Co-Sleeping in the News

A new study in the British Medical Journal has linked co-sleeping with Sudden Infant Death Syndrome. But read between the lines and it quickly becomes clear that, like all SIDS studies, there are many more factors at play than the fact that the deceased baby was sleeping with its parents.

For a start, it is a startling fact that among the 80 mothers of babies who had died, 25% had drunk more than 2 units of alcohol in the previous 24 hours. This compares to only 2% of mothers in a control group (though these figures may be skewed by the fact that the mothers of deceased babies were questioned at the weekend, when they were more likely to have been drinking). When drugs were also taken into account, the proportion of mothers of deceased babies who had been affected by drugs or alcohol climbed to 31%.

The finding that has hit the headlines hardest is that in 54% of the 80 cases of SIDS, the baby had been sleeping with a parent (which means that in 46% of the deaths, the baby was sleeping on its own). But this does not mean in a bed, safely adapted for co-sleeping. In fact 17% of the SIDS children had been sleeping on a sofa, versus 1% of the non-SIDS cases. The use of pillows was also found to be a statistically significant factor in the SIDS cases. I wonder how many more had been in a chair, sleeping on a parents' knee after a night feed where the parent had desperately tried to stay awake to avoid the terrible risk of taking the baby to bed.

Factors that were also found to be associated with SIDS, but which are less likely to be associated with co-sleeping were swaddling, maternal smoking during pregnancy, preterm birth, ill health, stomach sleeping and sleeping alone (not in the parents' room).

The presence of bedding over the head or face of the baby, a side sleep position, excessive bedding and clothing and postnatal exposure to tobacco smoke were not found to be associated with SIDS.

Tellingly, the researchers themselves said that co-sleeping should not be demonised. Their conclusions support what co-sleeping advocates have been saying all along: parents should be educated about safe co-sleeping before birth. That means not consuming alcohol or drugs prior to sharing a bed with a child, not smoking, not co-sleeping on a sofa or in a chair and not co-sleeping if the parents or the baby are very ill (though this is perhaps the occasion when our instincts make us more likely to bedshare). It also means keeping the baby next to its mum, having a safe sleeping environment with no dangerous gaps, keeping pillows and duvets away from the baby (which should preferably be on top of the covers with its own blanket, though I only did this for six months) and making sure the baby sleeps on its back (or possibly its side).

I know that having my baby in a cot in my room is in theory the "safest" sleeping arrangement. But I also believe there are positive benefits to sharing a bed, and my child would miss out on these benefits if she slept alone. It is very easy for the medical community to recommend using a cot, but the reality on the front lines of parenting can often make that a very difficult ideal to achieve. My daughter cannot usually be placed in a cot without waking, so cot sleeping would necessarily involve a lot of crying and that is not something I am prepared to inflinct on her. That is just my experience; it is possible that if she had been an "easier" baby, I would never have bedshared at all.

Cot sleeping became popular as bottle feeding went on the rise. Breastfeeding babies feed more frequently and for longer than bottle fed infants, and can only be fed by their mother. The night-time parenting of a breastfed baby is therefore easier if the baby co-sleeps some or all of the time. Co-sleeping is much more compatible with breastfeeding, and as breastfeeding numbers increase it is inevitable that more mothers will co-sleep (a recent study in the north-east found that 65% of breastfeeding mothers sometimes co-slept).

The NHS and UNICEF have not changed their advice to parents - cots are safest, but if you co-sleep, follow the above safety guidelines. Now, a study into SIDS where the co-sleeping babies were all doing it safely in a bed with responsive parents... wouldn't that be something?