Co-sleeping, also called the family bed, is a practice in which babies and young children sleep with one or both parents, as opposed to a separate infant bed. It has been widely practiced historically, is standard practice in many parts of the world, and is practiced by a significant minority in countries where infant beds are also used. There are conflicting views on its safety and health vis-à-vis a separate infant bed.

Contents 1 Introduction 2 Safety and health 2.1 Advantages 2.2 Precautions 2.3 Products for infants 3 Prevalence 4 See also 5 Footnotes 6 Further reading 7 External links

[edit] Introduction

Co-sleeping is standard practice in many parts of the world outside of North America, Europe and Australia, and even in the latter areas a significant minority of children have shared a bed with their parents at some point in childhood. One 2006 study of children age 3–10 in India reported 93% of children co-sleeping.^[1]

Co-sleeping was widely practiced in all areas up until the 19th century, until the advent of giving the child his or her own room and the crib. In many parts of the world, co-sleeping simply has the practical benefit of keeping the child warm at night. Co-sleeping has been relatively recently re-introduced into Western culture by practitioners of attachment parenting. A 2006 study of children in Kentucky in the United States reported 15% of infants and toddlers 2 weeks to 2 years engage in co-sleeping.^[2]

Proponents hold that co-sleeping saves babies' lives (especially in conjunction with nursing),^[3] promotes bonding, lets the parents get more sleep, facilitates breastfeeding, and protects against sudden infant death syndrome (SIDS). Older babies can breastfeed during the night without waking their mother.

Opponents claim that co-sleeping is stressful for the child^[4]. They also cite concerns that a parent may smother the child or promote an unhealthy dependence of the child on the parent(s). In addition, they contend that this practice may interfere with the parents' own relationship, by reducing both communication and sexual intercourse at bedtime, and argue that modern-day bedding is not safe for co-sleeping.

[edit] Safety and health

Co-sleeping can trigger conflicting advice among health care professionals.^[5] The U.S. Consumer Product Safety Commission warns against practicing it with babies^[6], but many pediatricians, breast-feeding advocates, and others have criticized this recommendation.^[7]

[edit] Advantages

One study reported mothers getting more sleep by co-sleeping and breastfeeding than by other arrangements.^[8]

It has been argued that co-sleeping evolved over five million years, that it alters the infant's sleep experience and the number of maternal inspections of the infant, and that it provides a beginning point for considering possibly unconventional ways of helping reduce the risk of sudden infant death syndrome (SIDS).^[9][10]

Stress hormones are lower in mothers and babies who co-sleep, specifically the balance of the stress hormone cortisol, the control of which is essential for a baby's healthy growth.^{[11][12][13][14]}

In studies with animals, infants who stayed close to their mothers had higher levels of growth hormones and enzymes necessary for brain and heart growth.^[15][16]

The physiology of co-sleeping babies is more stable, including more stable temperatures, more regular heart rhythms, and fewer long pauses in breathing than babies who sleep alone.^[17][18]

Co-sleeping may promote long-term emotional health. In long-term follow-up studies of infants who slept with their parents and those who slept alone, the children who co-slept were happier, less anxious, had higher self-esteem, were less likely to be afraid of sleep, had fewer behavioral problems, tended to be more comfortable with intimacy, and were generally more independent as adults.^{[19][20][21][22]} However, a recent study (see below under dangers) found different results if co-sleeping was initiated only after nighttime awakenings.

[edit] Precautions

Co-sleeping is known to be dangerous for any child when a parent smokes, but there are other risk factors as well.^[5] Some common advice given is to keep a baby on its back, not its stomach, that a child should never sleep with a parent who smokes, is taking drugs (including alcohol) that impede alertness, or is obese.^[23] It is also recommended that the bed should be firm, and should not be a waterbed or couch; and that heavy quilts, comforters, and pillows should not be used. Young children should never sleep next to babies under nine months of age.^[24] It is often recommended that a baby should never be left unattended in an adult bed even if the bed surface itself is no more dangerous than a crib surface. There is also the risk of the baby falling to a hard floor. Parents who roll over during their sleep could inadvertently crush and/or suffocate their child, especially if they are heavy sleepers and/or obese.

A recent report explored the relationship between ad hoc parental behaviors similar to traditional co-sleeping methodology, though the study's subjects typically utilized cribs and other paraphernalia counter to co-sleeping models. While babies who had been exposed to behaviors reminiscent of co-sleeping had significant problems with sleep later in life, the study concluded that the parental behaviors were a reaction to already-present sleep difficulties. Most relationships between parental behavior and sleeping trouble were not statistically significant when controlled for those preexisting conditions. Further, typical co-sleeping parental behavior, like maternal presence at onset of sleep, were found to be protective factors against sleep problems. ^[25]

[edit] Products for infants

There are several products that can be used to facilitate safe co-sleeping with an infant.

• bassinets that attach to the side of an adult bed, and which have barriers on three sides, but are open to the parent's side.
• bed top co-sleeping products designed to prevent baby from rolling off the adult bed and to absorb breastmilk and other night time leaks.
• side rails to prevent the child from rolling off the adult bed.
• co-sleeping infant enclosures which are placed directly in the adult bed.

[edit] Prevalence

A study of a small population in Northeast England showed a variety of nighttime parenting strategies and that 65% of the sample had bedshared, 95% of them having done so with both parents. The study reported that some of the parents found bedsharing effective, yet were covert in their practices, fearing disapproval of health professionals and relatives.^[26] A National Center for Health Statistics survey from 1991 to 1999 found that 25% of American families always, or almost always, slept with their baby in bed, 42% slept with their baby "sometimes", and 32% never co-slept with their baby.^[27]

[edit] See also

• Infant bed
• Secrets of the Baby Whisperer (book)

[edit] Footnotes

[edit] Further reading

• Jackson, Deborah. Three in a Bed: The Benefits of Sharing Your Bed with Your Baby, New York: Bloomsbury, 1999.
• McKenna, James J. Sleeping with Your Baby, Washington, D.C.: Platypus Media, 2007.
• Morelli, G.A., Rogoff, B., Oppenheim, D., & Goldsmith, D. (1992). Cultural variation in infant's sleeping arrangements: Questions of Independence. Developmental Psychology, Vol. 28, No. 4, 604-613.
• Thevenin, Tine. The Family Bed, New Jersey: Avery Publishing Group, 1987.
• Simard, V., et al. (2008). The Predictive Role of Maladaptive Parental Behaviors, Early Sleep Problems, and Child/Mother Psychological Factors. Archives of Pediatric and Adolescent Medicine Available at: http://archpedi.ama-assn.org/cgi/content/short/162/4/360

[edit] External links

• Mother-Baby Behavioral Sleep Laboratory at the University of Notre Dame.
• SafeBedSharing.org Information on how to make the family bed safe, parenting forums and informative links.
• Tribal Baby Practical tips and insights into the practice of sleep sharing.
• The Natural Child Project Articles on co-sleeping.
• Mothering Magazine Regularly updated questions and answers from co-sleeping expert Sarah J. Buckley.
• ABM Clinical Protocol #6: Guideline on Co-Sleeping and Breastfeeding An in-depth review of the literature on breastfeeding and co-sleeping from the Academy of Breastfeeding Medicine.
• Sharing a bed with your baby Leaflet from UNICEF's Baby Friendly Initiative in the United Kingdom.
• Meret A. Keller, Wendy A. Goldberg: Co-sleeping: Help or hindrance for young children's independence?, in: Infant and Child Development, vol. 13, no. 5, p. 369-388, Wiley InterScience, 2004

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