Cosleeping myths vs. research realities, Part I

As I said in a recent post, I have my own ideas about cosleeping in the sense of bedsharing, and they’ll be rather unpopular among the AP/NPer set. The latter make some rather extravagant claims about the benefits of cosleeping, which are simply not supported in the medical literature. What’s more, cosleeping under certain conditions make the practice risky, something which is too often glossed over in the AP/NP literature.

I might add that I’m also irked by the false dichotomy you see pro-cosleeping literature set up: You can “share sleep”, or, it’s implied, baby is stuck in a cold crib in a bedroom on the other side of the house. I agree that the latter isn’t a great idea either, but I don’t think I know anyone who put their small babies (under 2-3 months old, say) in separate rooms. Most people I know set up the crib in the parents’ room for the first few months, or use a bassinet. Roomsharing in the first months makes both practical and scientific sense.

Let’s have a look at the claims made for cosleeping vs. what has actually been shown to be true so far:

It’s oh-so natural – in the sense that many, if not most, primitive cultures cosleep, that’s true. That shouldn’t make it de rigeur for every parent in the world, though. Just because a practice may be a necessity in primitive or poor cultures doesn’t make it necessary in every human condition.

It helps Mom and baby sleep better – from the poking around I’ve done on the subject, this is, like losing weight while breastfeeding, strictly a YMMV kinda thing.

Psychological benefits of cosleeping – As I’ve pointed out, there is no evidence children of parents who cosleep (or follow any other AP/NP principles) are more securely attached than their crib-sleeping peers. In fact, a longitudinal study that followed bedsharers and their conventional counterparts for over 18 years found no long term psychological benefits or harm. I’ve already written about the so-called Harvard “study” which alleges psychological harm will befall babies who don’t cosleep (Short version: BS. 😉 ). I’d also like to mention there’s been an opposite claim – that babies are stressed by cosleeping (this one is an actual study, albeit of unknown quality as I can’t find the full-text article online). I’d wait for this study to be replicated before stating that as a fact.

Cosleeping promotes breastfeeding – This makes a good deal of sense, though causality has not been shown. I’ll note that it’s not necessary to actually have the baby in bed with you for this: an interesting study showed the same effect on breastfeeding initiation in the L&D ward whether the baby was in the mother’s bed or a side-car crib. It’s also important to remember that thogh breastfeeding has many benefits, it is but a means to the end of a healthy, alive baby. Which brings us to:

Cosleeping prevents SIDS – this is a very common claim used to support sharing a bed with your baby. The basis for it is circumstantial at best. It leans mainly on the research of Dr. James McKenna, who has found certain physiological characteristics in cosleeping mother-infant dyads as opposed to solitary sleeping ones. However, some of his research is contradictory – for example, in 1997, McKenna found that cosleeping infants are exposed to maternal carbon dioxide, which may be a stimulus for the infant to keep on breathing; a year later, they found that cosleeping infants actually had more incidences of central apnea. Also, the implications for SIDS reduction are merely speculative – McKenna has not proven that cosleeping actually reduces the incidence of SIDS in real life. Given the recent literature on the subject (some of which we’ll be reviewing in a few minutes), he’s actually, much to his credit, conceded that

The growing consensus is that bedsharing behavior is diverse, and can be practiced safely or unsafely. One way to conceptualize this issue is to think in terms of a
‘risks-benefits continuum’ wherein, depending on the presence or absence in the bedsharing environment of known risk factors, bedsharing can be protective in some situations and risky in others.

The other observation is that countries with a low awareness of SIDS seem to have a high percentage of cosleeping. However, low awareness doesn’t necessarily mean low incidence; for example, once the Japanese looked for more SIDS cases in the mid-to-late 90s, they found them, doubling their previously stated SIDS rate, though the SIDS rate was still some 40% that of the US. In addition, the SIDS rate of Asian-Americans is also very low; it may be there are genetic factors involved as well. Also, not all low-SIDS countries are high-cosleeping ones: If you look at this table, you can see that Hungary, the Netherlands and Slovakia all have SIDS rates as low or lower than Japan, and none of those countries has a bedsharing tradition.

So what really is the effect of cosleeping on SIDS? The answer is complex, but what seems quite clear is that sharing a bed with your baby as is commonly done by APers doesn’t reduce his chances of falling prey to SIDS, and in certain circumstances, may increase them.

We’ll be looking at the scientific literature regarding this, and what constitutes safe bedsharing, in the next post.

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One Response

  1. Just wanted to note, co-sleeping saved my son’s life. Had he not been in my bed, I wouldn’t have realized that he stopped breathing and been able to wake him up. Co-sleeping isn’t for everyone, but it does have benefits for those of us who choose it. (I also honestly do sleep better with him in my bed because if he’s not, I lie awake because I know I won’t wake up to hearing him over the monitor.)

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