Thursday, November 5, 2009

Premature Babies and Co-Sleeping: Would You Do It?

A recent comment on another post set me off wondering about whether I would co-sleep with a baby that was born prematurely.

The standard advice is always to not co-sleep with a premature infant, but if you were a strong believer in the benefits of bed-sharing and your baby is healthy, I am not sure whether this advice would be enough to convince you not to do it. Personally, I think I would co-sleep with a baby that was born only a few weeks short of term and was otherwise doing well.

Advice on the web is fairly thin on the ground because most sources stick to the usual co-sleeping recommendations without discussing the reasoning behind them. However the benefits of skin-to-skin contact and frequent breastfeeding for premature babies are well established, and as a result kangaroo care is routinely used in neonatal intensive care units. It would seem that co-sleeping would offer a method for parents to continue this close care at night, and it has certainly been demonstrated by researchers that bedsharing does increase night-time breastfeeding. The other benefits of bedsharing (more stable temperatures, more regular heart rhythms and fewer pauses in breathing) would presumably still be present when co-sleeping with a premature baby. A study in Biological Research for Nursing shows that co-sleeping helps to establish a premature baby's circadian rhythm.

The problem is that these benefits might be outweighed by the increased risks associated with co-sleeping with a premature infant. Whilst dangers like overlaying and suffocation can be mitigated by following standard guidelines, research has shown that there is an association between prematurity and SIDS. Since co-sleeping also increases the risk of SIDS (at least theoretically, though most studies lump sofa sharing and drunken co-sleeping in with the figures), combining the two risk factors might be considered one step too far.

Even in full knowledge of the facts, I think I would still co-sleep with a premature baby if my gut instincts told me that it was strong and healthy enough. This is really one of those questions that cannot be answered in the general case; each family needs to weigh up its own situation and make its own choice. It is worth noting that there are products such as sleep positioners that can be placed on an adult bed to safely contain a tiny baby and keep it on its back. They would certainly make side-lying breastfeeding difficult, but if they help to allay parents' fears about co-sleeping then they might be worth the expense.

The real reason I have written this post is to find out about real people's experience of co-sleeping with preemies. Did you have a premature baby and did you consider co-sleeping with it? Did you wait until it was 40 weeks from conception or did you start straight away? Even if you don't normally comment it would be really interesting to hear anything anyone has to say.

16 comments:

Sheryl said...

I would most certainly cosleep if my baby was healthy and and say four weeks premature or less.

The benefits of kangaroo care are undisputed and I would do my best to stay in constant contact with my little one to breastfeed on demand and provide skin to skin contact as much as possible.

M

Lisa - edenwild said...

If it were me, I would put my baby in an Arms Reach co-sleeper so that my baby was right next to me, but not in bed with me. I would breastfeed in bed if I could (if the baby is able), but not leave my baby there while I fell asleep. During the day I would definitely carry my baby all day long and skin to skin as much as I could. If I did venture to take my baby into bed, I would only do it with a harder mattress and no covers. I wouldn't take any chances with a baby that young!

global mamas said...

My first born was only two weeks early so not sure if that counts but I did not have any doubts about co-sleeping and still don't. Mind you my first was born almost 20 years ago and there didn't seem to be as much information as there is now...so I just did what felt right as I wasn't bombarded with fear from the outside. Now with my last bub (14 months) I hear the fear mongers and their stories but I am still convinced that co-sleeping is the safest and best way :)

Hobo Mama said...

I didn't have a preemie, but I do see that having a very small baby might make me consider cosleeping differently. My baby was very large and sturdy with a strong kick, so cosleeping never seemed dangerous to me. I think I would still cosleep with a premature infant who was old enough and healthy enough to take home from the hospital (assuming there had been hospital care involved), but I would be more cautious than I was for my son. As Lisa mentioned, I would do away with covers instead of just scrunching them down, and I would not use pillows instead of just arranging them so they were not near the baby's face. — Ack, do I sound like a dangerous cosleeper? I never advocate not following standard cosleeping safety measures, but in my own experience I felt comfortable bending a few rules. With a very small and premature infant, unlike my previous very large and vigorous infant, I would be more cautious to do things by the book. I agree that the skin-to-skin contact and temperature and breathing regulation would weigh heavily in my mind in promoting cosleeping. From the research I've seen, cosleeping is protective against SIDS so would be worth it as long as the cautions are followed.

And now I'll be quiet and hope some more mothers who actually had a premature baby will chime in. It's hard for me to imagine psychologically what it would be like to have a very small and fragile baby.

Cave Mother said...

Sheryl - so glad to read that in the first comment, someone agreed with me! I was afraid I would be slammed as an irresponsible blogger.

Lisa - Tend to agree, this might be what I would do although I have no experience with a baby who can actually be moved once it is asleep without waking it up. So it would depend on how lightly the baby slept I suppose.

global mamas - bombarded with fear. Yes, I know what you mean.

Hobo Mama - You don't sound like a dangerous co-sleeper, no. I have always had pillows on the bed too - I never understood how pillows could magically migrate from under my head to on top of my baby's face during the night. But yes, I think cautious co-sleeping would be the way to go with a fragile baby.

Romi said...

I never thought about co-sleeping with a preemie! You bring up so many interesting points..thanks so much. I'm going to link to your post on my website, Parentsask.com. We just put up a video on the subject of co-sleeping with Dr. Bob Sears and parenting expert. Betsy Brown Braun. (come take a look!!)

Melodie said...

This makes me think of the last episode of Grey's Anatomy (the only tv show I watch). There was a preemie and Alex, one of the surgeons, took his shirt off and slept in a chair with the baby nestled into his chest. You can bet your booty I'd co-sleep with a preemie. But I am a very very light sleeper and don't roll around a lot. It would likely be different for each person.

Bullajabbar said...

Sprout only weighed 4 lb 8oz and was born at 35 weeks, but as soon as I brought him home and put him in the cot we had, it was just too big. My husband and I had planned on co-sleeping, so I just decided that we may as well start. First off we have a queen (King by UK standards) sized bed, so there is alot of space. Secondly we had bought a positioner, this is absolutely wonderful, he isn't going anywhere but up or down. We put the positioner on top of the bedding, so if he does go down he isnt going to disappear under the covers.

Everything has worked out great. Not once has either of us forgotten he was there. And Sprout sleeps the majority of the night except to feed or be changed.

I am really happy I decided to ignore the advice and go with what I thought I should do.

Cave Mother said...

Bullajabbar - I'm so glad it's going well for you. I posted this article after reading your comment, and I was wondering what decision you had made. You have clearly found a solution that works for you. Sprout is a luckily little baby!

Cave Mother said...

Romi - I had a look at the video. Thanks for linking to me!

Prem2Pram said...

I had two premature babies and have to admit I never thought about co-sleeping with either of them.

I did however carry both of my littel ones around most of the day in a baby sling.

In Japan, the closeness between mother and child is so much a part of the culture that there's a word for it:............ Skinship.

I would also like to tell your readers about The Toddler Dictionary which is in aid of Bliss the charity for babies born too soon, too small, too sick.

The Toddler Dictionary is a small booklet that not only includes pages of great examples of toddler speak but it also prompts you to record your own.

From Abulab to ZibZib this is an A-Z of toddler words along with the adult translations. Selling at just £1.99 this is an ideal stocking present.

Please visit http://www.prem2pram.co.uk to purchase a copy.

Annie @ PhD in Parenting said...

Yes, I would. But just as I would with any newborn, I would take the co-sleeping safety recommendations very seriously. I would probably also set up an alternate sleep surface next to time as an option in case I was feeling particularly exhausted and felt that I could be a danger to the baby. As an aware and experience co-sleeping mom, I think I have a good gage of when I'm okay and when I'm not.

Danielle said...

I had a premature little one. He was in the nicu for 11 days. I didn't nurse until 8 days after birth. Before that I pumped every 2-3 hours around the clock but my milk didn't come in (too much stress). When we brought him home we coslept right away. I was feeling detached and I desparately wanted to breastfeed my son. Cosleeping helped my body get into mama-mode. Without it I'm not sure that my boy, now almost 9 months, would still be nursing or that we would have the strong bond that we do.

parents of premature babies said...

Sleeping beside a baby is needed especially for premature babies. Because babies will be more relax and comfortable if they will feel the body of their mother.

Anonymous said...

Hi there. My baby was born 9 weeks early and we brought him home 3 weeks before his due date. He sometimes sleeps in our bed with me but he has his own blanket and I'm a very light sleeper. I'd definitely say he sleeps more soundly next to me. I put him higher up the bed than me and he likes to touch my hair whilst he sleeps. Some nights though he sleeps soundly in his Moses basket. I let him choose :)

Anonymous said...

I realize this thread is a few years old... I have a preemie, born 32 wks who was in the NICU 5 weeks. When we brought him home we planned for him to sleep in an Arms Reach ccosleeper or a travel cosleeper that sits on top of the bed. We tried that for a week or so but he wouldn't sleep unless he was being held or laying right against me. Luckily, I am a light sleeper so having him next to me when sleeping has worked and we both get much need rest.