In the true spirit of this site, we’d like to make sure our readers have access to the facts about bed-sharing – especially in the light of press coverage about the SWISS study.
A couple of facts: A cot death means a death in a cot – not in the parental bed. The correct term is SIDS – Sudden Infant Death Syndrome. It basically means an unexplained infant death.
Many people mix up the terms co-sleeping and bed-sharing. Co-Sleeping is baby being in the same room as its parents on a separate sleep surface, usually a cot or moses basket here in the West, next to the parental bed. This is recommended as safe and protective against SIDS until a child is at least 6m old by most governmental/health agencies in the UK and America.
Bed-Sharing describes the practice of sleeping with your baby in the parental bed.
A death on a sofa is not a SIDS necessarily – sofa deaths are usually from crushing/overlaying or baby getting wedged where it can’t breathe.
There are more deaths in cots than there in a parental bed with parents practicing safe co-sleeping.
The press have made such a terribly irresponsible job of reporting the SWISS study that Unicef have been moved to make a statement:
UNICEF UK Baby Friendly Initiative statement on new research into Sudden Infant Death Syndrome and bed-sharing
Following the publication of new research on risk factors involved in Sudden Infant Death Syndrome (SIDS) and subsequent media coverage, UNICEF UK Baby Friendly Initiative has issued the following statement, the full version of which can be accessed by clicking the link at the bottom of the email.
The SWISS study, designed to investigate the factors associated with SIDS in 0-2 year-olds, draws a clear link between increased risk of SIDS and alcohol or drug use when co-sleeping with a baby, particularly on a sofa.
Much media coverage yesterday focused on the study’s statistic that 54 per cent of the infants in the study died whilst co-sleeping, without noting whether it was in a bed or on the sofa. In fact, the percentage of infants that died whilst sharing the parental bed was 38 per cent, which was the same as the percentage of infants that died in the cot.
The study, examining 80 SIDS infants and two control groups, one randomly selected, one of babies at high-risk of SIDS, showed that many of the deaths in a co-sleeping situation could be explained by “a significant multivariable interaction between co-sleeping and recent parental use of alcohol or drugs (31 per cent v 3 per cent random controls) and the increased proportion of SIDS infants who had coslept on a sofa (17 per cent v 1 per cent).” Other significant factors included pillow use, swaddling, smoking during pregnancy, whether the infant was preterm and whether the infant was in fair or poor health for the last sleep.
The authors conclude that “the major influences on risk were from factors amenable to change within the infant’s sleeping environment….Parents need to be advised never to put themselves in a situation where they might fall asleep with a young infant on a sofa. Parents also need to be reminded that they should never cosleep with an infant in any environment if they have consumed alcohol or drugs.”
In recognition of this, the UNICEF UK Baby Friendly Initiative has for some time been working to assist health professionals to discuss bed-sharing with parents so that risks can be identified and minimised, rather than attempting to promote restrictions which cannot be applied in parents’ real worlds.
A sample bed-sharing policy has been developed for hospitals and a leaflet for parents produced with the Foundation for the Study of Infant Deaths (FSID). Both are designed to promote safety whilst protecting breastfeeding, by educating health professionals and parents on the benefits, contra-indications and safety issues surrounding this practice. UNICEF has also been urging NHS trusts to acknowledge the gap in health professional’s knowledge and provide training on all aspects of bed-sharing, including best practice for hospitals and how to communicate the key messages effectively to parents depending on their needs and circumstances.
When the press and society at large makes parents frightened to bed-share, I believe this can be the most dangerous situation of all. We know that the majority of parents will bring a baby into bed with them at least sometimes. If your baby crys in the cot and settles instantly next to you, what would you do at 3am? Well, if you’re petrified that it’s dangerous, you may well take the baby downstairs, pace up and down and finally, exhausted, collapse on the sofa and fall asleep with your now peaceful baby. This kind of co-sleeping IS dangerous.
There is also a huge difference between what is known as ‘chaotic bed-sharing’ – a baby in bed with smokers or drug-takers, older siblings or inappropriate bedding or mattress. A breastfed baby sleeping side by side with his non-smoking, not obese mother, on a suitable surface, away from hazards like pillows and duvets has not been proven to be at greater risk than his cot-dwelling peer.
So instead of demonising co-sleeping, maybe our focus should be on educating parents on safe and responsible bed-sharing? Here is the Unicef Bed-Sharing leaflet, based on the best available evidence.
Here is James McKenna’s website. He runs the Mother-Baby Sleep Laboratory at the University of Notre Dame.