Co-sleeping

Co-sleeping (parent and child sharing a bed), common and accepted in many world cultures, always carries an air of controversy here in the US.  Almost 75% of parents co-sleep with infants but only 25% after 6 months old.  Generally, the American Academy of Pediatrics discourages the practice.  Below 12 weeks of age, there are some disputed reports of association with SIDS, especially for

  • Sleeping with a parent on a couch
  • Between parents
  • Parent is a smoker
  • Extremely tired parent
  • Parent consuming alcohol or drugs
  • Lots of pillows and loose bed covers

A recent study in the journal Developmental Psychology tracked 139 couples and found that prolonged co-sleeping was associated with increased family stress.  In families where co-sleeping continued beyond age 6 months, the mothers reported more fragmented sleep, less marital satisfaction, more difficulty working together as parents, and were less sensitive and more irritable towards their babies.  Perhaps not so surprisingly, there were no such reports or observations among the dads in the study.  Mothers who expressed more marital dissatisfaction at 1 month were more likely to continue co-sleeping past 6 months and those expressing satisfaction more typically terminated the practice before 6 months.  The authors emphasized that it was not clear what was cause and effect in their study: did the co-sleeping cause stress, or did more stressed couples engage in longer co-sleeping?

For many, co-sleeping is natural and a great family benefit.  It can be a real advantage for breastfeeding moms and many couples find that everyone sleeps better and longer when sharing the bed.  Claims that co-sleeping leads to “spoiled” children or to disruption of couples’ sex lives are anecdotal at best.  In my 31 years as a pediatrician, I have seen no evidence that co-sleeping children are more or less likely to be ill mannered or unruly and I certainly have no information about the frequency or quality of marital relations for those couples.

So I think co-sleeping, while certainly not for everybody, is a viable option for some families if both partners are in agreement and certain safety ground rules are followed:

  1. Under 4 months baby sleeps in bassinet next to bed
  2. Place baby on back to sleep
  3. Light clothing on baby to avoid overheating
  4. Baby should not sleep alone in adult’s bed
  5. Baby should not be on a soft mattress, sofa, or waterbed
  6. Make sure head and foot boards do not have openings to entrap baby’s head
  7. Snug fitting mattress to avoid baby entrapment
  8. Don’t cover baby’s head
  9. No pillows, quilts, or soft bedding on baby
  10. Avoid use of alcohol or drugs effecting alertness when co-sleeping
  11. Keep baby away from window treatment cords
  12. Avoid falling asleep with child on your chest.

Please send along questions and comments, and thanks for following.

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Fall allergies

Its so hot out currently that one can break a sweat just writing a blog so let’s keep this brief.  Soon we’ll be entering fall ragweed allergy season.  A recent review article in the British Medical Journal discovered that there is great variability in labelling indications and ages for most antihistamines, many of these drugs have not been adequately evaluated in children and their labeled cause and age indications are not based on clinical trials in children.

In other words, we are using most allergy drugs in our children based only on studies performed on adults plus little more than guesswork in how much should be used and even whether these medicines actually help children or relieve their symptoms or not .

This is important because we must remember that these drugs are far from being risk free.  Commonly seen side effects include:

So please be sure to think twice before administering anti-histamines to your children.  As I so often remind my patients: the presence of a symptom does not indicate the necessity of medications.  If your child is mostly eating, sleeping, and playing normally, without complaints of pain or discomfort, without disruption of school performance, then I think oral medication is not needed in that situation.

Here are effective non-medical interventions to use for your child’s allergies:

  1. Follow weather reports.  Mostly indoor play on high pollen days.
  2. Change clothes upon returning indoors.
  3. Shower frequently to remove pollen from skin and hair.
  4. Keep windows closed.
  5. Liberal air conditioner use if possible.  Change AC filters regularly.  Leave windows open briefly when turning on AC to allow clearing of any mold or dust out of the unit.
  6. Consider using a face mask in the morning and on windy days.
  7. Remove leaves from yard and gutters.
  8. Do not hang laundry outside to dry but rather use a drier only.
  9. Moderate eye symptoms can be managed with topical drops like visine, murine, or ketotifen (“zaditor”).

Please give me a call to discuss your child’s specific needs.  Thanks for following.