By Sarah Hagger-Holt

17th July 2012

Sarah Hagger-Holt looks at the benefits of co-sleeping and questions why it’s demonised in the media

By Sarah Hagger-Holt

17th July 2012

By Sarah Hagger-Holt

17th July 2012

I sat and listened as the nurse went through the discharge checklist. I’d been in hospital for two days after the natural birth I had hoped for ended in a last minute forceps delivery. I was tired, emotional and desperate to get my precious new daughter home.
The nurse ran through the pelvic floor exercises and breast-feeding support groups, then started on co-sleeping: how dangerous it was, how it increased the risk of cot death, how the safest place for our baby was a crib in our room, how you must always place your baby back in her cot after feeding. I stayed silent, feeling like a criminal.

I didn’t explain that we’d just bought a bigger bed and some foam sides to prevent anyone rolling out. Or that after many sleepless, tearful nights with our older daughter, we had finally worked out that taking her into our bed meant that everyone woke up much more rested and able to cope with the day. Co-sleeping right from the start felt like something that was at least worth a try.

Eighteen months later, our younger daughter still spends at least some of each night in our bed. She feeds, she goes to sleep, I go to sleep. We are careful not to cover her in duvets, we don’t smoke, we don’t sleep on a sofa – and we recommend this plan to friends: don’t buy a cot, buy a family bed! Our older daughter joins us when she chooses to – no more than once a month or so – although then it is a little bit of a squeeze.

The Moses basket stayed by the side of the bed, gradually filling up with our older daughter’s toys. And I stopped feeling like a criminal – except when the health visitor came round when we dusted down the Moses basket and cleared out the toys.

Once upon a time…
Then I saw a poster on a noticeboard in my local town centre. You may have seen one like it. Across a mock-up of a book of fairy stories is written: “Once upon a time I was with my mummy. She fed me and we both fell asleep together. I didn’t wake up. The end.” I nearly dropped my shopping bags. Hold on a minute, co-sleeping equals death? Really? It was time to investigate.

Start to look at the evidence on co-sleeping and you will find a few things that everyone agrees on, such as the risk of co-sleeping if you smoke, drink or take drugs. But you will also find that in many areas much is still up for debate.
Paediatrician Carlos Gonsalez writes about, what he describes as, the ‘myths of co-sleeping’ in his recent book about how to raise children with love. After running through the different studies from across the world that have been done in this area, he concludes: “It is curious the way that new discoveries are accepted or rejected depending on whether or not they coincide with pre-existing beliefs. Many experts are quick to remind the mother of the alleged dangers of co-sleeping, while failing to explain that if she is a non-smoker the majority of studies have found no danger whatsoever. Yet very few remember that it is far more dangerous for a baby to sleep in a separate room during the first few months.”

Stigma and silence
Francine Bates, Chief executive of the Foundation for the Study of Infant Deaths (FSID) who are responsible for the advert that so shocked me, admits they have received complaints about it, although she does not mention any plans to withdraw it. “It has been criticised by some,” she says, “who see it as a universal ‘don’t bed-share’ message. We all know that high-risk behaviour with regard to co-sleeping – like smoking, drinking or sleeping with your baby on a sofa – is dangerous, but it is difficult to get that message out without stigmatising people. This is a more generic message.”

However, the problem with this kind of message is that it does ends up stigmatising people. It stigmatises and silences those who choose to co-sleep, whether because they enjoy the benefits of easier breastfeeding and greater attachment or the joy of waking up to cuddles and baby babble (and sometimes a small child experimentally pulling your hair or sticking a finger up your nose).

Co-sleeping benefits
By contrast, the National Childbirth Trust (NCT) does support parents who choose to co-sleep with their babies. They explain that “sleeping in close proximity has many advantages for babies and for parents. The baby is able to breastfeed without disturbing the mother and is soothed by the presence of a parent. As a result, the baby is likely to cry less enabling the parents to get more sleep.”
Another benefit is that co-sleeping babies tend to sleep less deeply, and parents are more aware of their sleeping babies, both factors that decrease risk of cot death. Yet despite the benefits, the stigma remains. Among the pages of The Green Parent, sleeping alongside your baby may be discussed and accepted, but where else?

Complex reality
What worries me about this advert is that it is not the first time that a simplistic ‘no co-sleeping’ message has misrepresented the more complex reality. A 2009 Bristol University study which found links between bed-sharing, drinking, drugs is quoted by FSID, the Department of Health and others as strong evidence of the dangers of bed-sharing. Yet, even one of the study’s authors, Professor Peter Fleming, disagrees with the way in which the report was represented in the media.
Days after the report’s publication he said, “My view is that the positive message of this study is that it says don’t drink or take drugs and don’t smoke, particularly for breastfeeding mothers. We did not find any increased risk from bed-sharing.” The study showed that approximately half the deaths occurred while babies slept with their parents, and half the deaths occurred while babies were alone in their cots and Professor Fleming went on to say: “I don’t see anybody saying, ‘Don’t put your baby in a cot.’”
Co-sleeping is an age-old and common practice. It was a fact of life, not a matter of choice, when families all slept in one room. Even today, when it is frowned upon by some health professionals and a whole industry exists to sell cots and decorate nurseries, an NCT research review reports that almost half of all parents say that have shared a bed with their baby at some point. In some countries, such as Japan, a very high rate of co-sleeping and a very low rate of Sudden Infant Death Syndrome are both the norm.
I asked Francine Bates about how FSID develops culturally appropriate messaging on co-sleeping, when it is a normal and safe practice for people from East Asian backgrounds, including those living in the UK. Instead, she gave me a list of the cultural factors why co-sleeping is safer among these families rather than any others: women tend not to smoke or drink, they are more likely to breastfeed, beds are lower and harder and so on. It’s a list which fails to convince me of the dangers of bed-sharing in itself, and instead offers great reassurance that in fact bed-sharing is as safe – or more so – than any other sleeping arrangement. It’s all about how you co-sleep, not whether or not you do. That’s the message we need to be getting out.

Weighing up the risks
She also told me that their focus groups show that parents, especially young parents, another higher risk group, resent being lectured on what to do. Yet this seems in direct contradiction with so many of the messages we hear – from health visitors, social workers, mass media and advertising – which constantly tell us as parents exactly what we should do – and if we don’t listen we are putting our children at risk.
“Co-sleeping is not a risk-free behaviour, that’s what we’re saying,” insists Francine Bates. “But I wouldn’t say it was unsafe. After all, the vast majority of parents who co-sleep with their babies do it safely, there is no vast number of deaths. But a percentage of cot deaths do occur in families where there are no other risks.”
Nothing is risk-free. Imagine a campaign for safer driving, where instead of targeting drivers who drink or take drugs, all drivers are advised to throw their car keys away and stop driving. It isn’t going to happen. Our society sees the benefits of driving – a far riskier behaviour than co-sleeping – as outweighing the risks. We all want to see cot death reduced, we all to ensure our babies sleep safely and securely, but as parents we also have to be able to weigh up the risks and benefits for ourselves.

Messages and myths
I’m concerned that some of the messages and myths around co-sleeping prevent the benefits being heard and the debate being had. Parents who end up co-sleeping, regularly or occasionally, because it works for them and their children, are left feeling guilty that they are putting their child at risk. I would be very interested to hear from other Green Parent readers about the support – or lack of it – they have received when revealing a decision to co-sleep.
Some people find co-sleeping a beautiful, natural way to bond with their baby; for others it is simply the only way to get a good night’s sleep. Some intend to co-sleep from the start, others take a while to get started, embracing it gladly only once their baby gets older or their second or third child is born. Babies will also show their parents what they prefer, whether to be snuggled in close, or stretched out in a separate cot. I believe we have to keep on talking openly and honestly about our own experiences, sharing the risks and the benefits as we encounter them. And as long as we are acting in our babies’ best interests, there are many different ways to sleep easy.

What parents say
”I never had the intention of co-sleeping but always ended up doing it, they slept better, I could nap/feed and we all got a better night.” Victoria, mum of three, Bedfordshire

“I have a three-week-old daughter and I do not co-sleep with her. I am too scared I will roll over on her and suffocate her or hurt her.” Susan, British first-time mum, living in the USA

“We co-slept with our daughter on and off from the start when she wasn’t settling, then decided to give full-time co-sleeping a go after reading about the benefits. She still comes in with us if she’s having trouble sleeping, but asks to go back to her cot sometimes. We would definitely do it again.” Lorna, mum of one, Macclesfield

“I co-slept properly with my third, I still do for part of the night and think it’s wonderful. With the older two I didn’t, though did spend much of the night asleep in a chair with them on my knee. I wish I’d known then what I know now – co-sleeping would have been a much better choice.” Helen, mum of three, West Sussex

“I co-slept with my daughter from the very first night in hospital, and continued when we got home – I wanted to be close to her, and it was easier for night-time breast feeding. We never used a cot. We only settled her into her own room around the age of three. She now settles happily there.” Felicity, London

Find out more
Foundation for the Study of Infant Deaths (FSID): www.fsid.org.uk
Kiss me! How to raise your children with love by Carlos Gonzalez
Three in a bed by Deborah Jackson
www.guardian.co.uk/lifeandstyle/2009/oct/16/sudden-infant-death-syndrome-children
National Childbirth Trust co-sleeping research review: www.nct.org.uk/sites/default/files/related_documents/2009-Ed48-Bed-sharingandco-sleeping.pdf

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