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Co-Sleeping: The Risks and Benefits of the Family Bed

Whether or not to sleep with your baby is a decision that parents and medical professionals have long debated. For many years, pediatricians adamantly discouraged co-sleeping, and the U.S. Consumer Product Safety Commission supports that position, warning that co-sleeping can be hazardous to an infant. But parents all over the world have been co-sleeping for thousands of years, and many families in the United States are choosing to return to this traditional “family bed” as a way to nurture their babies and themselves, encourage breastfeeding, and strengthen emotional bonds. As a parent, you need to evaluate the information, weigh the benefits against the risks, understand your options, and ultimately make your own decision about whether co-sleeping is right for you.

Co-sleeping is a part of attachment parenting, a relatively new movement led by pediatrician and author Dr. William Sears. Dr. Sears encourages co-sleeping because of its benefits: it is good for keeping babies happy and secure; good for breastfeeding; good for strengthening family emotional bonds; good for raising secure, self-confident, independent children and good for the entire family.

While attachment parenters and other proponents of co-sleeping praise its benefits, the U.S. Consumer Product Safety Commission says that babies sleeping with their parents run the risk of death by strangulation and suffocation. They warn parents and caregivers to never sleep in the same bed with children under the age of two, citing a study showing that, between 1990 and 1997, 515 babies died in accidents linked to sleeping in adult beds. The study lists four major hazards for infants:

  • Suffocation associated with co-sleeping.
  • Suffocation due to infants being trapped or wedged between the mattress and another object.
  • Suffocation due to airway constriction when a baby is face down on a waterbed.
  • Strangulation in rails or openings on beds that allow a baby’s body to pass through while entrapping the head.These findings sound scary, but parents should also understand that while an average of 64 babies die every year in accidents linked to adult beds, 50 babies die every year in accidents linked to cribs. Even the authors of the study admit there is no way of knowing how many babies sleep with their parents, so it is impossible to definitively measure the relative risks of co-sleeping. Furthermore, many of the tragedies listed are linked to equipment failure: pillows, headboards, blankets, waterbeds, and other structures that block a baby’s airway or allow the baby to become wedged or strangled. Soft bedding, headboards, and waterbeds have been recognized as risks for years (whether in cribs or adult beds).Proponents of co-sleeping recognize that parents need to take the necessary precautions but feel confident that the benefits ultimately outweigh the risks. In 1997, the American Academy of Pediatrics recognized the benefits of co-sleeping (especially for encouraging breastfeeding) but did warn against soft bedding, lying a baby on his or her stomach, and the use of drugs such as cigarettes, alcohol, or illegal substances that may impair a parent’s arousal. In the end, you need to evaluate the pros and cons of the family bed and make the decision that best suits your family’s unique needs.

    If You’re Going to Sleep with Your Baby, Take Precautions.

    • Pillows, blankets, and soft mattresses can suffocate a child. If you plan to sleep with your baby, sleep on a firm mattress and minimize the use of pillows and blankets.
    • Consider the use of approved bed rails to keep the baby from falling off the bed.
    • Make sure that the baby has her arms and legs free so she can wriggle around and alert you if necessary.
    • Obese parents need to be very cautious (or, better yet, use a “side car” bassinet which attaches to the adult bed but allows the baby to sleep in her own space).
    • Put the baby to sleep on her back, or on her side.

    Do not sleep with your baby if you or your partner are:

    • Under the influence of any drugs or alcohol
    • A smoker (there’s research showing a link with SIDS)
    • Sleeping on a waterbed or soft mattress
    • Extremely fatigued and not easy to rouse
    • Very ill

    Do not sleep with your baby if your baby is:

    • Very sick, swaddled, or in a splint
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