hits counter
GALLERIES
Blog Index
The journal that this archive was targeting has been deleted. Please update your configuration.
Navigation
Sunday
Jan112009

Co-Sleeping Safety

As a follow-up to my post on the benefits of co-sleeping, I wanted to write a post about co-sleeping safety. I think this is important because too many people either believe that it is unsafe and therefore avoid it at all costs or they don't think twice about safety and can end up putting their baby's life at risk. Co-sleeping can be safe, but it can also be very unsafe.

Is Co-Sleeping Safe?

There is a war on co-sleeping. Public institutions (sometimes in partnership with crib manufacturers) are spending our tax dollars to scare parents from bringing their babies to bed with them. The media is using fear inducing headlines and horror stories to garner readership. But here is the thing. Saying that co-sleeping is dangerous is like saying that riding in a car is dangerous. There is no way to make car travel completely safe, but no method of travel is completely safe.  Most reasonable people take precautions to make car travel as safe as possible, but some idiots do stupid things like drinking and driving, not wearing a seat belt, driving too fast, or not putting their children in car seats. It is the same thing with infant sleep. Babies do die in their parents' beds. But they also die in cribs. There is no way to make either one completely safe, but co-sleeping is not inherently more dangerous than crib sleeping. In fact, when looking at the statistics on infant deaths in various sleep environments one researcher concluded that sleeping in an adult bed is twice as safe as sleeping in a crib once all  factors have been considered (to be fair, other researchers have reached other conclusions, but I have yet to see a study that properly accounts for all risk factors when comparing the safety of crib sleeping with the safety of co-sleeping).

Does SIDS happen in the parents' bed?

One of the claims often made about co-sleeping is that it increases the risk of SIDS. However, several studies by McKenna and others in the 1990s showed that co-sleeping actually helps prevent SIDS (see p. 124 of Natural Parenting - Back to Basics in Infant Care):

The sensory-rich sleep environment of bed sharing, which leads to more frequent arousals during deep sleep and more light sleep, from which it is easier for the infant to arouse, appears to confer a survival advantage for children at risk of SIDS (McKenna, 1996; McKenna and Mosko, 1990; McKenna et al., 1993).

 

Other research reported in the same article also indicates that societies where mother-infant co-sleeping is the norm have a low incidence of SIDS in comparison with countries that practice solitary infant sleep. In fact, SIDS used to be called "crib death" (until the crib industry complained) because the place that SIDS deaths happened was in cribs and it was virtually unheard of in societies that do not use cribs.

What about suffocation or overlaying?

Many of the publications and articles designed to scare parents away from co-sleeping suggest that there is a great risk of suffocation or overlaying. However, research shows that it is not co-sleeping itself, but rather other factors present in the co-sleeping environment that create this danger (from page 125 of Natural Parenting - Back to Basics in Infant Care):

While infant suffocation as a result of overlying by the parent in a bed sharing environment is not unheard of, unsafe conditions such as parental intoxication with drugs or alcohol, parental disease, extreme parental fatigue, or marked parental obesity have been found to be present in many of these cases (Bass, Kravath, and Glass, 1986; Gilbert-Barness et al., 1991; see also Carpenter et al., 2004; Gessner, Ives, and Perham-Hester, 2001).

 

In fact, when unsafe conditions are not present, mothers and infants are able to respond to each other, thereby keeping the infant safe (from Dr. James McKenna):

Anthropological and developmental studies suggest that mothers and infants are designed to respond to the presence of the other, and no data have ever shown that among mother-baby pairs who cosleep for breast feeding in a safe cosleeping/bed-sharing environment that mothers are unable to sense the proximity of their babies in order to avoid smothering them. Our own laboratory sleep studies of cosleeping/bed-sharing mothers infant pairs (2 to 4 month olds) reveal that both breast feeding mothers and their infants are extremely sensitive throughout their night - across all sleep stages - to the movements and physical condition of the other. The healthy infant, which includes most infants, are able to detect instances, where for example, their air passages are blocked. They can respond very effectively to alert the mother to potential danger, and they have the physical skills to maneuver out of danger, under normal circumstances.

 

Normal circumstances is the key here. Normal circumstances means a safe co-sleeping environment.

What about newborns?

A few studies have found that there is some increased risk of co-sleeping for very young infants (under 8 weeks in one case and under 11 weeks in another case). However, like many other studies that advise against co-sleeping, these studies didn't fully account for factors other than bed sharing that could have been the key contributing factor (e.g. alcohol use, drug use, smoking, maternal fatigue). From my experience and reading, the issue of maternal fatigue probably comes about most often in cases where families are not co-sleeping, but end up bringing their baby into bed with them out of sheer exhaustion due to the fact that their baby is not sleeping in the crib. These parents are not used to co-sleeping and that combined with their over-exhausted state and likely a sleep environment not designed for an infant, creates additional risk factors. As such, bringing a baby into bed with you when you are exhausted and not used to having the baby there is not advisable, but that doesn't make co-sleeping with newborns in unsafe when parents plan for it appropriately.

Despite the faults in reports that advise against co-sleeping with newborns, I think it makes sense to be particularly cautious about the safety of the co-sleeping environment in the early weeks when you are less accustomed to sleeping with a baby and when your baby is not yet able to roll over or free himself if he gets into an unsafe situation.

What is Unsafe Co-Sleeping?

People are going to co-sleep. Some babies just do not sleep well unless they are in close proximity to or even touching their mother. So rather than have a mother shamefully sneak her baby into bed with her, into an unsafe environment, I think public health authorities should be informing parents about how to create a safe co-sleeping environment. Since they won't do that, I'll give it my best shot using information from experts in this field.

  • DO NOT drink alcohol, do drugs or take medication: It is very important to ensure that nothing is impairing your ability to sense your baby's presence in bed. This means abstaining from alcohol before going to bed, not doing drugs and not taking medication.
  • DO NOT smoke: Smoking poses a significant risk for babies (in terms of SIDS and increased chance of asthma and other conditions) and parents should not smoke in the room that the baby is sleeping in and ideally not at all in the home.
  • DO NOT let a baby sleep next to an older child, pet, or adult that is not likely to sense the baby's presence: The person most in tune with the baby is a breastfeeding mother. Formula feeding mothers and fathers are less likely to sense their child's presence and should be more cautious about their co-sleeping arrangements. It is not safe to have a baby sleep with older children or pets as they can easily compromise the baby's safety.
  • DO NOT use heavy adult bedding: Blankets, duvets, pillows and other adult bedding pose a suffocation risk to your baby. Ideally, all adult bedding should be removed from the bed during the early months and only introduced with extreme caution as the baby gets older. Remember that for crib sleeping, it is recommended that babies be put to bed with nothing more than a light baby blanket, so it is safest not to exceed that in your bed either. Both the parents and baby should be dressed warmly enough (but not too warm!) that they do not require additional heavy blankets to keep them warm. A lot of parents that feel they cannot go without any blanket choose to use a sheet or light blanket and only pull it up to their waist and then have baby sleep up higher away from the blanket (of course you need to consider when doing this whether you are the type of sleeper that would subconsciously pull that blanket up to your chin in your sleep).
  • DO NOT let baby sleep on surfaces such as soft mattresses and waterbeds: Soft mattresses, squishy pillow top mattresses, memory foam, and waterbeds can all result in the baby sinking into the sleep surface and potentially obstructing the baby's ability to breathe. As a result, it is not safe to have an infant sleep on these surfaces.
  • DO NOT let baby sleep anywhere that has crevices or spaces where the baby can get stuck: Adult beds are designed for adults and not for babies. This is too bad, considering that upwards of 70% of parents bring their baby to bed with them at some point. As a result, it is important to be cautious of any crevices or other spaces where the baby could get stuck. Ensure that the bed is flush with the wall (if pushed up against the wall) and ensure that there are no spaces between the mattress and headboard where the baby could get caught.
  • DO NOT co-sleep on surfaces other than beds/mattresses: Sleeping on a couch or recliner is not safe. It is too easy for the baby to fall off or get stuck or smothered.
  • DO NOT leave your baby alone on an adult bed unless the bed and room are completely safe: Some parents will choose to use a crib or bassinet when they are not sleeping with their baby (e.g. for naps, early in the evening, etc.). Some parents choose not to have a crib or other separate sleep surface and therefore need to ensure that the bed and room are completely safe, i.e. the baby cannot fall to the floor, cannot get into anything that is dangerous if exploring the room, etc. We also found using a baby monitor turned up very high and checking on the baby if we heard any noise at all provided additional security.
  • BE CAUTIOUS about your impact on your baby: I explained above that breastfeeding mothers are very unlikely to overlay or otherwise hurt their baby. However, certain behaviours or characteristics of the mother can make this risk greater. People who are extremely overweight should ensure that they do not create a dip in the mattress that could create an unsafe crevice that the baby could roll into. Excessively long-hair should be tied back to prevent entanglement around the baby's neck. Parents should ensure that they do not wear clothing or jewelry that could cause the baby to suffocate or get entangled. Parents should not wear perfumes or other scented products to bed, as this can impact baby's ability to breathe clearly.
  • BE CAUTIOUS about your extreme exhaustion: Parents of newborns can often be extremely exhausted. If you are overly tired, you may wish to be more cautious than usual as your extreme exhaustion may result in you being less easily woken or more likely to roll over the baby or pull covers up over the baby's head. It may be best to have your baby sleep on a separate surface in those instances, but still close by.
  • DO NOT co-sleep if you and your spouse are not both committed to doing it and doing it safely: In order for co-sleeping to work and to be safe, both parents need to be committed to making it work. Dr. McKenna also advises that parents be sure that they would not think they had suffocated their baby if their baby did die of unknown causes (i.e. SIDS) in their bed. While it is unlikely, just like a baby can die of SIDS in a crib it could potentially happen in the parents' bed too and Dr. McKenna advises that parents should be sure they would not blame themselves or their spouse if  something did happen to the baby.

How To Create a Safe Co-Sleeping Environment

Dr. James J. McKenna defines a safe sleep environment as follows:

Infants should sleep on firm surfaces, clean surfaces, in the absence of smoke, under light (comfortable ) blanketing and their heads should never be covered. The bed should not have any stuffed animals or pillows around the infant and never should an infant be placed to sleep on top of a pillow. Sheepskins or other fluffy material and especially bean bag mattresses should never be used. Water beds can be dangerous, too, and always the mattresses should tightly intersect the bed-frame. Infants should never sleep on couches or sofas, with or without adults wherein they can slip down (face first) into the crevice or get wedged against the back of a couch.

 

Since adult beds and adult sleep environment are rarely made with infants in mind, there are a number of things parents should consider doing to turn an adult bed into a safe co-sleeping environment.

  • Have the infant sleep between the breastfeeding mother and a wall/bedrail: The breastfeeding mother is the one most able to sense and respond to the infant. As a result, the safest place for the infant is between the breastfeeding mother and either a wall, bedrail, or other product designed to ensure that the infant doesn't fall out of bed.
  • Dress warmly, but not too warm: When sleeping with my children as babies, I always wore a long-sleeved shirt so that I didn't feel the need for a blanket to keep my upper body warm. I would dress my baby in pyjamas and a sleep sack if required, depending on the temperature.
  • Consider putting the mattress on the floor: Putting the mattress on the floor is the safest way to co-sleep. This ensures that the infant doesn't sustain a fall from an adult bed and also takes away the worry about unsafe headboards and other bed parts. However, you still need to ensure that the mattress is placed flush against the wall and that there is no way for the infant to be trapped between the mattress and the wall.
  • Preventing falls: There are a number of safety products that can be us
    ed to prevent falls if you choose not to put the mattress on the floor. This can include traditional bed rails as well as newer products. With any product designed to prevent falls, it is important to ensure that there aren't gaps where the infant could get caught or fall and also ensure that they come high enough above the mattress that your infant can't be pushed easily over the top of it.  Some examples of products I like include the Safety 1st Secure Top Bedrail and the Snug Tuck Pillow (apparently out of business now), both of which sit on top of the mattress. Another option is the Humanity Family Bed, which lays on top of a regular bed.
  • Creating more space: Many parents wish to create some extra space for the baby within their sleep environment. This can be achieved in a number of ways. If you have purchased a crib, one option is to side car the crib. One family that did this due to the father's obstructive sleep apnea created detailed instructions including step-by-step photos on how to side-car the crib. Some parents may choose to purchase a co-sleeper that attaches to the bed, such as the Arm's Reach Co-Sleeper that attaches to the side of the bed.  Another option that doesn't create more space, as such, but that does create a seperate space for the baby is the First Years Close & Secure Sleeper. We used this product at the start with our son until we were more aware of his presence in the bed. The disadvantage of products like these is that the baby often outgrows them quickly.

  • Filling in spaces: If you do find that there is a gap between your mattress and the wall when you push the bed up against the wall, you may wish to consider filling it with high density foam that is cut to size and that fills the space completely. Another option many parents use is rolled up blankets.
  • Think carefully about co-sleeping with more than one child: Additional precautions are required when co-sleeping with an infant and an older child. Most importantly, the infant should not be placed to sleep next to the older child as that child could roll over, push, or otherwise hurt the baby. Often the best arrangement is for the older child to sleep in between the parents and for the baby to sleep between the mother and the wall or bed rail. Parents may also want to consider if they need additional space. Some families will use a California king mattress and others will use one of the tips in under the "creating more space" bullet to give everyone enough room to sleep comfortably.

Further Reading

Disclaimer

This information has been compiled based on the research that I have done for our family. Each family should do their own independent research to determine the safety of the sleep environment they are choosing for their family.

« Another academic weighs in on CIO | Main | Benefits of Co-Sleeping »

Reader Comments (96)

This is a very good set of posts but my wife an I just couldn't do the co-sleeping thing.

We have watched friends of ours struggle with getting their children out of their bed well into 5, 6 and 7 years old. I have a student in their teens who cannot get to sleep with out a parent present.

Although there are undoubtedly positives to co sleeping but if not done right ir can be a unmitigated disaster.

January 12, 2009 | Unregistered CommenterKeith Rispin

Keith, "unmitigated disaster" seems a bit dramatic! FWIW, all four of my kids have slept in our bed, and all have been out and sleeping on their own consistently by the age of 2-3 or so. We could have had them out sooner if we'd tried harder, but we rather enjoyed having them there. To me, having a 5-7 year old in my bed isn't ideal, but I wouldn't say it's a "disaster". If it were something I was unable to handle, I would work hard to get my kids out younger. There's no reason why it can't be done.

And I was that teen who never having previously slept in my parent's bed went through a phase where I was unable to sleep alone. It had nothing to do with habit (I'd never been a co-sleeper) and everything to do with nighttime insecurity/fear that suddenly hit me at that age. My parents treated me with sensitivity and I outgrew it. "Disaster" averted.

PhDinparenting, this is a great, detailed guide--thank you for writing it!! I spoke to a "no-co-sleeping" expert for an article I was writing for a mainstream parenting magazine. I really pressed him to explain his organization's strict stance despite the fact that evidence doesn't show co-sleeping to be any more dangerous than solo sleeping (especially when you look at studies and realize they lump things like babies sleeping on sofas alone and in beds with multiple siblings in with "co-sleeping"!) Finally, he admitted that from a public health perspective, the powers that be can only control (to some extent anyway) a crib. They can't come into each individual home to check an adult bed's bedding, positioning, softness, or the other people sleeping in it. So they just issue a wholesale recommendation against co-sleeping at all, even though he admitted that it can be done safely. I tell moms to remember that these kinds of public health recommendations have nothing to do with THEM--they are all about controlling an entire population, some of whom may not understand the difference between co-sleeping safely or unsafely.

January 12, 2009 | Unregistered CommenterMeagan Francis

[...] no guarantee of safety in every situation. When we read PhD in Parenting’s new blog post on how to cosleep safely, we thought it was a great time to update North Texas Natural Family with Dr. Linda Folden [...]

@Meagan: I agree completely. The public health authorites are taking a CYA ("cover your ass") approach to co-sleeping. The problem is that some babies just will not sleep separately from their parents and then their parents secretly bring them into bed with them, with no authoritative information on how to do it safely, and it is those situations that often end in tragedy. I don't have any problem with public health campaigns warning about the dangers of unsafe co-sleeping, but they need to recognize that telling people not to do it isn't going to stop them from doing it, so they should teach people how to do it safely instead.

January 12, 2009 | Unregistered Commenterphdinparenting

@Keith: Every family should choose the sleep situation that works for them, as long as it is safe. However, I try not to use anecdotal evidence from friends to determine how to parent my children. But if I was going to, I could come up with just as many "unmitigated disasters" from crib sleeping families. Toddlers that fell and hurt themselves climbing out of a crib, toddlers that left the house in the middle of the night without their parents knowledge only to be (luckily) found and brought home by a neighbour, kids that come out of their rooms a dozen or more times in the evening after having been put to bed, etc.

Along with the choice of a sleep environment that is going to work for your family comes a responsibility to ensure the safety of that situation and to use http://phdinparenting.com/2008/10/20/my-discipline-spectrum/" rel="nofollow">gentle discipline techniques.

January 12, 2009 | Unregistered Commenterphdinparenting

Do people really co-sleep without a pillow and blankets? I find that hard to believe, especially if you live in a cold climate. We often bring our son into our bed, and we use separate blankets. I tuck mine in under me and put it lower than our son. But I certainly use a pillow - I just angle it so it is far away as possible from his face. Am I being unsafe? If that is the case, then I will go through the agony (yes, agony - that boy has serious trouble remaining in his crib after a certain hour) of getting him to stay in there rather than not sleeping with a pillow. I already have a consistently strained back from awkward sleeping and rocking a child. I wouldn't want to add neck strain to the mix.

January 13, 2009 | Unregistered CommenterJane

@Jane

As with many things, there are varying degrees of safety. Using plush king sized pillows and a big king-sized comforter would not be safe. Using nothing more than a light blanket pulled up to the mother's waist and no pillow would be safest. But there are many possibilities in between and you need to assess the safety for yourself as best you can with available information.

Here is what we did:
- My husband and I use separate blankets (i.e. we each have our own twin-sized blanket on a king-sized bed) and use small pillows
- With our son, we used the The First Years Close & Secure Sleeper referenced in the post above and he slept in between us. This gave him his own space and protected him a bit.
- With our daughter, she slept in between me and the bedrail so that I didn't need to be concerned about my husband's bedding. I ensured that my blanket didn't go higher than my waist, wore a long-sleeved shirt to stay warm (we live in Canada), and put my daughter in a sleep sack. I slept on my side facing my daughter, with her sleeping at my chest. I used a small pillow and slept right on the edge of it with any extra pillow sticking out behind me.
- I am a very light sleeper and I was breastfeeding, the two of which combined to make me ultra sensitive to my child's presence and movements in the bed.

I know someone else that used one of the crib wedges (angled pillow that you put under the sheet in a crib to put baby on an angle) as a pillow, since it isn't fluffy like other pillows.

You need to make your own decision about what is best for your family, but obviously anytime you introduce any risk factor the risks increase and it is important to be that much more diligent and ensure that you aren't compounding multiple risk factors on top of each other.

January 13, 2009 | Unregistered Commenterphdinparenting

Oh, blast! You asked me for those studies on co-sleeping, didn't you? I've been frazzled with everything going on this past couple of weeks and clean forgot. Let me know if you still want them (looks like you found a couple of them, anyway).

Anyway, thanks for a great post which covers a lot of points that aren't always covered, such as the smoking risk. I'd add/correct a few things, though:

Firstly and most importantly, any adults in bed with baby NEED TO BE NON-SMOKERS in order to co-sleep with reasonable safety. Not just abstaining from smoking while actually in bed, but *non-smokers*. Full stop. If you can't do that, or your partner can't, then please DON'T co-sleep. There are a lot of studies showing that bedsharing with a parent who's a smoker has a marked association with SIDS. While these didn't differentiate between smoking in bed and being a smoker generally, few people are going to be smoking in bed with a baby there and I see no way that the number of people doing that could account for the total difference shown in risk when baby bedshares with a parent who's a smoker. The theory is that smoke particles may remain in the parent's lungs or clinging to their body, and the increased proximity during the night allows the baby to breathe these in, thus increasing SIDS risk. Whatever the reason, the data is clear – bedsharing with a parent who's a smoker is associated with increased risk. This isn't highlighted as often as it needs to be in discussions of co-sleeping safety, so, while I'm glad you made the point, I do want to make it absolutely clear that it isn't just a case of not smoking in the bed.

Secondly, I'd question the idea that baby is safest sleeping next to a wall or bed rail. There are known cases of babies dying as a result of getting wedged between the mattress and walls or bed rails. It's possible to take precautions against this in the way you described, but we don't really know how safe these precautions are. Mattresses can shift with time and leave a space against the wall where there wasn't one before. We don't know how safe high-density foam might be if a baby rolled face-first into it. I always co-slept with my baby on the outside of the bed.

Finally, it's not actually true to say that co-sleeping is safer than crib sleeping once you account for other factors. The 'Mothering' article you cited by Tina Kemmel is flawed because she made some crucial mistakes in categorising the data (see http://mainstreamparenting.wordpress.com/2008/01/26/bad-sciencethe-curious-case-of-tina-kimmel-and-the-cpsc/ for a good analysis of the inaccuracies of this study). McKenna's studies did raise hopes that co-sleeping might reduce the risk of SIDS, but didn't actually show this to be so, because he wasn't looking at how bedsharing rates compared between SIDS and non-SIDS babies; he was looking at physiological changes during co-sleeping, which gives us some interesting data to theorise over but doesn't tell us what's going to happen to SIDS rates in practice. Since then, there have been several large studies that have compared bedsharing rates in SIDS and non-SIDS babies, many of them controlling for other factors such as smoking and unsafe sleeping surfaces, and none of them have found the hoped-for association between bedsharing and lowered SIDS risk. Safe bedsharing seems to be *as* safe, or close to it, as safe crib sleeping after the first few months (evidence in the first few months is more contradictory, with some studies showing an increased risk even after controlling for several other factors). But the evidence just doesn't back up the theory that it's safer.

January 13, 2009 | Unregistered CommenterSarah V.

@Sarah V.

I'd still love to read the studies you referenced in this sentence of your comment:

Since then, there have been several large studies that have compared bedsharing rates in SIDS and non-SIDS babies, many of them controlling for other factors such as smoking and unsafe sleeping surfaces, and none of them have found the hoped-for association between bedsharing and lowered SIDS risk

If you could e-mail them to me or put a link here in the comments, that would be appreciated. It is hard for me to comment on them when I haven't seen them and the studies that I did find or saw referenced in other material did not control for risk factors.

January 13, 2009 | Unregistered Commenterphdinparenting

Thanks for this great article! We've been through lots of different combos of co-sleeping with our little guy. He's now 7 months old. He started in a bassinet beside the bed, then came in bed with us (using most of the safe co-sleeping tips rules), then we attached a crib sidecarred, where he slept for naps and for the beginning of the night before I went to bed.

We've just now put everything on the floor, and replaced his crib mattress with a single mattress, pushed between the wall and our queen mattress. This is the best combo so far, and is really working well for us. Owen is a very 'active' sleeper and when he's in bed with us he manages to get turned horizontally across the bed between us, his head in my husband's chest, his feet kicking me in the ribs, both of us clinging to the edges of the mattress while he gets the lion's share of the bed! :) Now he has his own sleeping space, and I can move into his bed to nurse him, and then either fall asleep with him, or climb back into the big bed. My husband is now back in our room most nights!

I really like your characterization of co-sleeping along a continuum of risk. I compare it to taking your little one in a car. Most risky - front seat, no seatbelt, to least risky - strapped into a properly installed rear-facing carseat in the middle of the back seat. Notice that this is not one of the options: Don't take you child in the car, ever!

January 13, 2009 | Unregistered CommenterLindsay

yay! ive been doing the right thing. during my son's first few weeks, because I was CS, we put him in the crib and I'll just carry him to nurse him. after a month, my hubby and I decided to put everything on the floor and sleep with our son. that worked! and still working for almost 6 mos now. I love co-sleeping with my son. i just noticed that my senses are heightened, just his gentle move, i can feel. so when he's hungry, I just put my shirt up and there he goes :)

January 14, 2009 | Unregistered Commenterohmymama

@Sarah V.

Thanks for the links. I'll read through them and comment or post about them when I have a chance.

With regards to your comment on McKenna, I absolutely agree that sleeping in a crib in the parents room is extremely safe (assuming the crib is kept clutter free, non-smoking environment, etc. etc.). Have a baby sleep in a crib in the parents' room is an excellent solution for those babies and families that it works for. I do not dispute that at all.

January 14, 2009 | Unregistered Commenterphdinparenting

The point I was trying to make about McKenna's work is that there's an inherent bias in that he's used a higher-risk form of crib sleeping for comparison purposes, and thus this would make co-sleeping look safer by comparison. That's just as skewed as using unsafe forms of crib sleeping for comparison.

I notice you've edited your comment on Kimmel's article, but I really don't think that covers it. It isn't just a case of 'other researchers found different results'. Esther's post found clear errors in Kimmel's categorisations that make her work invalid. There simply is *no* work comparing co-sleepers and crib sleepers with allowance for other factors that shows co-sleeping to be safer. None.

BTW, forgot to give you this link:

http://pediatrics.aappublications.org/cgi/content/full/112/4/883

That study estimates relative risks of smothering with co-sleeping and crib sleeping (the other studies I listed look at SIDS). It found a vastly higher risk of smothering with co-sleeping. Nearly all of that, of course, will be due to unsafe sleeping practices, and other studies do suggest that the risk associated with safe sleeping practices is extremely low. However, there's a hell of a big difference in risk there to account for; and, if you look at the factors that were involved in the deaths in both categories of location, it does look as though the risks associated with crib suffocations would be easier to eliminate completely than the risks associated with co-sleeping suffocations. I suspect that there probably is at least a slight risk associated with co-sleeping no matter how safe we try to make it - but, whether or not that's the case, the evidence just does not support claims that co-sleeping is safer.

January 31, 2009 | Unregistered CommenterSarah V.

[...] to get a good night’s rest. There are many benefits to co-sleeping and also important co-sleeping safety requirements to consider if you do decide this is right for your [...]

[...] Ontario coroner should stop telling people not to bed share and instead tell them how to bed share safely. Public health agencies don’t tell people not to travel by car, instead they tell them to use [...]

[...] Ontario coroner should stop telling people not to bed share and instead tell them how to make bed sharing safer. Public health agencies don’t tell people not to travel by car, instead they tell them to use [...]

[...] you choose, it is important to keep everyone’s needs in mind and to ensure that you take co-sleeping safety into [...]

[...] I got up that morning, I went straight over to PhDinParenting.com to read up on Co-Sleeping Safety. We don’t co-sleep, but if I am going to fall asleep with Penny in bed, our bed needs to be a [...]

[...] to PhDinParenting.com >> Co-sleeping Safety to learn how to reduce the risks of [...]

[...] think co-sleeping might be the right solution for your family I encourage you to read more detailed co-sleeping safety tips and the benefits of [...]

[...] to get a good night’s rest. There are many benefits to co-sleeping and also important co-sleeping safety requirements to consider if you do decide this is right for your [...]

[...] Co-sleeping Safety from PhD in Parenting [...]

October 15, 2009 | Unregistered CommenterSAFE co-sleeping…. (the

[...] said that if they are considering co-sleeping, they should read up about co-sleeping safety first to ensure that they are creating the safest sleep environment [...]

[...] sleep in a crib. By telling parents that co-sleeping is dangerous, rather than providing them with guidelines on how to make shared sleep as safe as possible, the government is playing a role in the deaths of co-sleeping babies. Tell parents not to drink or [...]

Keith,

All children are different and some need more emotional support from their parents than others. But I would venture to say that perhaps the families you know where the children continued to have trouble falling/staying asleep on their own, were families that were not consistently emotionally connected in all parts of their interactions. Sleep issues often crop up in people who are struggling with stress. My oldest daughter coslept with my husband and I until 3 1/2, and my 2-year-old is still with us. The younger one definitely needs more physical emotional connection, but I maintain a strong connection day and night and this builds up the trust that I will be there -- if not in person, then in emotional connection -- and helps the child form independence.

I did want to add that an excellent source of cosleeping education and support is Attachment Parenting International at www.attachmentparenting.org or through its Infant Sleep Safety Campaign.

December 1, 2009 | Unregistered CommenterR

[...] Co-sleeping safety [...]

[...] Academy of Pediatrics still advises against cosleeping rather than acknowledging it and providing safe co-sleeping guidelines.  Some even believe it should be illegal.  This news story on a local Fox affiliate recently [...]

[...] Co-sleeping Safety by PhDinParenting [...]

[...] article from PhD in Parenting is a great collaborative read on safe co-sleeping practices. Read it here. We follow ALL of safe co-sleeping practices. I breastfeed. We don’t smoke or drink. We are [...]

[...] done safely. Annie at PhDinParenting has put together a great list of the dos and don’ts of co-sleeping safety. I don’t believe a blanket statement telling people not to co-sleep is the answer. I think [...]

If someone reads through these comments again sometime, I'd love more links on sleeping with a toddler and a new sibling!
I'm due in September with my 2nd, and our 2yo is still in bed with us. We have a nice setup right now-a tempurpedic (sp?) type king mattress but firm (from Essentia) on the floor, and we recently moved the crib mattress that we barely used in the crib to the floor next to us, against the wall. It's almost the exact same height as our big mattress-about 6inches. Sometimes our 2yo stays over on the crib mattress, sometimes not. But, he can still nurse easily if he wants. He likes having 'his bed'. <3

In our current arrangement, though, it's wall, 2yo, me, husband. Should we move now so that my husband is between the 2yo and I? That way, when the baby's born, it will be 2yo, husband, me, baby? Does that make sense? My husband was a pretty light sleeper for our first, but I know it's not as safe to have the newborn next to the dad... I'm pretty sure the 2yo would not be happy if the new baby usurped his spot in 'his' bed.

July 12, 2010 | Unregistered CommenterSarah

Hi Sarah,

Did you see this post?

http://www.phdinparenting.com/2009/06/04/move-over-making-room-for-1-more-in-the-bed-part-3-of-a-series-on-preparing-for-baby-2/

I think if your 2 year old likes his current spot, then you could keep him there and just put Dad next to him. The newborn can then sleep between you and the edge of the bed, but you might want to look into something like the Snug Tuck Pillow in this post to keep the newborn from rolling onto the floor.

July 12, 2010 | Unregistered Commenterphdinparenting

Oh, thanks! Should have searched your site first. :)

It's only 6 inches-and a gentle roll down if he does roll, but I do think we'll be working something out along the lines of an edging for keeping him safely in bed. Thanks again!

July 12, 2010 | Unregistered CommenterSarah

Co-sleeping really work for us. My baby tends to move a lot from left to right back and forth and my husband couldn't get enough sleep to go to work the next day.
What I realised is, some babies sleep well on their own in a crib or a large bed, but some just can't sleep well on their own. Nowadays my 8-month old boy sleeps in the same room as us BUT on his own bed. We're using the Arm's Reach Co Sleeper. So i guess, we're still co-sleeping but at another level :-)

October 4, 2010 | Unregistered CommenterCasey@ Baby Home Safety

[...] that make products that support those practices. I’ve written about this before as it relates to co-sleeping and I’m saddened and angry to have to write about it as it relates to baby carriers [...]

I need to check here more often. Interesting reading and definitely some very valuable information. Thank you for posting this.

November 18, 2010 | Unregistered CommenterPaula Bauer

[...] kid who likes to sleep in a crib, that’s all right. If you have the sort of kid who likes to sleep with one hand on you, that’s all right. If you have the sort of kid who feeds every 3 hours for 10 minutes, [...]

[...] A crib. Bed sharing? Not only far safer than many “public safety” organizations (often crib-lobby-backed) would have you [...]

[...] “Cosleeping Safety”: Safety FAQs, photos, DOs and DON’Ts (PhD in Parenting blog) Possibly related posts: (automatically generated)Children at PlayWhen is a child a child?Going Wormwood LikeBe the first to like this post. [...]

[...] Sleep. Make sure your bed is baby-safe, and get yourself and Baby comfortable in the side-lying nursing position. The hormones released [...]

[...] a review of some of these studies, check out Cosleeping at The Natural Child Project, Co-Sleeping Safety at PhD in Parenting (with more links at the end of the article), and Safe Sleeping with Your Baby [...]

[...] -But what if you’re too worried about cosleeping safety to sleep soundly? In addition to “Bedsharing Still Useful,” you might want to look at this. [...]

January 23, 2011 | Unregistered CommenterSynchronized Sleeping

We are committed to co-sleeping and to breast feeding. We have learned that baby needs to be between Mom and the wall since Dad sleeps to rough for baby's safety. However I can't figure out how to alternate feeding him on each breast and keeping him between me and the wall. Any ideas?

January 26, 2011 | Unregistered CommenterWonkerer

I'm able to sort of roll a bit over my lower breast so my baby can reach my upper breast (heehee). I can't sleep through it, but it works. Now that my supply is evened out, I often only feed on one side all night and then he gets a big breakfast. :) It might only work with large breasts, though!

January 26, 2011 | Unregistered CommenterSarah

[...] And, if you do choose to co-sleep, please see this link for some common-sense precautions: http://www.phdinparenting.com/2009/01/11/co-sleeping-safety/ [...]

[...] Co-Sleeping Safety – a blog post with lots of links by PhD in Parenting [...]

I am away from my baby 10 hours a day, five days a week due to work. If I did not co-sleep with my baby, I feel that I would hardly see him. Bed sharing has been essential not only to our breastfeeding success (10 + months and still going strong) but one of the main reasons we are so closely bonded. Thanks for getting this information out there. On another note, I was completely unaware of the issues (and possibility) of co-sleeping before I had a baby. Once I decided to bed share, I thought I would get a lot of negative comments from people. I was pleasantly surprised that although people seem doubtful at first, after answering their questions, no one that I've talked has had a negative reaction.

March 17, 2011 | Unregistered CommenterDena

[...] Co-Sleeping Safety. Parents curious about co-sleeping – including those who never planned to co-sleep but find themselves bringing their children to bed with them for naps or at night anyway – will benefit from reading this great post, which dispels common co-sleeping myths and, most importantly, explains how to co-sleep safely.  Be sure to check out the list of helpful co-sleeping links at the end of the article.  (PhD in Parenting) [...]

[...] cautious about cosleeping. For more information please read: Sharing a bed with your baby - UNICEF Co-Sleeping Safety - PhD in Parenting Sleeping Safely With Your Baby - Dr Sears The Family Bed - [...]

PostPost a New Comment

Enter your information below to add a new comment.
Author Email (optional):
Author URL (optional):
Post:
 
Some HTML allowed: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <code> <em> <i> <strike> <strong>
Related Posts Plugin for WordPress, Blogger...