinet close by also for nights i would put her in there ..we had a big bed so there was plenty of room .although when she was from birth to a year it would just be a mattress on the carpet so she wouldnt fall off the bed..and i only had the pillow i used and not any other pillows that would cause danger and a throw blanket that wasnt heavy and our room would be the right temperature and she would wear clothes that was comfortable for her so she wouldnt get too hot or cold . before she fell asleep i would lay in bed with my baby girl and watch tv or talk on the phone or listen to music this was very helpful since she would fall asleep during the noise (not too loud though) and would never get startled. what works for me is the tv on sleep mode or the cd that played music would end so it wasnt playing all night to where i wouldnt hear her wake or cry. my baby was never fussy. as she got older she loved having her own room but some nights she still slept in my bed. and now i have a baby boy and i am bed sharing with him also and everything is fine.
[…] are generally half of other industrialized nations and co-sleeping is also the norm there (see Bedsharing and SIDS: The Whole Truth for a full review of their practices and SIDS rates). It is possible that breastfeeding has […]
What says it all for me is when you say that YOU felt an overwhelming urge to bedshare. Sorry darling it isn’t all about YOU. My ex sleeps with my 9 year old, he tells me he feels weird but she continues. What to do? I’m sure as long as she feels this “overwhelming urge” it’s okay?
Of course every parent should consider what works for their child as well. If your child is uncomfortable, he or you should talk to your ex about it. But bedsharing at 9 is normal in some cultures. However, I find your tone completely inappropriate for a piece of this nature. No where does it say everyone will feel the same, but the fact is that many (arguably a majority) do and yet are told it’s “wrong” yet clearly that’s not necessarily the case.
[…] of us could go bowling and get along fine; however, we differ in regards to where we each think the best place for a baby to sleep should be. I, personally, have had both of my children sleep in my bed since […]
I have actually heard and believe that co-sleeping or bedsharing is safer because you are closer or in direct contact with your baby so that if they were to stop breathing in the night while you are sleeping your breathing and movement will start them breathing again or you wake up from the silence. I have co-slept or bedshared with all 3 of my children. They are strong and healthy and there were no problems. I agree with the author about how when you first bring your baby into the world their is nothing that makes you want to seperate from your little new life. People who put their babies in a crib in another room will never understand what co-sleeping bed sharing truly is. Animals no not leave their newborns in another room while they sleep. It is too dangerous
The low SIDS rates in Japan are due to their delayed vaccine schedule (very little under 2 years of age), compared to the US which gives
“In 1975, Japan eliminated all vaccines for children under two and that when that happened; their infant mortality rate plummeted so that it was the lowest in the world.”
“Japan moved from 17th (a very high bracket) to the lowest infant mortality rate in the world (Jenny Scott 1991).”
Details with references are here:
http://www.whale.to/vaccines/scheibner1.html
one thing i’m curious about: the typical japanese mattress is a futon – a thick pad stuffed with cotton or other natural fibres.
the typical western mattress is stuffed with foam rubber (either polyurethane or latex) and flame-retardant chemicals.
i wonder what the role of off-gassing is in the higher SIDS rate in the West?
Very good question – I don’t know if anyone’s looked at it to be honest!
I am from the US but, I have lived in Japan for 22 years. All three of my children were born here and they all slept with my husband and I. Mainly cause Japanese apartments and homes are small is the biggest practical reason for cosleeping.
However, when we think of an infant, baby or child cosleeping with a parent we imagine them sleeping with us in the same bed. You have to imagine that we sleep on our own big futon and our infants, babies or children sleep on their own little futon next to us. Of course, as they get older they sometimes share the same futon with us. But generally, kids sleep on their own futon.
As for the type of materials used to make a futon. Most are cotton or recently polyester cotton blends. You also have to take into consideration we hang out this bedding almost daily when the weather is nice to air it out and keep it clean and free of any dust mites. In fact, there are whole speciality lines of futon for people with allergies to be dust and pollen resistant. Japan is very humid for the most part so it is important to keep the bedding aired out from getting moldy or propagating dust mites.
Also, I suggest using a different photo for a typical Japanese room. http://www.cnbhomes.com/wp-content/uploads/2014/10/magnificent-japanese-style-futons-w0GcI.jpg
Usually futon are folded up during the day and sometimes stored in the deep closet. My kids like to keep theirs out and sit on them like a mini sofa.
Overall, I was so impressed with your research. The west tends to have knee jerk reactions to everything. Personally, I honestly believe that there may be a very high possibility between the link of SIDS and early vaccinations. There just needs to be more significant studies to prove it.
Thank you and thank you for the image – hard to find some but I will definitely use the one you recommended!!!
With all due respect to everyone’s opinion, any decision a parent makes boils down to this:
You have been educated on what the current scientific research (and many infant death investigations) have demonstrated the correlation of bed-sharing and Sudden Infant Death Syndrome or Sudden Unexplained Infant Death. Now that you know, and understand, that you are taking the risk of doing something that knowingly has caused many deaths and parental heartache…
can you live with yourself and your guilt if your baby dies while you bed-share?
Your opinionated article lists a few articles while the American Academy of Pediatrics recommendation from the Task Force of SIDS lists 92 scientific, peer-reviewed sources…
http://pediatrics.aappublications.org/content/early/2011/10/12/peds.2011-2284
So if parents truly want to know the WHOLE TRUTH on Bed-sharing and SIDS/SUID…do your research on what has been demonstrated…look at the statistics. While some say, “I have slept with All my children;” I say, “you and your babies were lucky.” The parents who have lost the love of their life due to SIDS and bed-sharing wish they could turn back time, and I believe would scold you for taking the risk.
Why take the chance? Because it is not YOUR life? Because YOU are INVINCIBLE? Why not room-share and have the baby sleep in the safe baby bed? Would you take the chance of not placing your baby in an infant car seat and then drive 55mph? Would you take the chance of not placing your baby in a high chair and step away? Would you place your baby in the bathtub and step away?… If SIDS does happen to an educated parent, then that parent shall be held accountable, and shall be held negligent…possibly for manslaughter. Be your baby’s advocate and do not place the sweetheart at risk for death.
Thank you,
Certified Nurse Educator
and Advocate for evidence-based practice Maternal and Child Health Nursing
If you’ve actually READ the task force bit on bedsharing they are quite clear that it’s still controversial and thus they err on the side of saying “no”, despite acknowledging that it can be safe in some subgroups. These subgroups are what we are speaking of.
As for the fear-mongering you pull out, I know families that have lost their children in cots and wish they had bedshared – it goes both ways. The “why not do X?” ignores that that *doesn’t work* for many families. I, for one, would have been dangerously sleep deprived and that would have probably triggered the PPD that I was very lucky not to have gotten (as someone who ticked off all risk factors). My daughter would not sleep out of my arms. Wouldn’t. Put her down drowsy, she screamed. Put her down asleep, she was awake within a minute. I’m not saying *everyone* should bedshare – frankly, I don’t think that’s wise or feasible. However, saying “don’t do it” and ignoring the realities of why people do it is incredibly dangerous and puts more babies at risk when people take chances or fall asleep nursing on the sofa which is even more dangerous. Teach people how to do it safely if they’re going to do it. It’s just like sex ed… you can preach abstinence all you want, but if you want to be the absolute safest, preach abstinence and also teach people how to have safe sex.
Here is a great piece too from Dr. Melissa Bartick on the AAP stance!
https://bfmed.wordpress.com/2014/04/09/should-the-aap-sleep-alone/
[…] Y, ¿por qué los países con menor tasa de colecho tienen las mas altas de muerte súbita, como pasa en Estados […]
[…] Bedsharing and SIDS: The Whole Truth – Evolutionary Parenting https://gku.flm.mybluehost.me/evolutionaryparenting.com/bedsharing-and-sids-the-whole-truth/ The Do’s and Don’ts of Co-Sleeping – Evolutionary Parenting […]
[…] about SIDS rates, check out these articles: Co-Sleeping Around the World By: James McKenna, PHD BeBedsharing and SIDS: The Whole Truth Co-sleeping and SIDS […]
[…] Bedsharing and SIDS: The Whole Truth – Evolutionary Parenting: link. […]
[…] bed sharing then be safe? Dr. Cassels (2011) in he blog Evolutionary Parenting, seems to thinks so and cites statistics from Japan to support her point. I happen to agree with […]
What about the data that shows that SIDS deaths are lower among asians regardless of where they live? Presumably asian women living in the US would still have lower smoking and drinking rates, particularly first generation. But would the lower rates among asians experience explain why Japan has such low rates?
It’s a great point. However, they also cosleep more in Western cultures too! So we still can’t just say it’s genetic 🙂
When it comes to SIDS problem, I always recall the example of Finnish Baby Boxes. In Finland each expecting couple is given a maternity package in carton box, which is commonly used as a crib by Finns. The tradition origins from interwar period when Finland faces the problem of high infant mortality rate. Now, this Scandinavian country is perceived as a country with one of the lowest infant mortality rate all around the world. And the success lays not only in carton cribs, but it is more about awareness and prevention – Finnish Baby Box is given to women only, when she is visits a doctor.
It’s basically like this, when the one kid allergic to peanuts gets exposed by another kid and now no one can bring peanuts to school, thats SIDS. SIDS means the baby died without a known cause, but they mash any and all baby related deaths together even when parents kill their children, because they literally cannot explain it because they do not know. The information isnt 100% accurate. Its easier to say not to sleep with your baby if one isolated incident occurred, but then not explain that the parent may have had a soft bed or been drinking, etc
If bed sharing does not work for you then fine if it does then fine. But, don’t shame or make accusations towards a parent for doing what they feel is right for their child. My son slept fine in his crib while my daughter was literally attached me all the time and only slept while with me. I have a huge family, huge! All the mothers slept with their babies not one incident.
Regardless of what you believe is right or wrong respect other peoples choices. People have been sleeping with babies for thousands of years, and just because you do or don’t put your baby in a crib doesn’t mean you are any better or your child is any safer especially if you believe every “cause”of SIDS. Literally anything could cause SIDS, from using the wrong shampoo to over feeding.
I would be curious to see what your data would reflect in regards to vaccine-caused deaths that ends up being labeled SIDS. I wish someone would make the necessary adjustments and calculations then there would be a huge drop of SIDS related death to bedsharing because the bedsharing wouldn’t be the main problem then more parents would actually sleep with their babies. Why force babies to sleep separately from their parents and create early childhood traumas and sense of abandonment and put the baby thru “cry it out” methods, etc. I also noticed that someone did mention vaccines in the earlier comments but you did not respond. I understand that a lot of people do not want to mix their research with vaccines because people would potentially not take your studies seriously because you have connected vaccines but isn’t that what true research should do? Putting the full facts out there regardless of what the larger society says or the norms are because science is supposed to be evidentiary and done without bias to the best of the ability of the researcher.
[…] T n.d. ‘Bedsharing and SIDS: The Whole Truth’, https://gku.flm.mybluehost.me/evolutionaryparenting.com/bedsharing-and-sids-the-whole-truth/, retrieved 25 May […]
[…] de co-dormir les familles abondent aussi. Les parents qui co-dorment mettent leur bébé à annuler le risque pour les PEID, droite? Les parents qui dorment ensemble élèvent des enfants bien collé, trop attaché et […]
Hi,
for those who speak of the Japanese and the late vaccination schedule, sorry to say but you are wrong. The Japanse start their vaccinations around the same time as the US of European countries: https://www.jpeds.or.jp/uploads/files/20180801_JPS%20Schedule%20English.pdf
https://www.jpeds.or.jp/modules/en/index.php?content_id=7
On the other hand, I like that the article stresses out that there are very specific requirements to make co-sleeping safe. In my case, I find that our western sleeping style is not compatible with co-sleeping, which is why my baby girl sleeps in her own crib next to our bed.
We should be, as long as the parents are responsible (not drinking, smoking, drugging themselves while taking care of the baby), respectful of their own decisions. Being a parent is hard and finding something that works for both parents and the baby some times is a miracle. Instead of accusing each other and shaming parents for doing things differently than one would do, we could try understanding and supporting those decisions.
I don’t like people who believe to have the ultimate answer to a problem. As long as the parent is well informed and takes the necessary precautions nobody should shame them for whta they do.
It’s insensitive to call a co-sharer a murderer of their kid as it is to call selfish and ignorant to those who decide to use a separate bed for their child.
Honestly, parenting is hard enough as it is and we have enough self doubt to add random insensitive remarks.
I’m late to respond. Dr. Cassels, you are a hero. I wish more would be done to spread awareness of sidecarred cribs. And I am not referring to commercially-available gadgets such as Arm’s Reach Cosleeper, tm. The issue with such bedside sleepers is that there’s a ledge on the side nearest the bed, and that ledge requires Mother to sit up to lift the infant over. That repeated becoming vertical in order to place the infant back his bed, multiple times per night, is the cause of the kind of severe sleep deprivation that makes parenting no fun. The same holds for a 4-sided crib. Lifting the infant over that accursed side means Mom must wake fully each feeding and the infant will startle from being lowered.
Whereas, a properly set up sidecar crib [Full size convertible crib in 3-sided “daybed configuration”; Crib frame securely attached to parental bedframe; Baby crib mattress surface level with parental mattress surface; Baby mattress shoved over to butt up against parental mattress; Firm foam to fill ensuing gap on farside of crib; NO GAPS] is very like just an extension of parental bed for ease of Nighttime Parenting. No need to sit up to tend baby. Mom need only roll to edge of her mattress, pull infant to edge of his mattress; “meet at the joint,” so to speak. Then when finished (if anyone’s awake) roll infant to his back, already on his baby mattress. Mom can roll away on her own bed to get comfy if she wishes. But, in addition, sidecar crib offers a benefit above that of bedsharing in that risk of overlay (small to begin with) is rendered…just, silly. The sidewalls of the crib form a barrier to Mother’s legs. HOW could she manage to even get INto the crib accidentally in her sleep in order to squash Babe? Iz to laff.
Sidecar crib answers ALL the worries that the “Never Cosleep You’ll Smother the Baby!” contingent claims to worry about. Infant IS on his own firm baby mattress, so the “dent” in parental mattress due to Mom’s weight does not convey to infant and cause him to roll into you . Mother cannot overlay. Infant in his sidecar crib will not become entrapped between headboard and mattress. The sidewalls of the crib prevent falls, and being a full size crib, will last until toddlerhood. And, it facilitates breastfeeding as well as does bedsharing, at least in my experience. Lastly, Mom can make her bed such that her blanket is at the edge of her mattress so it cannot cover Baby’s face while in sidecar, but Mom need not do without a blanket entirely.
In addition, I’ll say I’m a fan of the Newton mattress. (Not a salesperson, just impressed when my daughter got one for my grandbaby.) Because it’s breathable, if rebreathed CO2 actually is a cause of SIDS, the Newton ought to be a superior sleep surface for a baby than a parental mattress, or, even, other baby mattresses. The fact that you can use a Newton is another reason that sidecarred crib may be superior to both bedsharing AND bedside sleepers.
If more were done to make parents aware of the benefits of sidecarring their cribs, I think much of the hysteria surrounding cosleeping would fade, and I think babies would beneft. They can still touch their moms. Moms can tend their babies easily while staying horizontal all night. Newton mattress may help by allowing CO2 to flow away from baby face. And AAP could be told, shush, Baby’s sleeping!
Great article! Ive also heard pro-co-sleepers state Japans numbers as evidence that co-sleeping is better period — and researchers are telling bogus lies in the West — it’s nice to see the actual story unfold! Thanks for this!