Monday 7 March 2011

Attachment Parenting Series: Bedding close to baby

Welcome to our fourth installment of the Attachment Parenting Series - Bedding close to baby! Don't forget to use the Mister Linky at the bottom to share your own co-sleeping information and experiences!


What is it?

Bedding close to baby, more commonly known as "co-sleeping", involves the parent and child sleeping within close proximity to each other. Ideally, this will mean the parent and child are sleeping in the same bed; however, many of the same benefits can be achieved with the baby sleeping in a co-sleeper next to the bed or a crib in the same room.

How can we encourage it?

Co-sleeping allows the parent to respond to the baby's nighttime needs promptly and with minimal disruption to sleep. It is the normative practice of most parents worldwide and throughout history, designed for the safety and security of babies. Only within the past 200 years has the idea of leaving infants to sleep on their own in a separate room become popular practice in our society, and we have yet to fully understand the physiological and psychological consequences of this transition away from normal biological sleep habits.

There tend to be two primary objections to co-sleeping: First, that solitary sleep will encourage independence and autonomy in the child, and second, that co-sleeping is unsafe due to the risk of suffocation. The validity of both these assumptions will be examined below. Recognizing the benefits of co-sleeping and knowing how to co-sleep safely may help to encourage the acceptance of this practice in our own society.

Benefits

Not only is co-sleeping safe when done following common-sense guidelines, but it also brings with it many physiological and psychological benefits.

Co-sleeping encourages breastfeeding. Physical proximity means that the baby will nurse more frequently, thereby receiving greater immunological and caloric benefits, sustaining the mother's milk supply, and assisting in the suppression of the mother's ovulation. Co-sleeping makes breastfeeding easier for mothers as well, allowing them to breastfeed the baby with minimal sleep disruption. Breastfed babies will feed more often than formula-fed babies because of the composition of breastmilk (low in fat and protein compared to other mammals, providing fewer calories per feeding), making co-sleeping a particularly desirable arrangement for both mother and baby.

Co-sleeping, and bed-sharing in particular, regulates breathing, heart rate, and body temperature through skin contact and sleep interactions between parent and child. Babies who bed-share have higher oxygen levels and fewer episodes of sleep apnea. Co-sleeping reduces the risk of SIDS due to both physical proximity and the regulation of sleep patterns when bed-sharing. Solitary sleep encourages long stretches of deep sleep before the infant is physiologically ready for this. Because our society pushes babies to sleep through the night from very early ages, co-sleeping often requires a shift in mindset. Rather than viewing nightwaking as a problem, we must recognize it as a healthy and normal biological reality due to the composition of breastmilk and the danger of deep sleep in younger babies.

Co-sleeping increases the ability of the parent to respond if the child needs help. Whether medical- or trauma-related, co-sleeping gives parents the best opportunity to hear and intervene if their child is in distress. Bed-sharing in particular makes the parent keenly aware of the baby’s current state.

Co-sleeping decreases sleep disruptions in both parent and child. Because the mother is able to respond to her baby’s stirrings before they become cries, the baby will frequently breastfeed during the night without fully waking up. The comforting presence of the parent may allow the baby to pass through stages of light sleep without waking or to resettle himself if he does wake up. The mother, too, is able to remain partially asleep while tending to the child. Neither parent must rouse themselves fully to tend to the cries of a baby in another room.

Co-sleeping meets the child's emotional needs, providing them with the normal, safe environment that they are designed to expect. Separation anxiety and nighttime fears are reduced and replaced with the comforting and reassuring presence of a parent, allowing the baby to develop positive sleep associations. When co-sleeping, the child does not have to cry to rouse the parent. Because of the extra cortisol released during crying, research indicates that babies who sleep alone are more susceptible to stress disorders. Rather than becoming clingy, the child whose nighttime needs are met develops the trust and emotional security needed to grow into a confident independence. Parents may worry that if they allow their baby into their bed, the child will never want to leave; however, all children will eventually want their own space as they begin to individuate from their parents.

Co-sleeping promotes attachment by allowing the parent to become more finely aware of and responsive to her baby’s cues. It allows reconnection for the working parent. Co-sleeping is one more way to encourage connection between parent and child, making it easier to parent in a more natural and instinctive manner.

Safety

There is a definite fallacy in the assumption that when a baby dies in a crib, it is due to SIDS, but when a baby dies in an adult bed, it is due to asphyxiation. However inappropriate this misconstruction may be, it leads to an important distinction: Rather than questioning whether it is safe to sleep with a baby, parents should become educated on how to sleep with their baby safely.

Co-sleeping came under fire in 1999 when the U.S. Consumer Product Safety Commission (CPSC) released a warning against co-sleeping based on an eight-year study it had done on unintentional suffocation and strangulation in children under the age of two. The following media frenzy reported that 515 children had died in an adult bed over a period of 17 years. In a major conflict of interest, the subsequent campaign against co-sleeping was a joint effort between the CPSC and the Juvenile Product Manufactures Association (JPMA), an association of crib manufacturers.

Neither the media nor the CPSC/JPMA, however, reported the 2,700 infants who had died of SIDS (formerly known as “cot death”) in the final year of the study, nor the 34,000 total cases of SIDS that occurred during the time period covered by the study. Similarly misleading, no distinction was made between safe and unsafe co-sleeping practices in the children who had died in an adult bed (further external study, for instance, showed that 79 of those 515 deaths occurred on waterbeds, an unsafe sleeping surface for babies).

Just as they would when choosing a crib, parents must observe safety guidelines if they plan to co-sleep with their baby. A comprehensive list of these guidelines can be found here.

Transitions

More than just a decision about where your baby sleeps, co-sleeping requires a recognition of your family’s nighttime needs throughout the changing years. Different stages of the child’s development may call for different arrangements. The emphasis should be on being available to your child to meet his needs, just as you would during the day, rather than on adopting any one particular sleeping arrangement.

When a transition is needed, it should be done gently and with an understanding response to the child’s feelings. A familiar pre-bedtime routine may help to ease the transition. Young children are often comforted by the presence of a parent as they fall asleep in their own bed, growing out of this need when they are developmentally ready.

Parents may find that gradual steps are met with less resistance than moving a previously-co-sleeping child into his own room. If a bed-sharing arrangement is no longer working, a crib or toddler bed in the parents’ room or a mattress on the floor will move the child out of the main bed while providing the child with the continued reassuring presence of his parents. Alternatively, a child may begin the night in his own room with the understanding that he is welcome into the parents’ bed if he wakes up during the night.

What if it doesn't happen?

Parents may be unable or unwilling to co-sleep with their children. There are many alternatives to co-sleeping that will allow the parents to respond to their child’s nighttime needs and to be available to them during the night as they are during the day.

Try an alternative form of co-sleeping

If parents find that bed-sharing is an undesirable arrangement, there are other forms of co-sleeping that may be considered. A sidecar arrangement is one option, with a crib, bassinet, playpen or co-sleeper placed directly adjacent to the bed. This has many of the benefits of physical proximity while still providing the baby with his own surface to sleep on. A crib (or bassinet, playpen, etc) elsewhere in the room is also considered a form of co-sleeping, allowing the parents to respond more quickly and easily to the child’s nighttime needs. While the AAP does not endorse bed-sharing, they do recommend room-sharing for the first year of the child’s life.

Respond with sensitivity to nighttime needs

If it is decided that the baby will be sleeping in a separate room, parents must still be aware of the importance of being available to meet their child’s needs throughout the night. This may be more disruptive to the parent when the child is in a separate room, but accepting and respecting a baby’s needs remains an integral part of attachment parenting. (More next week on belief in the language value of your baby's cries.)

Increase touch during the day

Babies thrive on touch. Because solitary sleep reduces the amount of touch a baby receives, the parent who is unable or unwilling to co-sleep can make up for some of this lost touch during the day. Babywearing is one high-touch method of meeting this need while allowing the parent to go about their daily routine.

Our experiences

With our first child, our journey into co-sleeping (particularly bed-sharing) was an unexpected one. Although he slept with me during our two-night stay in the hospital, we placed him in a bassinet sidecarred to our bed when we brought him home. This allowed me easy access to him during the night while encouraging him to sleep in his own space. We had a crib set up in the next room and intended to move him there when he outgrew the bassinet.

This was fine for the first three months. He was sleeping throughout the night by the time he was a month old, waking up nearly frantic with hunger. Looking back, I recognize that bed-sharing would have encouraged him to nurse more often during the night, but at the time I was content to leave a sleeping child be so long as he was growing fine (and he was).

But at three months, as those babies who sleep through the night early are prone to do, he began to wake up during the night – at first just once or twice, but then more and more until at one point he was waking up every single hour all night long. I was exhausted, but each time he needed to be fed I would wake up, turn on the lamp, sit up, feed him, lay him back down in the bassinet, turn off the light, and go back to sleep.

One night, however, I woke up in a panic because I didn’t remember laying the baby back down after I had last fed him. Convinced I had dropped him on the floor, I searched the area until finally noticing him sound asleep in his bassinet. I was both relieved that he was safe and terrified that my exhaustion was going to cause me to fall asleep and drop him during a feeding.

From that night on, he slept in our bed. When he woke up to eat, I was able to latch him on and fall back asleep. Although his sleeping didn’t improve again until he was a year old, bed-sharing meant that I was able to get far more sleep than I had been getting previously. I also discovered that having him next to me felt far more natural and right than when he had been sleeping on a separate surface.

When I was pregnant with our second child, I began to transition him into his own bed. I would nurse him as usual, then sit next to his bed until he fell asleep. When he woke during the night, he was welcome to join us in our bed. Eventually we transitioned away from that as well, providing him with a pallet and blanket on the floor for when he came into our room in the middle of the night. Now three years old, he puts himself to sleep at bedtime and continues to make use of the pallet most nights, an arrangement we are all happy with.

When our second child was born, I had the bassinet beside the bed, ready and waiting. I reluctantly placed him in there that first night. Five minutes later, I pulled him back out and tucked him against me, and we both peacefully fell asleep.

Although he didn’t sleep through the night as early as his brother did, he was a far better sleeper in the long run. We continued to put him to sleep in our bed for the next fourteen months, only recently moving him in with his older brother. Like his brother, he joins us in our room when he wakes up during the night.

We are happy with our co-sleeping arrangements and intend to continue this pattern of bed-sharing from birth, transitioning to starting the night in their own bed when they are ready, and moving them to a pallet on the floor when necessary. The pallet will remain available to them for as long as it is needed.

Summary

Sleeping with your baby during the night and carrying him throughout the day is the most natural way to meets the baby's physiological and psychological needs. It allows the parent to respond quickly to the baby's cues with minimal disruption to sleep.

Co-sleeping encourages frequent breastfeeding. It has numerous physiological benefits, including the regulation of infant breathing, heart rate, body temperature, and sleep patterns and a reduced risk of SIDS. It increases the ability of the parent to hear and intervene if the child is in distress. Both parent and child experience fewer sleep disruptions when co-sleeping. Co-sleeping has psychological benefits as well, allowing the parent to better meet the child's emotional and nighttime needs, resulting in the trust and security a child needs to grow into a confident independence. It promotes attachment between parent and child and allow reconnection for the working parent.

Despite warnings against placing a baby in an adult bed, statistics reveal that when common-sense safety guidelines are followed, co-sleeping is safer than placing a child to sleep in a crib in a separate room.

Nighttime sleep arrangements should remain flexible in order to meet the changing needs of both parent and child. Necessary transitions should be undertaken in a gentle and responsive manner. A gradual approach is often a good first step when moving a child out of the adult bed.

If parents are unable or unwilling to bed-share, they may wish to consider other forms of co-sleeping such as side-carring or room-sharing. If they do choose a solitary sleep arrangement for their baby, it remains important that they be available to meet the nighttime needs of their baby. Parents can emphasize a high-touch relationship with their baby during the day in order to make up for the decreased amount of touch a baby receives when sleeping alone.

Parents should be assured that choosing to welcome your baby into your bed is not spoiling him or allowing him to manipulate you. Rather, co-sleeping is the normative practice worldwide and throughout history, biologically intended for the baby's safety and security. Regardless of the chosen sleep arrangements, being aware of and responsive to the child's nighttime needs will help to promote connection and attachment between parent and child.


Recommended Reading:

Co-sleeping Information by Dr. Sears
Articles on Co-sleeping at The Natural Child Project
Sleeping with Your Baby: A Parent's Guide to Cosleeping by James McKenna, Ph.D.
Good Nights: The Happy Parents' Guide to the Family Bed (and a Peaceful Night's Sleep) by Jay Gordon, M.D.


Now it's your turn! Add your link using the Mister Linky below to share your thoughts, experiences, resources, or struggles as they relate to bedding close to baby. I look forward to reading them! See you next Monday for our fifth installment - Belief in the language value of your baby's cry!


9 comments:

  1. Hey! I've been loving your series. I grew up in CIO family and I just couldn't stomache it. My first baby I went the route you did, and she was a great sleeper, only waking up a few times a night, so it worked fine. My second baby changed everything though, so even though I swore no baby would ever sleep in my bed, that was where she ended up. And to my suprise, I ended up loving it! My third slept peacefully in our bed until she started needing her space at about a year old when we put her into a crib in our room. And I'm looking forward to a new little friend in our bed this spring. I linked something wrote about sleep, not really about co-sleeping, but it's related.
    It's strange how many of the commentors on my post jumped at the chance to reccomend sleep schedules and CIO. : )

    ReplyDelete
  2. Until I had my baby I had never heard of, nor considered co-sleeping. When he outgrew his sidecar bassinet, I started becoming very anxious about putting him in the crib in another room. After reading many articles (like yours) I became aware of bedsharing as an option. Thanks for putting this out there! My son in now 10 months old and still breastfeeds throughout the night. I am away from him all day at work and don't know what I would do without our time, so close together, at night.

    ReplyDelete
  3. This was such a great entry! I bookmarked the sleep safety list so thank you for that!

    I've always planned on having my babies in the bed, because we were in my parents bed. I always thought it was normal!

    My husband was concerned more about not realizing our baby was between us so we are going to use a co-sleeper until our little girl is bigger than she is just going to sleep in the bed rather than having her own space attached to the bed.

    I just can't imagine my baby sleeping in another room without me. It gives me anxiety just thinking about it!

    ReplyDelete
  4. Our co-sleeping was accidental as well. Due to the c-section I was barely able to get up and down out of a chair, let alone out of bed to get a baby out of a crib! We started out the first several days sleeping in the recliner, with him in my arms in the boppy so he couldn't fall, nursing. He would wake up, I'd switch him to the other breast, and we would both fall back asleep. Once I was feeling better, I still didn't feel great and getting in and out of bed was still an issue, so he came to bed with me. I'd never meant for it to happen that way, but it did, and it stuck, and I'm glad for it.

    Our current arrangement is that if he wakes in the night and yells for me, I move to his room, where he has a double bed, and sleep with him the rest of the night; Daddy is a light sleeper, so this works best for us for him to be able to sleep.

    In discussing trying for #2 and finding out that the adjustable-rail style crib we had for Raiden has now been totally recalled, I've been asking if we even need to buy a crib for #2, or just figure out how to fit myself, Raiden and a baby in his double bed safely. (So far, we're undecided. Maybe you should write something on a family-bed, too ;).)

    ReplyDelete
  5. Thank you so much for this. I came a bit late to the AP party, or so I thought. Our babies ended up in our bed pretty much every night. We had a crib in our room (only about a foot from the bed) and they stayed in our room until at least age 2 (26 mo, 36 mo, & 4 years.) Looks like maybe I was doing something wrong after all.

    ReplyDelete
  6. Young Mom, I loved your post about recognizing your own need for sleep. Such an important point. The phrase "sleep anorexic" made me giggle, but how true! We can't do it all at the expense of our need for sleep.

    This Is Us, excellent point on the portability of bed-sharing!

    Karyn, we didn't own a crib for our second child either. It would be a bit more of a juggling act to have a family bed in the kids' room, since you couldn't have the two of them in the same bed alone...hmm, interesting. Maybe a co-sleeper for the baby next to the double bed in Raiden's room? I'm personally still dreaming of a king size family bed for our crew, preferably on the floor, but it's a no go with my husband so far. ;)

    Staci, I hope you meant that it looks like you were doing something right after all! It's wonderful that you had your children in your room even before you consciously chose attachment parenting.

    ReplyDelete
  7. I love co-sleeping. Most nights my girls start in their own room and usually Rylee comes to my bed halfway through the night. Sometimes we all still sleep in my bed though. It really just depends on what is going on. Sometimes, Emma (8) still just wants to sleep with me because she wants to be close to me. We plan to continue co-sleeping with any future kids we might have. I'm really happy that Josh is an advocate for co-sleeping too :)

    ReplyDelete
  8. I'm new to your blog & LOVE it! I'm late to the game on this, but....

    I never knew I was an attachment parent until I got pregnant and my inner-hippie was born. My pre-hippie self was known to say: no child ever died from crying to sleep; and no babies in MY bed!; and other nonsense.

    Once my son was born, he had some health issues (he's all fixed & crazy healthy now), and we were so darn glad to have him home that the only place we could imagine him being was right there next to us. We were scared because he was so tiny that he ended up in a bassinet next to me, but once he was big & strong enough to nurse side-lying, he was in bed all the time! I needed to sleep, he needed to eat, it worked so well.

    Now he spends most nights in his crib. He's an active sleeper & was keeping everyone up. He still ends up in bed next to me, though, when I don't feel like being up for the day at 5:30! I know I can get at least another hour out of him if he's dozing on the breast =) Plus, it's good snuggle time & good for both of us.

    I'm SO glad I educated myself with the biology & mechanics of successful breastfeeding, and I never had any expectation of "sleeping thru the night." I had to consciously decide that a long breastfeeding relationship was more important than a few hours of sleep.

    I get a lot of strange looks from my family & friends for having done things so differently, but I know I've done right by my son & my family.

    ReplyDelete
  9. Ashley, I can so relate. It wasn't until halfway through my pregnancy with my first that I started shifting from "kids just need more tough love!" to a more natural, instinctive, and gentle parenting approach. I'm so glad your little guy is healthy now and that you found your way to attachment parenthood!

    ReplyDelete