Co-sleeping
Encyclopedia
Co-sleeping is a practice in which babies and young child
ren sleep
close to one or both parents
, as opposed to in a separate room. It is standard practice in many parts of the world, and is practiced by a significant minority in countries where cribs are also used. Bed-sharing, a practice in which babies and young children sleep in the same bed with one or both parents, is a subset of co-sleeping. Co-bedding refers to infants (typically twins or higher-order multiples) sharing the same bed. There are conflicting views on bed-sharing safety and health compared to using a separate infant bed. The conflicts surrounding infant sleep are exacerbated by the misuse of the term co-sleeping interchangeably with bed-sharing.
The American Academy of Pediatrics does encourage room-sharing (sleeping in the same room but on separate surfaces) in its policy statement regarding SIDS
prevention, but it recommends against bed-sharing with infants.
, 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 bed-sharing.
Bed-sharing 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, bed-sharing simply has the practical benefit of keeping the child warm at night. Bed-sharing 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 bed-sharing.
Proponents hold that bed-sharing saves babies' lives (especially in conjunction with nursing
), promotes bonding
, enables the parents to get more sleep
and facilitates breastfeeding. Older babies can breastfeed during the night without waking their mother.
Opponents claim that co-sleeping is stressful for the child when they are not co-sleeping. 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-bedding.
warns against practicing it with babies because of risk of suffocation or strangulation, but many pediatricians, breast-feeding advocates, and others have criticized this recommendation.
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).
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.
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.
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.
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. However, a recent study (see below under precautions) found different results if co-sleeping was initiated only after nighttime awakenings. Co-sleeping from birth or soon afterwards is the norm except in some Western cultures.
, is taking drugs
(including alcohol
) that impede alertness, or is obese. It is also recommended that the bed should be firm, and should not be a waterbed
or couch
; and that heavy quilt
s, comforters, and pillow
s should not be used. Young children should never sleep next to babies under nine months of age. 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, or getting wedged between the bed and the wall or headboard. Parents who roll over during their sleep could inadvertently crush and/or suffocate their child, especially if they are heavy sleepers, over-tired or over-exhausted and/or obese. Co-sleeping advocates also recommend that the baby should only sleep next to the mother, on the outside of the bed with mattress on the floor (without a box-spring).
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.
Child
Biologically, a child is generally a human between the stages of birth and puberty. Some vernacular definitions of a child include the fetus, as being an unborn child. The legal definition of "child" generally refers to a minor, otherwise known as a person younger than the age of majority...
ren sleep
Sleep
Sleep is a naturally recurring state characterized by reduced or absent consciousness, relatively suspended sensory activity, and inactivity of nearly all voluntary muscles. It is distinguished from quiet wakefulness by a decreased ability to react to stimuli, and is more easily reversible than...
close to one or both parents
Parenting
Parenting is the process of promoting and supporting the physical, emotional, social, and intellectual development of a child from infancy to adulthood...
, as opposed to in a separate room. It is standard practice in many parts of the world, and is practiced by a significant minority in countries where cribs are also used. Bed-sharing, a practice in which babies and young children sleep in the same bed with one or both parents, is a subset of co-sleeping. Co-bedding refers to infants (typically twins or higher-order multiples) sharing the same bed. There are conflicting views on bed-sharing safety and health compared to using a separate infant bed. The conflicts surrounding infant sleep are exacerbated by the misuse of the term co-sleeping interchangeably with bed-sharing.
The American Academy of Pediatrics does encourage room-sharing (sleeping in the same room but on separate surfaces) in its policy statement regarding SIDS
Sudden infant death syndrome
Sudden infant death syndrome is marked by the sudden death of an infant that is unexpected by medical history, and remains unexplained after a thorough forensic autopsy and a detailed death scene investigation. An infant is at the highest risk for SIDS during sleep, which is why it is sometimes...
prevention, but it recommends against bed-sharing with infants.
Introduction
Bed-sharing is standard practice in many parts of the world outside of North AmericaNorth America
North America is a continent wholly within the Northern Hemisphere and almost wholly within the Western Hemisphere. It is also considered a northern subcontinent of the Americas...
, Europe
Europe
Europe is, by convention, one of the world's seven continents. Comprising the westernmost peninsula of Eurasia, Europe is generally 'divided' from Asia to its east by the watershed divides of the Ural and Caucasus Mountains, the Ural River, the Caspian and Black Seas, and the waterways connecting...
and Australia
Australia
Australia , officially the Commonwealth of Australia, is a country in the Southern Hemisphere comprising the mainland of the Australian continent, the island of Tasmania, and numerous smaller islands in the Indian and Pacific Oceans. It is the world's sixth-largest country by total area...
, 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
India
India , officially the Republic of India , is a country in South Asia. It is the seventh-largest country by geographical area, the second-most populous country with over 1.2 billion people, and the most populous democracy in the world...
reported 93% of children bed-sharing.
Bed-sharing was widely practiced in all areas up until the 19th century
19th century
The 19th century was a period in history marked by the collapse of the Spanish, Portuguese, Chinese, Holy Roman and Mughal empires...
, until the advent of giving the child his or her own room and the crib. In many parts of the world, bed-sharing simply has the practical benefit of keeping the child warm at night. Bed-sharing has been relatively recently re-introduced into Western culture by practitioners of attachment parenting
Attachment parenting
Attachment parenting, a phrase coined by pediatrician William Sears, is a parenting philosophy based on the principles of the attachment theory in developmental psychology. According to attachment theory, the child forms a strong emotional bond with caregivers during childhood with lifelong...
. A 2006 study of children in Kentucky
Kentucky
The Commonwealth of Kentucky is a state located in the East Central United States of America. As classified by the United States Census Bureau, Kentucky is a Southern state, more specifically in the East South Central region. Kentucky is one of four U.S. states constituted as a commonwealth...
in the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
reported 15% of infants and toddlers 2 weeks to 2 years engage in bed-sharing.
Proponents hold that bed-sharing saves babies' lives (especially in conjunction with nursing
Breastfeeding
Breastfeeding is the feeding of an infant or young child with breast milk directly from female human breasts rather than from a baby bottle or other container. Babies have a sucking reflex that enables them to suck and swallow milk. It is recommended that mothers breastfeed for six months or...
), promotes bonding
Human bonding
Human bonding is the process of development of a close, interpersonal relationship. It most commonly takes place between family members or friends, but can also develop among groups such as sporting teams and whenever people spend time together...
, enables the parents to get more sleep
Sleep
Sleep is a naturally recurring state characterized by reduced or absent consciousness, relatively suspended sensory activity, and inactivity of nearly all voluntary muscles. It is distinguished from quiet wakefulness by a decreased ability to react to stimuli, and is more easily reversible than...
and facilitates breastfeeding. Older babies can breastfeed during the night without waking their mother.
Opponents claim that co-sleeping is stressful for the child when they are not co-sleeping. 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
Intimate relationship
An intimate relationship is a particularly close interpersonal relationship that involves physical or emotional intimacy. Physical intimacy is characterized by romantic or passionate love and attachment, or sexual activity. The term is also sometimes used euphemistically for a sexual...
, by reducing both communication
Communication
Communication is the activity of conveying meaningful information. Communication requires a sender, a message, and an intended recipient, although the receiver need not be present or aware of the sender's intent to communicate at the time of communication; thus communication can occur across vast...
and sexual intercourse
Sexual intercourse
Sexual intercourse, also known as copulation or coitus, commonly refers to the act in which a male's penis enters a female's vagina for the purposes of sexual pleasure or reproduction. The entities may be of opposite sexes, or they may be hermaphroditic, as is the case with snails...
at bedtime, and argue that modern-day bedding
Bedding
Bedding refers to the materials laid above the mattress of a bed for hygiene, warmth, to protect the mattress, and for decorative effect. Bedding is the removable and washable portion of a human sleeping environment. It is more easily and economically replaced than the bed itself...
is not safe for co-bedding.
Safety and health
Health care professionals disagree about bed-sharing techniques, effectiveness and ethics. The U.S. Consumer Product Safety CommissionConsumer Product Safety Commission
The United States Consumer Product Safety Commission is an independent agency of the United States government created in 1972 through the Consumer Product Safety Act to protect "against unreasonable risks of injuries associated with consumer products." The CPSC is an independent agency that does...
warns against practicing it with babies because of risk of suffocation or strangulation, but many pediatricians, breast-feeding advocates, and others have criticized this recommendation.
Advantages
One study reported mothers getting more sleep by co-sleeping and breastfeeding than by other arrangements.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
Sudden infant death syndrome
Sudden infant death syndrome is marked by the sudden death of an infant that is unexpected by medical history, and remains unexplained after a thorough forensic autopsy and a detailed death scene investigation. An infant is at the highest risk for SIDS during sleep, which is why it is sometimes...
(SIDS).
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.
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.
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.
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. However, a recent study (see below under precautions) found different results if co-sleeping was initiated only after nighttime awakenings. Co-sleeping from birth or soon afterwards is the norm except in some Western cultures.
Precautions
Bed-sharing is known to be dangerous for any child when a parent smokes, or has a history of skin infections, but there are other risk factors as well. 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 smokesTobacco smoking
Tobacco smoking is the practice where tobacco is burned and the resulting smoke is inhaled. The practice may have begun as early as 5000–3000 BCE. Tobacco was introduced to Eurasia in the late 16th century where it followed common trade routes...
, is taking drugs
Medication
A pharmaceutical drug, also referred to as medicine, medication or medicament, can be loosely defined as any chemical substance intended for use in the medical diagnosis, cure, treatment, or prevention of disease.- Classification :...
(including alcohol
Alcohol
In chemistry, an alcohol is an organic compound in which the hydroxy functional group is bound to a carbon atom. In particular, this carbon center should be saturated, having single bonds to three other atoms....
) that impede alertness, or is obese. It is also recommended that the bed should be firm, and should not be a waterbed
Waterbed
A waterbed, water mattress, or flotation mattress is a bed or mattress filled with water. Waterbeds intended for medical therapies appear in various reports through the 19th century...
or couch
Couch
A couch, also called a sofa, is an item of furniture designed to seat more than one person, and providing support for the back and arms. Typically, it will have an armrest on either side. In homes couches are normally found in the family room, living room, den or the lounge...
; and that heavy quilt
Quilt
A quilt is a type of bed cover, traditionally composed of three layers of fiber: a woven cloth top, a layer of batting or wadding and a woven back, combined using the technique of quilting. “Quilting” refers to the technique of joining at least two fabric layers by stitches or ties...
s, comforters, and pillow
Pillow
A pillow is a large cushion support for the head, usually used while sleeping in a bed, or for the body as used on a couch or chair. There are also throw pillows , which are pillows that are purely decorative and not designed for support or comfort...
s should not be used. Young children should never sleep next to babies under nine months of age. 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, or getting wedged between the bed and the wall or headboard. Parents who roll over during their sleep could inadvertently crush and/or suffocate their child, especially if they are heavy sleepers, over-tired or over-exhausted and/or obese. Co-sleeping advocates also recommend that the baby should only sleep next to the mother, on the outside of the bed with mattress on the floor (without a box-spring).
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.
Products for infants
There are several products that can be used to facilitate safe co-sleeping with an infant:- special-purpose bedside bassinetBassinetA bassinet or bassinette is a bed specifically for babies from birth to about four months, and small enough to provide a "cocoon" that small babies find comforting....
s, which attach directly to the side of an adult bed and are open to the parent's side, but have barriers on the three other three sides. - bed top co-sleeping products designed to prevent the baby from rolling off the adult bed and to absorb breastmilk and other nighttime 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.
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. 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.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.
- 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
External links
- Mother-Baby Behavioral Sleep Laboratory at the University of Notre DameUniversity of Notre DameThe University of Notre Dame du Lac is a Catholic research university located in Notre Dame, an unincorporated community north of the city of South Bend, in St. Joseph County, Indiana, United States...
. - 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 InitiativeBaby Friendly Hospital InitiativeThe Baby Friendly Hospital Initiative , also known as “Baby Friendly Initiative” , is a worldwide programme of the World Health Organization and UNICEF, launched in 1991 following the adoption of the Innocenti Declaration on breastfeeding promotion in 1990...
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
- Information about parents' decisions regarding sleep issues with their babies The Bernard L. Pacella, MD Parent Child Center