When I ask parents the question “What do you know about co-sleeping?”, I typically get one of three responses:
- “Oh, I would not do that. I wouldn’t feel safe”
- “The hospital/Dr told us we should never do that” OR
- I get a guilty look, with parents saying in ashamed tones “we have been doing it sometimes, because it’s the only way the baby will settle”
All 3 responses come from a place of fear that has been instilled in them from many sources over time. This message can be difficult for mother's because co-sleeping is a natural instinct, and it is often the only way that a baby will settle.
Why we should always discuss safe co-sleeping
It is the biologically normal way of sleeping. It is a healthy, shared instinct between mother and baby, that has been practiced for eternity. Despite all the warnings not to bed share, 80% of babies are in their parent’s bed for at least some of the time. It is far more dangerous to ignore this fact and not educate on safe bed sharing.
Setting up a bed space so that baby is safe when you fall asleep is far more protective than the very real possibility of you falling asleep while sitting on a couch feeding or trying to get baby to settle. So many unsafe spaces a baby could slip into in this scenario.
As babies are settling into life, and at later stages when they are going through developmental leaps or experiencing pain, they will feel more secure and often settle more easily if they are beside their mother.
The biggest protector against SIDS is breastfeeding, whist co-sleeping is an activity most highly protective of breastfeeding.
How to safely co-sleep
La Leche League international identify 7 safe sleep guidelines and all the corresponding benefits of it. For more information you can refer to website here.
Australian breastfeeding associations offer similar safety information here.
The key safety points are as follows:
Baby is exclusively breastfed
There are a few reasons this is important:
- Firstly, breastmilk is easier to digest, and babies do not go into as deep a sleep as formula fed babies - formula feeding doubles risk of SIDS
- Secondly, when a mother is exclusively breastfeeding and she is not taking any medications or other substances that would alter her level of drowsiness, she would never roll on her baby. A breastfeeding mother is completely hormonally in tune with her baby and is aware of baby the whole time, even in her sleep
- Thirdly, the instinctive position that a breastfeeding mother and baby adopt whilst bed sharing is protective. Baby is placed near the breast and mothers curl their body around the baby in a C shape. This position provides a safe space for baby with mum’s arm above baby’s head protecting him/her from pillows above and mother’s thigh below baby’s feet stop him sliding down in the bed. A bottle-feeding mother and baby do not naturally adopt this same positioning
Risk factors to avoid
- Smoking is a significant risk factor for SIDS. Ensure your baby is not exposed to smoke. No smoking in or outside the house.
- Baby being out of care of a responsible adult. Ideally baby sleeps in same room within sight and touch of a responsible adult i.e. someone who has not taken any medication or other substance that will alter their awareness
- Premature babies or babies with other health issues may be at higher risk of SIDS and challenged by conditions desirable for healthy fully term infant. Bed sharing may not be appropriate in this case
- Tummy sleeping baby. The natural breastfeeding position sees babies on their side for feeding rolling onto their back post feed. Mothers maintain the protective position as described above. So, it is generally safe if mum falls asleep whilst breastfeeding, however where possible baby should be rolled onto back at end of feed.
- Overheating. Babies should not be swaddled whilst co-sleeping. Dress in same warmth of clothing as yourself
Make a safe sleep surface
- Ensure that mattress is firm enough that trough isn’t created by your body
- If bed beside wall or you are using bed rails, ensure there is no gaps – can stuff this space tightly with a rolled-up towel
- If you don’t feel safe regarding baby falling out of bed, you could choose to put the mattress on the floor
- Normal pillow and light bedding is fine, but remove excess pillows, bolsters, stuffed toys etc
- Ensure there are no loose strings or cords in the bed or on you (no jewellery, long hair tied back).
- If your partner is in the bed, you should sleep between your baby and partner. Your partner does not have the same hormonal protection as a breastfeeding mother and rolling on baby during sleep is possible
Take home message
Bed-sharing is the biological normal, and there will be times that this practice is the only thing that will easily settle an unsettled baby. It likely will not be a constant, or permanent sleeping arrangement. You choose what is right for your individual family. As long as you follow the safety guidelines listed above, this is a valid option that may offer far more settled nights and a gentler transition for your baby as s/he settles into life on earth.