SIDS and co-sleeping: Time to Avoid
Blanket Statements
by
Barbara Behrmann, Ph.D.
(c)
2006
Another day, another article that
indicts co-sleeping as a risk factor for SIDS.
This time the article
Solving the SIDS Mystery,
appeared in the November 13 issue
of U.S. News and World Reports. The article’s
main intent was to report on a recent study in
JAMA (Journal of the American Medical
Association) in which researchers discovered
abnormalities in the part of the brain (the
medulla) in babies who died of SIDS compared to
the medullas of babies who died of other
causes. This is significant because it points
to a biological basis for SIDS. Researchers
also believe that SIDS ultimately will be found
to have multiple biological causes that make
babies more susceptible to environmental risks
such as soft bedding or cigarette smoke.
The problem starts here, in how these
environmental risks are discussed. And it’s
representative of a problem characterizing much
of the discourse surrounding SIDS.
Is Bed Sharing Always Dangerous?
The article
screams loud and clear that co-sleeping is a
risk factor for SIDS. But is it? Has culture
made biology that irrelevant, yet alone
dangerous? The biological norm, remember, is
that baby mammals sleep with mommy mammals.
Granted, other mammals don’t sleep on soft
mattresses with heavy blankets. They don’t
abuse alcohol and drugs which would make them
less responsive to any distress their baby may
have. And I’ve never known a mother panda to
smoke cigarettes, a known risk factor for SIDS.
But these situations are not the same thing as
co-sleeping in general.
Studies show it is not bedsharing itself
that puts babies at risk, but the circumstances
surrounding it; e.g., a parent smokes or abuses
drugs or alcohol, a mattress is too soft;
bedding is too heavy and too close to the baby’s
head; and the baby is lying in a position other
than on its back, etc. But these are risk
factors for babies who sleep in cribs, too. Why
blame bed-sharing across the board? For the AAP
to make policy recommendations for all
mothers and babies based on circumstances in
high risk settings or on high risk populations
is unscientific and unethical.
Moreover, co-sleeping babies tend to follow the
sleep patterns of their mothers. This helps
them develop more mature sleeping and breathing
patterns. Babies who sleep alone, on the other
hand, have more difficulty rousing themselves
from deep sleep – a factor that may contribute
to SIDS.
To be sure, there are many situations in which
it is not safe for mothers to sleep with
their babies. But to declare that bedsharing is
itself a risk factor for SIDS is downright
wrong.
What
About Infant Feeding?
While co-sleeping is the
scapegoat for many infant deaths, voices are
strangely silent when it comes to infant
feeding.
Yet
breastfeeding is recommended for SIDS
prevention, even by the AAP (American Academy of
Pediatrics). And if we know that breastfeeding
reduces the risk of SIDS, we can turn
that statement around and (using breastfeeding
as the biological norm and thus the appropriate
basis for comparison) assert that
formula-feeding increases the risk of
SIDS. So while the U.S. News and World Reports
article is quick to point out other ways parents
can reduce risk, such as placing babies on their
backs to sleep, there is nothing that even
suggests they can also reduce risk by
breastfeeding.
These biases and omissions are even more
significant when we consider the relationship
between breastfeeding and sleeping
arrangements. Studies document that mothers and
babies who sleep together nurse more often
during the night than those who don’t share
sleep. It also helps prevent breast engorgement
and breast infections. Perhaps most
importantly, though, it is just easier to nurse
when you don’t have to get out of a warm bed to
do so.
The bottom line is losing a baby to SIDS is
devastating. And any new insights we can obtain
to help us keep a cherubic baby from becoming a
mortality statistic is great news. But let’s
not necessarily throw the baby out from the
bed! Let’s not confuse science with ideology
and cultural biases. After all, for most of
human history, and still in most of the world
today, human babies have slept with their
mothers. Just like other mammals do.
For more
information about SIDS, bed sharing, and much
more, visit the
website
of Dr. James McKenna, Director of the Center for
Behavioral Studies of Mother-Infant Sleep at the
University of Notre Dame and one of the leading
authorities on the topic.
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