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Thursday 17 March 2022

Co-sleeping: time to talk

Monkey baby-carrying. User 825545 via Pixabay.
Co-sleeping has been demonised by SIDS networks because evidence suggests that it correlates with higher levels of unexplained infant deaths. However, in western societies, approximately 50% of babies and parents co-sleep (i.e. sleep on the same surface) at least some of the time, with combination bedsharing (where a baby starts the night in one sleep location and ends the night in bed, usually with mum) the most common type. In other places around the world, 100% of parents co-sleep with babies: this is just the cultural norm. It's also what anthropologists think is the most natural way to sleep based on other precocial mammal babies, especially primates.

And it has its benefits.

Breastfeeding babies will feed better, grow better, and have better nutrition if they co-sleep with mum, and all babies see better parental attachment and neurological development – factors which are missed out when SIDS is prioritised. There is even some research indicating that people who co-sleep as children are more independent and socially developed as young adults.

But mostly, there just isn't the research.

For example, no one has studied the relative risks for breastfeeding-related bedsharing separately from just breastfeeding (reducing SIDS) or just bedsharing (increasing SIDS), but they have been estimated as maybe 1 or 2 per 10,000, compared to 1 per 2000 generally. According to UK data (because the data is different enough for different countries to be worrying in itself!), bed-sharing for smokers or those who smoked during pregnancy carries a 12 x increased risk of SIDS, but there is no significant increased risk for non-smokers. Case control studies on SIDS tend to be blunt instruments, categorising a whole range of different sleeping situations into a few small groups: in a cot, on a sofa, or in a bed. This means that baby positions are not taken into account, and face down sleeping on the chest of a mother compared to a cot has not been evaluated. There isn't any evidence that sleeping face down on the chest of mum (a common co-sleeping position, also similar to baby in a sling) is any less safe than in a cot, according to Durham sleep anthropologist Dr Helen Bell.

Whilst co-sleeping happens more often with mum, dads also co-sleep: but probably less safely. Research suggests that around 50% of dads are synchronised to their babies’ sleep cycles and needs, whilst about 50% are oblivious to them (and often sleeping deeply). But this could be cultural too: dads self-report that they tune out of baby when mum is around, and synchronisation correlates well to fathers who are primary caregivers.

Father and sleeping baby. Wolfowitz via Wikipedia Commons.

The result of all this is that there is no guidance on safe co-sleeping, even though so many parents do it. The policy on this reminds me of abstinence teaching: you can't just say don't do it, because people will. It's better to advise people how to have safe sex – or safe sleep – and this won't increase the number of unwanted babies, abortions, or SIDS deaths. So, let's start talking.

Read more about SIDS in our article on the topic.

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