Family Forum / Pregnancy / Breastfeeding / February 2004

OMG! I have no idea how to help you there. I can't imagine it would be
possible to have that come through. What, are they going around to
every country in the world where this is the norm and taking all those
babies away? Where do you live? What a shock!
Marie

Posting again...
It occured to me that everytime I have seen someone argue against
cosleeping because of the risk of SIDS, they start mentioning
suffocating, getting caught between mattress and wall, etc. It's not
about SIDS, it's always about death from accidents.
Not that that is any help either but since there's no evidence that
cosleeping causes SIDS they usually use that other stuff so I'd look
out for it.
Here are some articles I found:
http://www.nichd.nih.gov/publications/pubs/sidsfact.htm
"Recently, scientific studies have demonstrated that bedsharing,
between mother and baby, can alter sleep patterns of the mother and
baby.  These studies have led to speculation that bedsharing,
sometimes referred to as co-sleeping, may also reduce the risk of
SIDS.  While bedsharing may have certain benefits (such as encouraging
breast feeding), there are not scientific studies demonstrating that
bedsharing reduces SIDS.  Some studies actually suggest that
bedsharing, under certain conditions, may increase the risk of SIDS.
If mothers choose to sleep in the same beds with their babies, care
should be taken to avoid using soft sleep surfaces.  Quilts, blankets,
pillows, comforters, or other similar soft materials should not be
placed under the baby.  The bedsharer should not smoke or use
substances such as alcohol or drugs which may impair arousal.  It is
also important to be aware that unlike cribs, which are designed to
meet safety standards for infants, adult beds are not so designed and
may carry a risk of accidental entrapment and suffocation."
"There is some evidence to suggest that breast feeding might reduce
the risk of SIDS.  A few studies have found SIDS to be less common in
infants who have been breast fed.  This may be because breast milk can
provide protection from some infections that can trigger sudden death
in infants."
http://www.theage.com.au/articles/2003/12/27/1072308726011.html?from=storyrhs
"Research indicated that babies sleeping in the same room as a
committed caregiver were half as likely to die of sudden infant death
syndrome as a baby sleeping alone in a room, he said.
Babies who shared beds had fewer and shorter apnoeas, or suspensions
of respiration, in the deepest stages of sleep than those who slept
alone."
http://www.nd.edu/~prinfo/news/2002/9-10z.html
"In Japan, which has the lowest rates of infant mortality and SIDS,
about 90% of parents sleep with their babies."

There is an anthropologist (I think that's what she is) and I think
her name is Karen Dettweiler? I couldn't find anything on her so I
must be wrong, but she has said when mother and baby sleep together,
their breathing patterns synchronizes.

I hope some of this might help.
Marie

You want the research of James McKenna, which is written about extensively by
Meredith Small in the book _Our Babies, Ourselves_ (there is a chapter
specifically about sleep).  Unfortunately, I have no idea how to go about
finding actual abstracts or the like on the 'net, but perhaps someone here
does.  But go get the Small book and use her annotations.

If "reputable sources" for your purposes includes pretty much anything written
by a pediatrician ;-) then you can use Dr. Sears and Dr. Jay Gordon.  Both have
websites that may be useful.  (Don't recall the address of Gordon's, but Sears
is www.askdrsears.com)

Should you be confronted with stories of cosleeping babies' deaths, remember
that in almost all reports it turns out that the baby died not of SIDS but of
suffocation, that the adult involved was drunk or drugged, and that the baby
was sleeping on a couch or other unsafe place rather than in an actual bed.  If
you look for those elements in any evidence that the proponents of this
nonsense have, you will probably find them.

Holly
Mom to Camden, 3yo
EDD #2 6/8/04

It is all a matter of cultural perspective.  In some cultures NOT cosleeping
is considered "child-abuse"  so...they need to work on promoting SAFE
co-sleeping practices, not ethnocentric rules/laws!

"Yet in the majority of cultures in the world (and in Western cultures until
perhaps 200 years ago), babies sleep in the same bed with their parents,
typically until they are weaned, a pattern often called cosleeping.  Such an
arrangement has many supportive reasons, including lack of alternative space
for the infant to sleep in some cases.  More often, cosleeping seems to
reflect a basic collectivist value, one in which contact and interdependence
rather than separateness are emphasized (Harker & Super, 1995).  Morelli and
her colleagues (1992) report that the Mayan mothers they interviewed, most
of whom practice cosleeping, considered the U.S. practice of separate
sleeping as tantamount to child neglect.  They are shocked and disbelieving
when told that U.S. infants often sleep in a separate room, with no one
nearby.
   Morelli also reports that bedtime among the Mayan families she studied
was rarely a time of discord or difficulty between parent and child, as it
so often is in Western families in which infants and toddlers sleep
separately from the adults.  Mayan children also rarely used stuffed animals
or other "transitional objects" to comfort themselves as they fell asleep,
while this is common among Western infants and toddlers.  Thus, the cultural
assumptions affect not only what we consider "normal" and "right" for
children; they shape the interaction between parent and child, including the
nature of their common disputes or struggles."  (From TextBook: The
Developing Child-Helen Bee)

Where in the name of God do you live?
My personal opinion "f.ck them", pardon my language.
If that's the case, lets report parents who drink even in small
amounts
smoke, take cough medicine, cook their eggs runny, feed their kids
beef
because SOMETIMES kids die from these things.
Sheesh

One of the posters mentioned culture factor for cosleeping. In my case
I'm having to cosleep because that's the ONLY way my dd will go to
sleep. I tried every trick there is to make her sleep in the crib but
she just won't. For some moms like me, cosleeping is not a choice,
it's the only option. I love her dearly but honestly, I would've been
lot happier if she sleeps in the crib but she doesn't. The minute I
move an inch away from her, she wakes up no matter what time of the
night it is. I take all precautions to avoid SIDS but there's no way I
can do without cosleeping.

Hope these help if not exactly what you need:

http://www.mothering.com/editorials/editorial113.shtml

Also some info on this page

http://www.mothering.com/action-alerts/index.shtml

I think there is a more in depth Mothering article but I can't find it.

-- Dagny

From the perspective of a co-sleeping mama who loves it, unfortunately
I can't.  You can quote James McKenna, who shows that co-sleeping
babies' breathing is more in sync with their moms and attempt to
extrapolate that therefore SIDS rates will be lower.  You can quote
Dr. Sears, whose research standards are, shall we say, very much his
own.  But you can't find hard data that supports the idea that
co-sleeping is protective against SIDS.  So far all the hard data
shows the opposite.

Though moms and babies probably are evolved to sleep together, this
evolution didn't take place in the context of foam or innerspring
mattresses and pillows and blankets for warmth.  Probably the safest
sleeping arrangement is mom and baby on a straw mat in a tropical
climate where no more than a light blanket is needed.  At the same
time, making it a hotlineable offense is plain silly.  Either those
proposing it are doing so as a publicity stunt or they're not too
bright.

Kate
and the Bug, 8 months

Forget the research issue - what about invasion of one's privacy? Like
another poster suggested, then people should be reported for smoking in
the house of an infant.

Contact the ACLU

Jeanne

Sounds like a urban legend to me.

I asked this question months ago.  At the time no one could find a
recent
peer reviewed study which compared night time death rates in
co-sleepers
vs. crib sleepers, and found lower rates for the co-sleepers.  One
woman
claimed she would find the studies, but that was three months ago, and
she
has never posted any.

On the other hand, finding studies showing that co-sleeping is MORE
dangerous is easy.  There are lots:
                                                                     
      |
Co-Sleeping Safety Data (Update 3: Jan 22, 2004)

This is a annotated bibliography covering the safety of co-sleeping
with
infants.  I have included EVERY study, which I can find an on-line
abstract
(or the entire paper is on line) in English, which meets the following
criteria:
  1. The research was published in 2000 or later.
  2. The research was peer reviewed.
  3. The research focused on actual death rates (not suspected causes
or
     mechanisms).
  4. The research compared death rates for co-sleepers vs.
non-co-sleepers.
  5. The research was done in developed (not third world) countries.
This bibliography does NOT include editorials, opinion pieces, or
letters to
the editor.  The main sources for these abstracts are PubMed, SCIRUS,
and web
archives of medical journals.  If you find any other studies, please
tell me,
so I can add them.

Summary: of the nine studies found, seven found co-sleeping to be more
dangerous
than cot sleeping, and two studies found no added danger from
co-sleeping.  No
study found co-sleeping safer than cot sleeping.  Not one.  Some of
the studies
focused on SIDS, some focused on suffocation, some covered both.  

Quotes from the Research:

"The most conservative estimate showed that the risk of
suffocation increased by 20-fold when infants were placed to sleep in
adult
beds rather than in cribs. The public should be clearly informed of
the
attendant risks." [SCHE03]

"Almost all SIDS deaths in Alaska occurred in association with prone
sleeping,
bed sharing, or sleeping outside a crib." [GESS01]

"bed sharing showed an increased risk of dying accidentally, when
compared
with infants sleeping in designated infant containers" [BEAL00]

"Bed-sharing appears to increase the proportion of unexplained deaths,
regardless of the position of the infant." [THOG00]

The Papers:

[BEAL00]
Sudden infant death syndrome in South Australia 1968-97. Part 3: is
bed sharing
safe for infants?
Beal SM, Byard RW
J Paediatr Child Health 2000 Dec 36:552-4
http://reviews.bmn.com/medline/search/record?uid=MDLN.21012639&refer=scirus
   "bed sharing showed an increased risk of dying accidentally, when
compared
    with infants sleeping in designated infant containers"

[CARP04]
Sudden unexplained infant death in 20 regions in Europe: case control
study
R G Carpenter, L M Irgens, P S Blair, P D England, P Fleming, J Huber,
G Jorch, P Schreuder
Lancet 2004; 363: 185-91
http://www.thelancet.com
   "For mothers who did not smoke during pregnancy, OR for
bed-sharing was
    very small (at 2 weeks 2·4 [1·2-4·6]) and only significant during
the
    first 8 weeks of life."
 One way to phrase this in a one sentence headline is:
    Co-sleeping with children under 2 months old was a significant
    risk factor for SIDS.

[CARR01]
Sudden Infant Death Syndrome, Bedsharing, Parental Weight, and Age at
Death
Cindie Carroll-Pankhurst and Edward A. Mortimer Jr
PEDIATRICS Vol. 107 No. 3 March 2001, pp. 530-536
http://pediatrics.aappublications.org/cgi/content/abstract/107/3/530?maxtoshow=&
HITS=10&hits=10&RESULTFORMAT=&fulltext=co-sleeping&searchid=1068846875876_9946&s
tored_search=&FIRSTINDEX=0&sortspec=date&resourcetype=1&journalcode=pediatrics
   "By demonstrating that among an urban population at high risk for
SIDS,
    bedsharing is strongly associated with a younger age at death,
independent
    of any other factors, this study provides evidence of a
relationship
    between some SIDS-like deaths and parent-infant bedsharing,
particularly
    if the parent is large."

[FERN03]
Sleep Environment and the Risk of Sudden Infant Death Syndrome in an
Urban
Population: The Chicago Infant Mortality Study
Fern R. Hauck, Stanislaw M. Herman, Mark Donovan, Solomon Iyasu,
Cathryn Merrick
Moore, Edmund Donoghue, Robert H. Kirschner, and Marian Willinger
Pediatrics 2003; 111: 1207-1214
http://pediatrics.aappublications.org/cgi/content/abstract/111/5/S1/1207
   "Several factors related to the sleep environment during last
sleep were
    associated with higher risk of SIDS: ... bed sharing overall (OR:
2.7;
    95% CI: 1.8–4.2), bed sharing with parent(s) alone (OR: 1.9; 95%
CI:
    1.2–3.1), and bed sharing in other combinations (OR: 5.4; 95% CI:
2.8–10.2)"
   
[GESS01]
Association between sudden infant death syndrome and prone sleep
position,
bed sharing,  and sleeping outside an infant crib in Alaska.
Gessner BD, Ives GC, Perham-Hester KA.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1
1581445&dopt=Abstract
   "Almost all SIDS deaths in Alaska occurred in association with
prone
    sleeping, bed sharing, or sleeping outside a crib."

[IYAS03]
Risk factors for sudden infant death syndrome among northern plains
Indians.
Iyasu S, Randall LL, Welty TK, Hsia J, Kinney HC, Mandell F, McClain
M, Randall
B, Habbe D, Wilson H, Willinger M. JAMA. 2002 Dec 4;288(21):2717-23.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1
2460095&dopt=Abstract
   Found that infants who died were more likely to co-sleep (59.4%
vs.
   55.4%), but this relation was not statistically significant.

[SCHE03]
Where Should Infants Sleep? A Comparison of Risk for Suffocation of
Infants Sleeping in Cribs,
Adult Beds, and Other Sleeping Locations
N. J. Scheers, PhD, George W. Rutherford, MS and James S. Kemp, MD
PEDIATRICS Vol. 112 No. 4 October 2003, pp. 883-889
http://pediatrics.aappublications.org/cgi/content/abstract/112/4/883?maxtoshow=&
HITS=10&hits=10&RESULTFORMAT=&searchid=1068833062184_5846&stored_search=&FIRSTIN
DEX=10&minscore=5000&journalcode=pediatrics
   "Reported deaths of infants who suffocated on sleep surfaces other
    than those designed for infants are increasing. The most
conservative
    estimate showed that the risk of suffocation increased by 20-fold
when
    infants were placed to sleep in adult beds rather than in cribs.
The
    public should be clearly informed of the attendant risks."

[THOG00]
Sleep position and bed-sharing in sudden infant deaths: An examination
of
autopsy findings
Jon R. Thogmartin MD, Charles F. Siebert, Jr MD and William A. Pellan
AS
From Palm Beach County Medical Examiner Office, West Palm Beach,
Florida.
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WKR-45SR7D1-1H&_cover
Date=02%2F28%2F2001&_alid=128612081&_rdoc=1&_fmt=&_orig=search&_qd=1&_cdi=6913&_
sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=1a30538b9
ea46661bbf85336bdc6f88d
The Journal of Pediatrics Volume 138, Issue 2 , February 2001, Pages
212-217
   "Bed-sharing appears to increase the proportion of unexplained
deaths,
    regardless of the position of the infant."

[WILL03]
Are risk factors for sudden infant death syndrome different at night?
Williams SM, Mitchell EA, Taylor BJ.
Department of Preventive and Social Medicine, Dunedin School of
Medicine,
University of Otago, New Zealand.
Arch Dis Child. 2002 Oct;87(4):274-8.
   "The interactions between time of death and bed sharing, not
sleeping
    in a cot or bassinet, ... [several other factors] were also
significant,
    or almost so."

Papers Not Listed

[ARNE01]
Changes in the epidemiological pattern of sudden infant death syndrome
in southeast
Norway, 1984-1998: implications for future prevention and research.
Arnestad M, Andersen M, Vege A , Rognum TO
Arch Dis Child 2001 Aug 85:108-15
   "For SIDS victims, an increase in the number of infants found dead
while
    co-sleeping is seen"
This paper was not included above because it was unclear if the quote
was due
to the popularity of co-sleeping, or if the rate of death was
increasing.

[WILL01]
Scott Med J. 2001 Apr;46(2):43-7.  
Sudden unexpected infant deaths in Dundee, 1882-1891: overlying or
SIDS?
Williams FL, Lang GA, Mage DT.
   "It might be prudent to inform parents that co-sleeping is a risk
factor
    for SIDS  and that it should therefore be avoided."
Although this study technically fulfills all the requirements, it's
focus on
deaths over 100 years ago caused me not to list it above.

[MUKA99]
Leg Med (Tokyo). 1999 Sep;1(1):18-24.
Sleeping environments as risk factors of sudden infant death syndrome
in Japan.
Mukai T, Tamaki N, Sato Y, Ohno Y, Miyazaki T, Nagamori H, Hara S,
Endo T.
Department of Forensic Medicine, Tokyo Medical University, 160-8402,
Tokyo,
Japan
   "In addition, the co-sleeping habit, which was not uncommon in
Japan, seems
    to contribute to certain deaths of infants whose causes of death
were
    controversial. In the investigation of SIDS, therefore, the
sleeping
    environments, such as bedclothes and the co-sleeping habit, as
well as
    the sleeping position should be taken into consideration as risk
factors."
This study was published one year before my cut-off, so it is not
included
above.  However because many people claim data from Japan shows the
safety of
co-sleeping, including it here.

Some Famous Papers That Didn't Make It (and Why)

The McKenna papers are very popular on AP and co-sleeping web sites,
but none are included for two reasons: they are all way too old, and
none of them measured actualy death rates in children.  Really!  These
papers which supposedly justify co-sleeping as an anti-SIDS method
NEVER studied babies who died of SIDS!

A more serious problem with McKenna's work is that it was based on
a discredited theory of SIDS.  The modern view of McKenna work is
that is shows a serious problem with co-sleeping.  That co-sleeping
infants are under stress.  For example:

[HUNS02]
The sleep of co-sleeping infants when they are not co-sleeping:
evidence
that co-sleeping is stressful
Hunsley M, Thoman EB Dev Psychobiol. 2002
Jan;40(1):14-22.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1
1835147&dopt=Abstract
   "Each of these differences indicates a markedly lower arousal
    level in the long-term co-sleeping infants. This sleep pattern
    has been repeatedly found to be an indicator of stress. We infer
    that a major source of stress for these infants is the experience
    of sleep disturbance documented for infants when they were
co-sleeping.
    Based on extensive evidence for long-term effects of early
stress, we
    conclude that co-sleeping should have significant implications
for
    infants' neurobehavioral development."

The famous 1999 study by the Consumer Product Safty Commission (a US
government department responsible for regulating cribs and beds) is
not
included here because it was published one year before the cut off.
It found
serious risk associated with co-sleeping, just as all the studies here
did.

Many people ask about Dr. Sears's research, but I can not find a
single
peer-reviewed paper every published by Dr. Sears.  I have looked at
some of
his web pages, and although they often state that co-sleeping is
protective of
SIDS, the papers he cites are typically very hold (mid 1980s to
1990s).  He
cites papers my McKenna and others in the same lab: Moska, and
Richard, which
did not study infants with SIDS at all.  

Other web pages I've seen have vague references to "New Zealand
studies" or
"British studies", which are not specific enough to track down.  I
suspect
they refer to very old research, but it is impossible to tell.

General Background Information

Odds ratios (OR) are a way of measuring extra risk. An equally risky
activity would have an OR of 1.0  Something three times as dangerous
would have an OR of 3.0.  For various reasons, odds ratios of less
than 2.0 are not usually considered significant.

For comparison, the OR for getting lung cancer if you smoke is 20.0.

Joshua Levy

Here is a link for The Mother-Baby Behavioural Sleep Laboratory at Notre
Dame. It is very supportive of co-sleeping.
http://www.nd.edu/~jmckenn1/lab/introduction.html
I see from reading other replies that Dr. James McKenna (one of the
researchers) has already been mentioned.
Carolyn

I *just* posted this to some groups I'm on.  How apropo.  :-)

-----------
http://www.nd.edu/~jmckenn1/lab/faq.html    I remember
when I first became aware of James McKenna's sleep
articles several years ago.  I was so amazed that
there was actual research outlining benefits to shared
sleep- I had just thought it was easier than a crib.

http://www.naturalchild.com/james_mckenna/

=====
Kate, http://www.cs.colorado.edu/~kolina/advantages-of-formula.html 
Mom to Ursula (9!), Sage (6.5), Benno (3!!)    Nature's way is
straight and unerring, foursquare and calm, great and tolerant.
Everything is accomplished without the necessity of fabricated
purpose. Man's way is equally self-evident. His internal
principles are correct; his external acts are righteous; his results
are certain. ~ I Ching (B.C. 1150?)  Chinese Book of Changes
http://listserv.uts.edu.au/mailman/listinfo/parent-l
http://groups.yahoo.com/group/Just-Moms/ :-)
-------------------------------------------

I know there is a lot more, but this should get you started. :-)

kate

Mothering had an issue devoted to co-sleeping somewhere around sept/oct
'02.  They list references for their articles, so getting your hands on
that issue would be a good place to start.

FWIW, my hospital (SW VA, US) encouraged me to co-sleep and helped me
figure out how to nurse lying down.