To co-sleep or not to co-sleep

Safety is the question

Being the parent of college-age students, the concept of co-sleeping wasn't one I even considered when my children were babies. Infants just didn't sleep in the same beds as their parents; at least not in the beds of any of the parents that I knew. I did, however, take many a nap on the sofa with my baby nestled snugly on my chest. It was my favorite time of day; I could just feel how content and secure my babies were. How could an act so nurturing and bonding and natural not be OK?

In reality, and in retrospect, that probably wasn't the safest sleep situation for my babies. I admit to being exhausted -- like most parents of infants -- and could easily have turned over in my sleep and injured my child -- or worse.

With a recent study conducted by the Centers for Disease Control comes a startling revelation about infants co-sleeping with parents. The study analyzed U.S. infant mortality data from 1984 through 2004 to explore trends in accidental suffocation and strangulation in bed and other sudden, unexpected infant deaths. While rates of sudden infant death syndrome have significantly decreased, infant deaths from accidental suffocation or strangulation have quadrupled in the past 20 years in the United States.

The study links this dramatic increase to co-sleeping -- where parents, or other caregivers, share a sleep surface with baby, and indicates "overlaying on a shared sleep surface" as a major risk factor for accidental suffocation.

As science and technology advance, so does our knowledge, and what was standard or recommended practice in the past becomes obsolete -- and even unsafe -- in the present.
Babies once were taken home from the hospital in the arms of their parents, not secured in car seats; went to sleep on their tummies, as advised by pediatricians and everyone else once upon a time; and slept in cribs adorned with bumpers, pillows and stuffed animals. Today, parents know that any unnecessary objects in a crib present significant danger and that putting babies to sleep on their backs is the proper placement and has been proven to decrease incidents of SIDS.

The concept of co-sleeping is hardly new. In fact, it is standard practice in most cultures throughout the world. The psychological, emotional and physical issues of co-sleeping have been hotly debated by those who support and those who oppose it.
Dr. Barbara Pena, pediatric emergency specialist at Miami Children's Hospital, said that as with most controversial issues, both sides have a point.
"There are certainly benefits to co-sleeping, but there are obvious dangers, as well," she said. "The thing is, everyone has their own ideals, and studies aren't likely to change their thinking."

Parents offer many reasons for the decision to have their baby sleep in bed with them. For Michelle Davis of Delray Beach, the reasons were more practical than cultural. She was exhausted and said she felt it was safer to have her daughter in bed. She could also wake her baby more easily, as the infant often fell asleep while breast-feeding.
Miami resident Marialys Gruneiro had no intention of co-sleeping with her first child, but after many nights of a wailing baby, the elementary school teacher did her own research and found information she needed to make the decision that was right for her. Gruneiro said she is now "a strong believer" in co-sleeping.
"It is such a beautiful bonding experience to share the family bed with your newborn," she said.

So, while there is no lack of proponents, you can't deny the negatives either. Again, most of the accidental suffocation or strangulation deaths of infants in the CDC study were caused by accidental overlay: parent rolling over onto the infant. For many, sharing their bed is not worth that risk.

Though Davie mother of three Kristen Dever allowed her infants occasional naps and some nights in a sleep positioner in her bed, she is not an advocate of co-sleeping.
"I felt that [my husband] was a heavy sleeper and was worried about rolling over on the baby," she said.
She did, however, keep her babies close by in a bassinet next to the bed.
"I never would have chosen for any of my children to sleep in the bed due to the pillows, my husband, quilts, you name it. I did whatever I could do to keep [my babies] as close as possible without actually being in the bed the entire night. It might have been convenient for me due to breast-feeding, but it made me too nervous."

Pena, who has witnessed the pain and guilt of the parents of babies who have died or were injured as a result of co-sleeping, strongly urges parents to "do it the right way." So do trusted organizations such as the American Academy of Pediatrics and the CDC. All concur about the immeasurable benefits of keeping an infant in the same room with parents.
"Interestingly enough, studies have shown a decrease in SIDS if a baby co-sleeps or sleeps in the same room as a parent," Pena said.

The AAP does not recommend bed sharing and cautions that infants should never share a bed with someone other than a parent and never co-sleep on a waterbed, couch or armchair. Smokers should not co-sleep with a baby; nor should adults who are drinking alcohol or using medication, which may make it more difficult for them to wake up.

Co-sleepers that attach to the side of a parents' bed are being touted as safer alternatives to having your baby in your bed. The problem is that regulated safety standards by either the Consumer Product Safety Commission or the American Society for Testing and Materials have yet to be established. Though some parents opt for co-sleepers as a compromise, others don't find them at all effective, and some have proven deadly. If you are considering a co-sleeper, check the CPSC Web site for warnings about bassinets that also serve as co-sleepers. The bottom line, according to the AAP, is that the safest place for a baby to sleep is in a separate sleep surface -- such as a bassinet, crib or cradle -- with no excess bedding, pillows or toys.

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