Cosleeping

Cosleeping is finally out in the open. For years, this has been a topic taboo for parents to discuss with their friends, coworkers or even, sometimes, their pediatrician. Last week there was an article published (http://bit.ly/nw955n) that stated cosleeping is not as dangerous as we previously thought. This statement got a lot of press and people are speaking out.

The most important thing that I can say is this: cosleeping is a decision that each family must address individually. The answer isn't the same for every family, or even for every child within a given family. You have to do what is right for you and your baby. Yes, I just said it. I spoke out against current recommendations. It is not the first time I have taken this stand on this issue. The bottom line is that you get to choose. Do what is right for you and your child.

Cosleeping is also called bedsharing. It is the norm in most parts of the world today. It was the norm in the US for over a century. I don't really know when it lost popularity here. The 21st (and late 20th) century imposes many difficulties on childrearing. (Another one is the daycare-driven idea that all children should be potty trained by age 2). To say that no child and no parent should cosleep is unrealistic and unproven by research.

There are many benefits to cosleeping. For mothers and infants who are breastfeeding, the advantages are pretty obvious. It makes breastfeeding easier and more efficient. Cosleeping babies breastfeed more often and longer. There are also studies that show moms sleep as deep as usual, but babies do not. This may make them less susceptible to SIDS. It is known that SIDS is less common in countries where cosleeping is the norm, but a causal effect has not been proven. Finally, there is a lot of interaction that occurs between mother and child during sleep (http://bit.ly/q6WaP8).

There are also disadvantages to cosleeping. The most obvious is that the parental bed is no longer the sanctity of a couple. When I talk about cosleeping with new or prospective parents, many fathers picture 2 or 3 children in their bed and no longer having private time with their wives. If this were the case, how did they get the 2nd and 3rd child? Seriously, though, having 3 children in your bed is seldom the case, and not something I am recommending. Having a baby is a huge change in your family dynamics. Talk to each other about this before, during and after your baby's birth. Start having a regular date night, if you aren't already doing that. Get help if you are struggling with the transition. Don't automatically blame cosleeping. However, cosleeping is a choice. It may not be for you, and that's okay.

The other disadvantages have to do with safety concerns. If your baby is cosleeping, make sure they sleep on their back or side. Discourage your child from sleeping on their tummy. Don't cover baby's face or head with bed linens. Avoid pillows, stuffed animals and other fluffy things. Some infants have gotten injured by having their head get caught in the headboard. Check your headboard and make sure this can't happen. Also, make sure baby can't get trapped between the mattress and the bedframe. Don't allow toddlers and older children in the same bed with an infant. They simply aren't mature enough to show awareness of the baby while they are sleeping. The same goes for parents who are under the influence of alcohol or drugs that cause drowsiness: they may be less aware of the baby's presence. This could lead to someone rolling onto baby and suffocating him or her. Infants exposed to cigarette smoke are more prone to SIDS. If you smoke, don't cosleep. In fact, if you smoke, please quit. It is unhealthy for parents and for children of all ages. If you cannot do it alone, help is available. Never leave your infant alone in the parental bed. Naps without mom or dad will need to be in a bassinet, play yard or crib.

What about transitioning infant to his or her own bed? Well, that is a lot like weaning your baby. It has to be a mutual decision between parents and child. Many children transition to their own crib quite well between 5 and 9 months of age. Others aren't ready for that transition until grade school. Most are somewhere in between. My oldest child coslept the first 3-4 months of her life, then went into a crib without any fuss. My youngest was the polar opposite of that. He was born while I was in training and on call (in the hospital) every third night. When I was home, he wanted me all to himself for the first hour, and in the middle of the night. By 5 months, he was sleeping in a play yard next to our bed. He would wake up around 2:00 and cry until placed in our bed. At 9 months, we put him in a crib. He would still wake up and cry to be put in our bed around 2:00 am. By 13 months, he was climbing out of the crib and coming to find us. This meant he didn't wait until 2:00. He would come to our bed as soon as he sensed we were asleep. The more we tried to put him back in the crib, the more he fought it. He needed to know we were available to him. At all times. Finally, we gave in and let him decide where he wanted to sleep. (As if we really had a choice. He could climb out of the crib!). He would start out in his crib or bed, and when he became lonely he would come to us. Once he realized he was in control, he started coming to our bed later and later each morning. Eventually, he was climbing into our bed 10 minutes before the alarm went off. The anxiety level in our home dropped considerably and everyone slept better.

Newer studies show there is no emotional or psychological damage cause by cosleeping. I am still waiting for someone to study the psychologic advantages of cosleeping. However, I am not holding my breath.

In summary, there are advantages and disadvantages to cosleeping. Some of the "disadvantages" have recently been debunked. Most importantly, cosleeping is a decision. It must be made individually by each family based upon the needs of their baby.


Nanette Nuessle, MD, FAAP
House Call Pediatrician, Overland Park, KS

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