Parents get mixed messages on co-sleeping

by Emilia Askari

DETROIT — Parents of newborns are faced with conflicting information about whether sleeping with their babies is safe.p. On one side, groups like the U.S. Consumer Product Safety Commission and the American Pediatric Society warn that sleeping with infants can be dangerous.

On the other, child care experts, including authors Dr. William and Martha Sears, say if done correctly, sleeping with infants can strengthen bonds between parents and children while ensuring better rest for the entire family. There’s even some evidence that carefully sleeping with infants can decrease the chances of sudden infant death syndrome.

The mixed messages concern Michigan health experts who are finding many infant deaths labeled SIDS were caused instead by suffocation by a blanket, fluffy pillow or a sleeping family member. A panel of doctors, nurses and government regulators began meeting earlier this year to develop a coordinated, statewide message on how to put infants to bed.

The goal is to give parents options while making sure that whether they choose a crib or bed, they are aware of important safety considerations.

Meanwhile, many parents are sold on the benefits of the “family bed” or sleeping with their infants.

Deana and Marc Manganello have three children who started out sharing their parents’ bed. Olivia, 4, and Natalie, 2, moved to their own beds at about age 1. Five-month-old Isabella starts the night in a bassinet, then moves to her parents’ bed when she wakes a couple of hours later.

“Everyone tells me my kids are going to grow too attached to me, but that’s not true,” Deana Manganello says. "Just the opposite. My kids are very independent. … I really wish they would get the word out there on how to safely bed share like they get the word out about how to safely use cribs.

“Obviously, it’s not for everybody. But for those who want to, why should they worry that they’re going to kill their kids? I also think that everyone should know the rules so they don’t accidentally fall asleep in a bed that’s unsafe for babies.”

Researchers say it’s difficult to know how many parents snuggle with their newborns, but many experts, including James McKenna of the University of Notre Dame, believe the practice is increasing along with breast-feeding, which is believed to improve babies’ health.

Because breast milk is more easily digested than baby formula, doctors and child-care experts agree that breast-fed babies wake more often to feed. In addition, studies from McKenna’s Center for Behavior Studies of Mother-Infant Sleep at Notre Dame show that breast-feeding babies and their mothers experience lighter sleep than others. Therefore, McKenna and other researchers say breast-feeding mothers are somewhat more likely to bring their babies to bed with them.

“There’s not a right answer and a wrong answer,” he says. “It’s a choice. Parents usually do not select one way. Sometimes they sleep with their baby. Sometimes they don’t. Sleeping arrangements are very fluid. So they really need to understand safety issues in all contexts.”

The technical term for sharing a bed with your baby is co-sleeping. If parents use a firm mattress and refrain from alcohol, drugs or smoking, proponents say it’s safe.

In other parts of the world, parents sleep with their babies and do not set up a separate nursery with a crib. In places such as Asia, Africa and the rest of the developing world, the incidence of sudden infant death syndrome is much lower than in the United States.

Japan has one of the lowest SIDS rates in the world at less than 0.2 deaths per 1,000 live births.

McKenna’s conclusion: Sleeping customs in these countries create safer conditions for infants. The Japanese sleep on hard futons and use small, hard pillows unlikely to envelop a small head. Other Asian cultures use small hammocks to hang babies above their mothers’ beds or sleeping mats.

Upscale baby stores and catalogs have begun to offer accessories to facilitate safe sleeping with infants. They include a device called the Co-Sleeper that’s similar to a crib with a floor that adjusts to the height of the parents’ bed. It straps onto the side of the bed.

Another item, the Snuggle Nest, consists of a cloth pad attached to a plastic, open-ended basket that goes in the parents’ bed.

Molly O’Shea, a doctor with Beverly Hills Pediatrics in the Detroit area, is not shy about mentioning to patients that she slept with her three children. “I chose to do it when they were newborns for the first six to eight weeks because I was nursing; it was a time that required a lot of nighttime attention and it was easier,” she says.

“I imagine there are a lot of people who think it’s taboo to say that you do it,” she adds. “There are very few families who plan a family bed. There are a lot more who have a family bed because it just happens. I would encourage people to be up-front about it with their pediatrician, at least.”

July 9, 2002

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