Move Over, Mom and Dad

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Can Co-sleeping Work For Your Family?

WebMD Feature

Mention "family bed" or "shared sleeping" at any playgroup or cocktail party, and you're likely to spark a flurry of responses, whether it's whispered confessions, raised eyebrows or plain dig-in-your-heels soapbox routines.

You won't get any less of a hodgepodge of opinion from the experts on the practice, also called co-sleeping.

The American Academy of Pediatrics (AAP), the U.S. Consumer Product Safety Commission and many doctors discourage it, mostly due to potential safety hazards, while other child-rearing experts, including pediatric guru William Sears, say the family bed is a healthy, natural setup.

"There are reasons why it's not always going to be the best thing, but it certainly is not inherently bad by any stretch of the imagination, as long as certain basic precautions are taken," says Dr. George Cohen, senior attending pediatrician at Children's National Medical Center in Washington, D.C., and editor-in-chief of the AAP's "Guide to Your Child's Sleep" (Villard, 1999).

The fact is, it's a personal choice that's right for some families and not for others. Sift through the issues and if the "Three's Company" (or Four or Five) approach fits your family, then just be sure to build in some safety measures.

The Family Bed Safety Checklist

Despite the fact that co-sleeping is the norm in almost all cultures around the world, U.S. pediatricians and parents worry most about two things: that a baby will become entrapped in bed or bedding and suffocate, or that an adult will roll over on top of an infant and injure or suffocate the child.

"As comfy and nice and bonding as it might seem, it's very dangerous for the infant," asserts Dr. Douglas Baker, chief of emergency medicine at Yale-New Haven Children's Hospital and member of the AAP's section on pediatric emergency medicine. "We've had three kids in the last three or four months who have been suffocated by co-sleeping."

The U.S. Consumer Product Safety Commission released a controversial study last year, published in the Archives of Pediatrics and Adolescent Medicine, showing an average of 64 deaths per year between 1990 and 1997 among babies under age 2 who slept in adult beds.

But many pediatricians, breast-feeding advocates and others harshly criticized the results, claiming the study was unreliable in large part because it didn't sufficiently consider underlying causes for the deaths or compare like statistics for babies who slept in cribs.

If you do want to share their bed with your children, pediatric experts recommend these safety precautions:

• Make sure your young baby sleeps on his back on a firm surface and avoid placing him on top of soft, fluffy mattresses, waterbeds or comforters and quilts. One of the major risk factors for sudden infant death syndrome (SIDS) is putting babies to sleep on their stomachs, especially on soft bedding or waterbeds.
• To avoid the risk of rolling onto your baby, never share a bed with any infant or young child if you're intoxicated or on prescription or over-the-counter medications that could interfere with your ability to awaken easily, such as antidepressants, sleeping pills and some antihistamines. Obesity is another risk factor for rollover accidents. If you are a smoker, you probably shouldn't share a bed with your baby, because infants of smokers are at increased risk of SIDS and childhood respiratory illnesses.
• Prevent your baby from falling off the bed by placing her between mom and a guardrail, or between both parents. In "The Baby Book" (Little, Brown and Company, 1993), Dr. Sears advises against the latter, saying fathers don't exhibit the same keen awareness of a baby's presence while asleep.
• Make sure the headboard and footboard don't have openings in which a baby's head or limbs could get caught.

Bedside Breast-feeding

One of the benefits of sleeping with your baby is that it's much easier to handle nighttime feedings if you don't have to drag yourself out of bed to rescue a hungry infant.

"We planned not to sleep with the baby," says Jessica Huff, a mother of two from New York, "but within a week the baby was in the bed -- it was just so much easier." The choice between getting up to sit in a chair and nurse or rolling over to do it was a no-brainer, she says.