Putting baby to bed … safely
Tuesday, October 27th, 2009
There's a lot new mothers have to figure out. Near the top of the list is the tough task of getting an infant to sleep. Many moms say snuggling up in the same bed lets the baby – and the rest of the family — get a good night's rest. But many doctors say that's a dangerous way to put a baby to bed. WHYY has more on co-sleeping.
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Chester County mom Kerri Klugewicz has lots of experience putting little ones to bed.
Kerri Klugewicz
There's four kids in the house. The youngest is 10-month-old Isabelle. She sleeps in bed with mom and dad, nestled at Kerri's side.
Klugewicz: That's all they know is mother's heartbeat and her sounds and her scent and that's what brings them comfort.
Co-sleeping is the norm at her home now, but when she was pregnant with her first child, Klugewicz didn't plan on sharing a bed with the new baby.
Klugewicz: I had imagined that I would nurse the baby and then I would lay her down, and she would just drift off to sleep on her own, and wake up next time she needed to be fed, and it would be very simple.
But the baby slept best in bed with mom. Klugewicz is a breastfeeding coach and she says sleep schedules synch up much better for nursing when moms and babies sleep side-by-side. She's also convinced that co-sleeping is a good way to monitor an infant's needs.
At St. Christopher's Hospital for Children in Philadelphia doctors agree: There is something protective about having a mom nearby at night.
But the hospital follows recommendations from the American Academy of Pediatrics. Room sharing is encouraged, but not bed sharing.
In the St. Chris ER: It's really, really important to put the baby on his back to sleep. Not on the side, not on the belly or anything like that.
The hospital changed its policy a year and a half ago after several infant deaths. In each case, the baby was rushed to the ER, unconscious and not breathing. Kirsten Johnson Moore is the director of emergency nursing.
Kirsten Johnson Moore
In the St. Chris ER: So if you see on the picture you don't want to have any clutter in the crib, or anything, at all. And it really, really important that you have the mattress fit really, really well against the sides.
St. Chris stepped up its education efforts, and there's a new policy: When an infant is treated in the emergency room, the parents get a lesson in safe sleeping
Moore says stuffed toys and fluffy blankets can easily smother an infant. In adult beds, infants can get wedged between the headboard and the mattress. And she says sometimes, parents roll onto their babies.
Moore: You would think: 'I'll wake up. I'll hear them and I'll wake up.’ But you are really so sleep deprived as a new parent, that that's not always reasonable.
In Philadelphia many sudden and unexpected infant deaths are linked to unsafe sleeping environments, including bed sharing.
St. Chris pediatrician Eileen Tyrala:
Eileen Tyrala
But co-sleeping advocates say the push to bed babies separately discounts parents' ability to figure out what's best for their infant.
Anthropologist James McKenna directs The Mother-Baby Behavioral Sleep Laboratory at the University of Notre Dame.
McKenna: It dismisses the important responses parents are designed to give to their babies to make the babies happy and settle the baby that permit the baby and the parent to get more sleep.
McKenna says co-sleeping allows a mother to detect when an infant is in distress, but the academy of pediatrics says the evidence doesn't support claims that bed sharing lowers infant death risks.
Still, McKenna says there’s no better safety precaution than a mother’s hard-wired instincts.
McKenna: The biology is so powerful that unites both mothers and babies in the evening, especially at breastfeeding. That simply won't be stamped out by someone claiming that they know better than the mother and the baby.
Pediatrician Eileen Tyrala's message to moms is very different. She says an adult bed is a dangerous place for babies and the benefits of bed-sharing don't outweigh the risks.
Tyrala is backing state legislation to require all Pennsylvania birth centers to give new parents safe sleeping education. The bill floundered last session, but supporters are trying again.
More info:
Co-sleeping and bedsharing on WHYY's weekly online discussion, Digest This.
Only in a society where we have ample heating, and low chances of human or animal attackers, would a mother ever feel safe putting an infant to sleep in a separate room.
I think as a species we have conditioned ourselves to believe that our instincts take the backseat to the "experts".
Co-sleeping can be just as safe, if not safer than crib sleeping. Both require you to use common sense when providing a safe environment.
Mother's intuition is not something to ignore. I would suggest that parents safely practice the sleeping arrangements that work best for their own family.
THe important message here is that education is the key to making informed decisions. Cosleeping may be right for some and not for others. THe risks that are inherent in cribs or in cosleeping are not always known, and having an understanding through learning about the pros and cons of any sleep arrangement will result in better sleep, health and overall security for the family. We have a large section about sleeping on THe Baby CD and work everyday with OBs nationwide to help them educate new moms about all topics that can be a concern.
Tim Kelley
President
http://www.TheBabyCD.com
As a family practice physician and a mother of two, with three years of breastfeeding experience, I solved the problem of night feedings by having my baby next to my bed in a bassinet. I could just reach over when the baby woke up to nurse,and safely place the baby back in the bassinet to sleep when I was finished. By keeping diaper supplies nearby, I didn't even have to leave my bed to care for the baby, but my child slept in a safe environment. The only time I fell asleep while nursing, I awoke to find my husband rolling over onto my son, with a blanket covering my baby's face. He was fine, thankfully, but never again did I sleep with a baby in my bed.Babies are safest while sleeping in a safely constructed crib on their backs, with no pillows or puffy blankets or quilts. Snuggle with babies when they are awake, but keep them safe while they sleep. With a crib next to your bed, a baby is safe, but close at hand.
I was pretty hesitant at first to put my son, now 5 months in our bed because he'll never leave. I've been breastfeeding and it's so convenient to feed him because he falls back to sleep quicker. It's sad that my husband is a wild sleeper that I tell him to sleep in the other room. He doesn't mind because it keeps the house quiet and everyone is sleeping peaceful. I do think about SIDS, but I try my best to keep my son away from covers and blankets. Naturally I don't get much sleep so I check on him every often to see if he's okay. I am not a roll around sleeper because I stay on my side all night to get ready to feed him. I do LOVE the time I have with my son and I know he LOVES it too. I'm just concerned that he kicked my husband out of the bed for sure!!!
The questions from Connie above are really insightful. James McKenna's extensive work on this issue supports co-sleeping as do the practices of many mothers not just in the USA but all over the world. In many cultures, entire families share sleeping space, including newborns, with no harmful effects.
It's hard for me, as a scientist and as a nursing mother who sleeps with her seven month old, to entirely trust the American Academy of Pediatrics. As an organization, they tend to gloss over particulars and individual well-being in the name of "public health." Their stand on vaccines alone, in my view, undermines their credibility (does a newborn really need a Hep B shot on the first day of life, particularly when pregnant women receiving prenatal care are generally tested for it? Sure, it might work from a public health perspective but it is not necessarily beneficial to your individual infant or mine).
Yes, perhaps co-sleeping is likely not best for those who drink alcohol, use drugs, are morbidly obese, have sleep disorders, and so on…is anyone out there at these hospitals collecting real data on infant deaths and the particulars of that co-sleeping family? It seems doubtful…Too bad. And shame on hospitals and doctors for making blanket policies and programs to prevent co-sleeping that is based on faulty/incomplete data and what I view as pseudoscience.
You can click here to see video and more info from McKenna's Univ. of Notre Dame Sleep Lab: http://www.nd.edu/~jmckenn1/lab/faq.html
I am from West Africa living in the US and co sleeping is almost a requirement in our culture. This is the time for mom and baby to bond and for mom to get some sleep. I have a two year old who I breastfed. I too wanted to take the advice of the hospital and keep the baby in her basinet but I found that was exhausting having to get up and pick her up, breastfeed and put her back. Finally my mother who was here visiting from Africa told me to put her in bed with me, stick the breast in her mouth and get some sleep. The baby slept longer and so did I.
Daddy had to move to the floor so we could have more space. My mom said never in all her years of living in Africa had she ever heard about a mother smothering her baby while she slept. I could not imagine it either unless drugs or alchohol was involved. As tired as i was when my daughter was an infant I was checking her often to see if she was breathing or if she took a deep breath I was up checking her. And I went back to work immediately after having her so I was also tired from working all day and coming home to an infant who was still feeding every 2-3 hours. Rolling over my baby while i slept–hmmm, it's a difficult pill to swallow.
Am sure it has happened but I don't understand it.
I sympatize with all the mothers who have lost their little ones by SIDS. I think the fear they put in me at the hospital where I had my baby was probably the reason why i was so alert with her laying next to me.
The only downside of co sleeping is getting the little rascal out of your bed. My little one is almost two and getting her to sleep in her crib which by the way is in my room is next to impossible.
This was an interesting story. I had my baby at a birth center, and they encouraged co-sleeping. They discussed behaviors that make co-sleeping riskier; however, this story did not break out the statistics for deaths due to co-sleeping. I am wondering how many of the cases involved alcohol, smoking, a soft mattress, etc. Breaking out the statistics might help people to determine whether they can provide a safe enough environment to bring their babies into bed.
1) Are infant deaths reported at St. Christopher's nursing cosleeping babies or non-nursing cosleeping babies?
2) What are percentages of nursing v. not-nursing babies?
3) Is alcohol involved?
4) How does rest of world view this? What do their researchers say? (I know co-sleeping is much more acceptable in most other countries than USA.)
5) Should moms maybe be advised to get rid of headboards and put matress on floor? (What percentage of deaths are headboard v rollover?)
6) Is Dad the problem in rollovers?