Sunday, March 24, 2013

The Co-Sleeping Controversy - Why I Don't Obey the Rules

Despite the warnings and scare tactics, thirteen years ago, I decided that bed-sharing was the best option for me and my first son.

Back then, I wasn't the educated mom that I consider myself to be today, after bearing and raising eight children. Back then, I wouldn't DARE tell the pediatrician that they should check their facts. Back then, thirteen years ago, I would either lie and say that my child slept in a bassinet or a crib or I would try to avoid the question altogether.

Just recently, though, when I took my eighth child to her new doctor, I once again received the brow-beating that pediatricians now give co-sleeping parents. Basically, her standpoint was that I was taking a HUGE risk and was putting my baby's LIFE in harm's way! And, I also had a recent conversation with another "child advocate" about my choice to co-sleep and was again told how dangerous it was and that I should get a crib, just in case my pediatrician called CPS on me for admitting that I co-slept with my baby. To this, I asked, "Why? Where is the LAW that states I cannot co-sleep with my baby? In addition, SHOW ME the real, hard statistics that say that the adult bed is less safe than the crib. Too many babies have died in cribs, too!" I knew she couldn't produce these laws and facts, because they don't exist.

Today, unlike when I was a new mother with my first few children, I will be honest (for a long time, I was forced to be what I call a "closet co-sleeping parent". I would lie to the doctor, the WIC office, etc. about our sleeping habits. Yes, my child slept in a bassinet or a crib. Now, I openly, honestly and self-righteously tell the pediatrician that I co-sleep with my babies. (Yes, we think that the so-called "family-bed" is the right choice for our family.)

Today, I'm far more educated and can back up my parenting strategies and techniques with hard facts, statistics, and research.

Today, I'm going to tell you why the American Academy of Pediatrics (AAP) and the majority of individual pediatricians are WRONG and how they are sadly misinforming parents. I have yet to take my children to a pediatrician who agreed that bed-sharing was SAFER for babies, and they certainly won't talk about what a great bonding experience it can be.

Well, I have done my research and I'm going to tell you why I believe that the family bed IS SAFER. And, I'll also elaborate on the bonding experience that it provides, even when we're sleeping.

Bed-Sharing Deaths vs. Crib Deaths

If you're a parent, then you probably know that the co-sleeping controversy stems from the infant deaths that have occurred in adult beds. But, did you know that the scare tactics that are being used to persuade parents into using cribs, which has become a national campaign against bed-sharing, actually started as a joint effort of the USCPSC and the JPMA?

Let me spell that out for you...the USCPSC is the U.S. Consumer Product Safety Commission and the JPMA is the Juvenile Products Manufacturers Association. Well, isn't that a hoot, considering that if we parents believe that our beds are unsafe for our babies, then we would have to...purchase a crib (otherwise known as a product - or juvenile product)!

But, I'm not going to base my entire claim that co-sleeping is safer than cribs on the fact that two associations who fair to gain from the "you have to use a crib or your child will die" campaign are ahead of it all. I have hard facts and statistics for you, too.

The Crib vs. Adult Bed Research

Let's talk about the research. And, let's start with Dr. Sears, who was the first person to say that co-sleeping was good for babies - and parents! Dr. Sears also co-slept with his children. He says that when parents ask him, "Where should my baby sleep?", he responds by telling the parent that they should have their baby sleep wherever baby and parent sleep best. Period.

Dr. McKenna is a well-known SIDS (Sudden Infant Death Syndrome) researcher who will testify that the adult bed is safer than a crib. His testimony is the result of 30 years of research and you can read his article "Co-Sleeping and Biological Imperatives: Why Human Babies Do Not and Should Not Sleep Alone". But, basically, if you don't want to read the article, Dr. McKenna discusses several topics, including how sleeping next to your baby is "biologically appropriate", different organizations that DO support bed-sharing, and that the family bed environment can be made to be SAFER than the crib.

According to Dr. McKenna, the following organizations support the family bed:
  • The Academy of Breast Feeding Medicine 
  • The USA Breast Feeding Committee 
  • The Breast Feeding section of the American Academy of Pediatrics 
  • La Leche League International 
  • WHO
The common thought amongst these groups, as well as Dr. McKenna, is that our ancestral mothers bed-shared due to breastfeeding. Why shouldn't we?

Dr. Margot Sunderland, the director of education and training from The Centre for Child Mental Health in London agrees with Dr. McKenna's stance on co-sleeping, as well. She says that children whose parents co-slept with them tend to grow up to be calmer, healthier adults, and they also may experience less amounts of stress than children who slept in cribs alone. Her book, The Science of Parenting, explains her opinion on bed-sharing.

In Dr. Sunderland's book, she uses evidence from 800 different scientific studies to prove her theory, that co-sleeping is by far healthier than an infant sleeping alone. Many of the studies that Dr. Sunderland examined included brain scans to find out how infants' and kids' brains react in particular situations. She says that cortisol, a hormone that is related to stress, is increased in the infant body when they are separated from their parents.

One neurological study even revealed that the brain activity of an infant who is separated from a parent showed similarities to exhibiting physical pain! (And then we have the parents who let their babies CIO - "cry it out"! I'm not trying to judge here, but just imagine putting these two concepts together. Infants who sleep alone in cribs exhibiting signs of physical pain in their brain scans and then the parents practicing the CIO method. What exactly does the baby LEARN from this? When they are in pain, they cry and no one comes to comfort them?)  

Dr. Sunderland says that children should sleep with their parents up until they are 5 years old for maximum benefits and that this long-term co-sleeping is much healthier for children than sleeping alone.

Meredith F. Small, the author of Our Babies, Ourselves: How Biology and Culture Shape the Way We Parent, says that according to studies, when a mother co-sleeps with her baby, the infant learns how to regulate his or her heartbeat, breathing, muscle movements, and brain wave activity. These same studies revealed that infants who sleep alone experience a difficult time regulating their body functions. These infants are also fussier and have more sporadic breathing.


The Biggest Co-Sleeping Fear

I can understand that some people may sleep like logs, but I am not one of them. One tiny inkling of a whimper from one of my children, and I'm wide awake. This goes right along with how Dr. McKenna describes bed-sharing mothers. As long as they are not inebriated with alcohol, sleep medications, or endless nights of sleeplessness, the doc suggested that "breastfeeding mother-infant pairs exhibit increased sensitivities and responses to each other while sleeping, and those sensitivities offers the infant protection from overlay".

This takes care of the biggest co-sleeping fear - or scare tactic, if you want to call it - that you will roll over on your infant during the night and suffocate him or her.

The Statistics

I told you that I would back up my choice with real, hard statistics, so you're probably wondering at this point,"Where are the REAL facts and statistics?" After all, all I have done is talk about some doctors' opinions, which goes against the majority of doctors and organizations across America.

First, let's talk about Japan. In Japan, the bed-sharing is a normal practice in their culture. You won't hear a Japanese pediatrician (unless they are practicing in America, of course) claim that the family bed is a big no-no.

Get this: Japan has the lowest SIDS rates in the world. Additionally, the SIDS Global Task Force conducted an international survey which revealed that cultures, like Japan, that practiced the highest amount of bed-sharing and co-sleeping produced the lowest SIDS rates. Food for thought...

Are these facts still too vague for you? No problem, I have more.

The U.S. Consumer Product Safety Commission conducted a study about SIDS that was released in 1999. Here's what they came up with:

  • There were 515 cases of accidental deaths of infants in adult beds between 1990 and 1997. If broken down by year, there was an average of 65 infant deaths each year in adult beds.
  • During the same period of time, there were 34,000 total SIDS cases. That breaks down to about 4,250 cases each year. 
So, to look at an average year, we would compare the 65 deaths that occurred in adult beds versus the 4,250 total SIDS cases. I'll figure it out quickly for you. That means that only 1.5% of the total SIDS cases each year occurred in adult beds. And, where did the other deaths occur? The study didn't say it, so we can't necessarily assume that the other 98.5% of infants died in cribs, but wouldn't you say that this "Bed-sharing Is a Big No-No!" is a bit unfounded at this point?

What needs to be done is a REAL comparison of SIDS deaths in the adult bed versus SIDS deaths in a crib to ensure that there are no misconceptions. Until this type of study is conducted, I still would wager that the majority of the 98.5% of deaths did, in fact, occur in cribs, bassinets, playpens, and other products that were being used in order to avoid the family bed.

How Is A Crib Safer?

I understand that there are numerous SIDS cases that still haven't been solved. The parents will never know what the exact cause of death was for their infant. However, I am also well aware that crib deaths have occurred due to all kinds of different safety issues.

The U.S. Consumer Product Safety Commission conducted a study that was outlined in the report "Hazard Analysis: Crib Related Deaths". Here are just some of the crib safety issues that posed a threat of death:

  • Positional asphyxia/suffocation due to bedding in the crib (including bumpers!)
  • Hardware problems
  • Entrapment between object and crib
  • The child was entangled in blind cords hanging too close to crib
  • Entrapment between side rail and mattress
  • Improper mattresses
  • Structural failure
  • Entrapment due to improper slat placement
So, how can anyone say that a crib is safer than the family bed at this point? Obviously, more specified research needs to be conducted to compare the exact amount of infant deaths in the adult bed versus the crib (and other recommended sleeping products for babies) before we continue to brow-beat co-sleeping mothers!

The Benefits of Bed-Sharing

Besides the fact that it's been so much easier and faster to tend to an infant (especially my breastfed infants) during the night when they are right next to me, there is actually a list of benefits that both mothers and children can reap from co-sleeping. Some of these benefits were already discussed earlier in The Research section, like the baby's ability to better regulate their body functions and the lowering of stress of an infant. 

First, as I mentioned, the breastfeeding. Because the baby is right beside Mommy, it is much easier for the mother to breastfeed her baby as many times as the baby wants during the night. The more she can breastfeed, the more "good stuff" the baby gets, the healthier the baby. And because co-sleeping makes it so much more convenient for the mother to breastfeed, she will be more likely to breastfeed longer, and the longer a mother breastfeeds, the lower her chances are of getting breast cancer.

Dr. McKenna also pointed out that "irrepressible (ancient) neurologically-based infant responses to maternal smells, movements and touch altogether reduce infant crying while positively regulating infant breathing, body temperature, absorption of calories, stress hormone levels, immune status, and oxygenation." They cry less frequently and sleep longer. What mom doesn't want that?

In layman's terms, co-sleeping increases the amount of time that an infant will sleep, because they are subconsciously content and tend to be in sync with their Mommy when they are sleeping next to her. After all, they've been inside of your body for 9 months. What makes anyone think that a baby would want to be very far away from their "home"?

This makes sense, because there's this thing called "nature". And, if you think about other mammals, like dogs and cats, you will realize that most mammals sleep curled up with their young. Why shouldn't we do the same?

Another benefit of bed-sharing is that you can tend to your baby's needs more quickly. If your baby is sleeping in a crib in another room, or even across the bedroom, it takes more time to get to them, and you may not even hear their cries when they first start calling for you. When they are right next to you, you not only hear them right away, you are right next to them to comfort them immediately, and this is the exact type of reassurance that your new little person needs. Additionally, your baby doesn't have to wake so fully when they are right next to you and they are attended to quickly, meaning they can get back to sleep faster and easier.

Bonding time is increased to include all night long when you choose the family bed. While you may not be interacting, the baby can still smell and feel you, hence increasing that bond.

Co-sleeping babies also develop better sleep habits next to mommy.

Long-Term Co-Sleeping Benefits

In the long-term, research has also shown that co-sleeping promotes higher self-esteem. For example, boys whose parents co-slept with them them between the ages of birth and five years had much higher self-esteem. They also experienced less anxiety and guilt.

Women whose parents co-slept with them as babies showed less discomfort with affection and physical contact when they became adults.

A study of military based parents (Forbes et al., 1992) also showed that co-sleeping children's teacher evaluations were significantly higher in the behavior category, as opposed to children whose parents did not let them sleep in the family bed. To compliment this study, another study in England (Heron, 1994) revealed that children who did not enjoy the family bed tended to be less happy, harder to control, were more fearful, and exhibited a larger amount of temper tantrums than their co-sleeping counterparts.   

Another study that was conducted amongst 5 ethnic groups from large U.S. cities revealed that co-sleepers in each ethnic category were generally more satisfied with life than those whose parents did not let them sleep in the adult bed (Mosenkis, 1998).

What Stance Should Pediatricians Take Then?

So, now we come back to the subject of pediatric recommendations. What should pediatricians be telling parents? First of all, let's stop the scare tactics and brow-beating!

This is not strictly my opinion. All of the researchers that I have mentioned earlier would tend to agree that instead of brow-beating parents who co-sleep, they should be EDUCATING ALL PARENTS. Otherwise, we are still going to have the "closet co-sleeping parents" who refuse to admit that they sleep with their babies for fear of being judged or getting a visit from Child Protective Services.

My recommendation, like so many other INFORMED researchers, parents, and educators, is to educate parents on their choice of sleeping behaviors. If a parent chooses EITHER the crib or the adult bed for their infant, that is their choice, but we need to remember that babies have died under BOTH circumstances, so we need to educate ALL parents, regardless of their choice in sleeping with their baby or putting them in a crib.

In case you would like to make sure your sleeping choice is made the safest for your child, here is a list of safety measures for the adult bed and a list of safety measures for the crib.

To You Parents Who Do Co-Sleep:

If you feel like putting your baby in a crib is like putting your child behind bars...if you feel like your warmth and comfort throughout the night in the adult bed is much better for your baby...if you feel like it's more natural and safer to co-sleep, then do it!

Don't feel like you are backed into a corner by any so-called "child advocate" who wants to brow-beat you about co-sleeping with your child! It is the most natural thing to do, after all! Stay informed, follow all safety guidelines, and don't feel like you need to do something, like putting your child in a crib, just because of the scare tactics that have circulated for so long now.

Do what is comfortable for you and your family. And, if it comes down to it, arm yourself with the ammunition in this article to show how educated and informed you are about your decision to co-sleep!

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