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.