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The Family Bed: Should You Co-sleep with Your Baby?

On March 14, 2010, a couple in Reedsburg, Wisconsin, discovered their 3-month-old baby dead in bed with them. According to AP news reports, the couple brought their baby into their bed after an early-morning feeding—something they had also done with their two older children—and later discovered he had stopped breathing.

For families who did or still do co-sleep, this type of story is very difficult to hear. But according to the Consumer Product Safety Commission’s (CPSC’s) latest study, at least 64 babies under age 2 die each year from sleeping in adult beds. These deaths result from accidental smothering by an adult, getting trapped between the mattress and headboard or other furniture, and suffocation on a soft water bed mattress. Nikki Flemming, a CPSC public-affairs specialist for the past eighteen years, insisted in a phone interview that research shows that the safest spot for babies is in a crib, without any bedding or bumpers, and sleeping on their backs.

With that said, I personally know of many parents who have co-slept with their children, especially those who breastfed. It’s a tempting prospect, as it means a mom doesn’t have to constantly get up to feed or wake up a sleeping baby after she finishes eating. I recall doing this many times with both of my own babies after a late-night or early-morning feeding.

Besides the fact that co-sleeping is more convenient in this regard, parenting experts such as Dr. Sears and others who advocate attachment parenting are in favor of the practice. Dr. Sears’s argument is that sudden infant death syndrome (SIDS) is a larger concern—causing up to 4,250 deaths a year—and that safe co-sleeping helps parents keep a closer eye and ear on their infants. In one of Dr. Sears’s latest articles on safe sleeping, he called for scientists to conduct a thorough study to determine the number of parents who co-sleep and the main causes of SIDS, since this latest CPSC study showed deaths that were non-SIDS-related.

Boy, is this topic confusing for today’s parents. To shed light on this issue, I interviewed Robert Hamilton, MD, a Santa Monica, California–based pediatrician who has been practicing for 26 years, is a father of six, and is the coordinator of Light House Medical Missions, providing medical assistance to the children of Sierra Leone. I was a bit surprised to learn that Dr. Hamilton largely agreed with Dr. Sears, though he added a few caveats regarding safety.

“Listen, the reality is that a lot of people co-sleep with their children. Around the world, mothers co-sleep all the time ... I really have no problem with co-sleeping, but with rules. The mother can’t be on medication or pain medication or using alcohol. She can’t be using anything that would alter her responsiveness,” Dr. Hamilton said.

Most mothers are highly sensitive to their baby’s presence and often just don’t sleep as much as they should when co-sleeping, he pointed out. Dr. Hamilton added that the scenario of a parent’s rolling on top of the baby is highly unlikely, unless the parent is under the influence of some medication or alcohol.

But what about suffocation? It’s important to not place a baby on a water bed or on a bed with a very soft mattress or additional puffy bedding (such as a comforter) that the baby could roll over on and end up facedown in—“use common sense,” says Dr. Hamilton. And if your desire to have the baby close is mainly to ensure that you can hear his breathing, Dr. Hamilton advises parents to consider purchasing a co-sleeper, a small, flat, adjacent crib that attaches to their bed but allows the parents to slide the baby off the mattress. (If you buy a used co-sleeper, be sure to check the status of its model number with the CSPC first, as some models from years past have been recalled.) Another option is to place the baby’s crib, bassinet, or pack-n-play at the foot of the bed for the first four to six months.

For more guidelines on safe sleeping, the CPSC recommends the following:

  • Always place your baby on his or her back to sleep, to reduce the risk of SIDS.
  • Always leave your child’s head uncovered while sleeping.
  • Make sure your bed’s headboard and footboard don’t have openings or cutouts that could trap your baby’s head.
  • Make sure your mattress fits snugly in the bed frame so that your baby won’t become trapped in between the frame and the mattress.
  • Don’t place a baby to sleep in an adult bed alone.
  • Don’t use pillows, comforters, quilts, or other soft or plush items on the bed.
  • Don’t drink alcohol or use medications or drugs that may keep you from waking and may cause you to roll over onto, and therefore suffocate, your baby.
  • Don’t place your bed near draperies or blinds where your child could be strangled by cords.