To Your Health

by The Controversy Over Cosleeping

By Paulette Avery, R.N., M.S.N.

In September 1999, Ann Brown of the Consumer Product Safety Commission (CPSC) made this recommendation: "Don't sleep with your baby or put the baby to sleep in an adult bed. The only safe place for babies to sleep is in a crib that meets current safety standards and has a firm, tight-fitting mattress."

Before this recommendation was made, I had always told new parents that it was all right to sleep with the baby in their bed, especially during the early weeks of breastfeeding when the baby feeds so frequently. After all, my firstborn had slept in our bed until he was two. But as a result of the CPSC recommendation, I became reluctant to tell parents it was safe, although my gut told me it was. Unfortunately, I didn't take the time to research the issue, but like many people, took the CPSC at their word and assumed they knew what they were talking about. Now I know otherwise.

I recently attended a conference where the keynote speaker was James J. McKenna, Ph.D., professor of anthropology and director of the Mother-Baby Behavioral Sleep Laboratory at Notre Dame University. Although he does not consider himself a proponent of mother-infant cosleeping, he believes it is a safe practice and that the CPSC was off base making their recommendation against it. Dr. McKenna spoke on the subject for three hours. I will do my best to give you his key points.

One of Dr. McKenna's main objections to the CPSC recommendation against bedsharing is that their conclusion that it is an unsafe practice is based on "anecdotal, incomplete data or from populations in which identifiable risk 'factors' are known to envelop the 'bedsharing' experience." In other words, the CPSC did not base their statements on well-designed scientific studies that would carefully compare death rates from SIDS or SUDI (sudden unexpected death in infants) between babies who routinely sleep in cribs and those who sleep in bed with their parents. And many of the infant deaths on which they based their statements occurred in situations where the parents had been drinking or were under the influence of drugs.

Secondly, Dr. McKenna believes the CPSC recommendation comes from a cultural viewpoint where "normal" infant sleeping behaviors are based on studies done with bottle-fed infants sleeping alone in cribs. Additionally, the general culture in the U.S. is biased toward teaching infants to become independent at an early age, including the ability to sleep away from their parents. As an example of this bias, when a baby dies in a crib sleeping in the face down (prone) position, the death is blamed on the baby's position (there is a great deal of research to support the benefits of putting a baby to sleep on its back). On the other hand, when a baby dies in an adult bed sleeping prone, the contributing factor identified is the bedsharing.

Dr. McKenna is not alone in his concern about the CPSC recommendation. According to a report in the LA Times of October 4, 1999, "rather than clarifying the situation, the warning prompted outrage and ridicule among parents, pediatricians and researchers, who say that sharing a bed has many benefits for children and their parents."

If you sleep with your baby or are considering the pros and cons of this practice, keep in mind that it must be done safely. Studies indicate mother-infant cosleeping should not be done when a parent smokes or is very obese. It is also important that parents be sober so that they can respond appropriately to the infant. Sleeping on a couch or recliner with a babyis not recommended, as the baby may slip down into a crack and suffocate.

If you are a breast-feeding mother, sleeping with your baby has benefits for both of you. The baby can more easily maintain body temperature, will cry less and return to sleep more quickly. Moms report feeling more rested in spite of the fact that bedsharing babies breast-feed more often.

So decide for yourself what is best for you and your baby. It might be helpful to consider that in many other cultures, including Japan and Guatemala, cosleeping is the norm. For further information, check Dr. McKenna's web site:

Paulette Avery is a registered nurse and a freelance writer specializing in health issues.