Babies and safe co-sleeping

Sleep near the parents – in the same room – during the first months of the baby’s life enforces breastfeeding, and protects against Sudden Infant Death Syndrome (SIDS), the most frequent cause of infant death. For this reason, the AmericanAcademy of Pediatrics recommends that the newborn should sleep in its parents’ room.

Co-sleeping is when the baby sleeps in the bed of parents. It is a common practice, which health professionals used to discourage until recently. More recent studies, however, show that sleeping with the mother helps with the continuation of exclusive breastfeeding, and is not associated with SIDS, if certain safety rules are observed. So, sleeping in the mother’s bed is no more risky than other choices, if parents observe certain safety rules;

1. They should not smoke. There is proof of an association between sleeping with smoker parents and SIDS, but not for nonsmoker parents.

2. They should not drink alcohol in quantities or frequently (more than one – two drinks per week).

3. They should not use sedatives, like antihistamines, anti-stress medicine etc.

4. They should not take illegal drugs.

5. The mother should not be overly tired, with reduced reactions.

6. The mother should breastfeed. A baby who is fed with a bottle should not sleep with its mother. It has been found that mothers, who don’t breastfeed, sleep with their back to the child, and react much less to its needs during the night. To the contrary, a breastfeeding mother usually sleeps at a position that protects the child, and turns towards the child frequently in her sleep, in order to feed it in a reclining position. Breastfeeding protects from SIDS.

7. The baby should not have been born prematurely or underweight.

8. The baby should not have a fever or an acute disease.

9. A wide adult bed should be used, instead of a couch or an armchair.

10. The room should not be very cold. There shouldn’t be need for a heavy cover that could extremely warm the baby.

11. The room should not be extremely hot. A temperature of 18-22 degrees Celsius is ideal.

12. The baby should not wear too many clothes – not more than the ones the parents wear.

13. The baby should be placed on its back, in the middle of the bed, between the parents, or with pillows at the edges, so that it doesn’t fall off the bed.

14. There should be no pillow at the back of the child.

15. The bed’s mattress should not be soft or sinking.

16. There should be no dangerous gaps between the bed and the mattress, where the child can get trapped.

17. The baby should never be covered above the neck. Covers should be attached at the foot bed.

18. The baby should be covered with a light infant blanket or a sleeping bag. Studies have shown that babies who sleep with their parents experience warmer conditions as compared to those who sleep separately. However, babies who sleep with their mother can maintain adequate thermoregulation, thus succeeding in having a smooth body temperature throughout the night.

19. No other child or pet should sleep in the same bed.

20. They should not leave a bigger baby alone on an adult’s bed.

Finally, there is recently internationally research interest for the practice of co-bedding. According to it, the baby sleeps in its own crib, but this is located next to the parents’ bed, to the height of the head. The baby’s crib is surrounded by railings, except for the side towards the mother’s bed, which has no railing, so that it is in continuation with the mattress of the parents. This way, parents and child have their own space, but at the same time sleep together, so that in case the baby wants to breastfeed or wakes up, the mother can easily respond appropriately by bringing it close to her without having to get up.

Stelios Papaventsis MRCPCH DCH IBCLC 2011

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