by Tami E. Breazeale
|Solitary infant sleeping is a
principally western practice which is quite young in terms of
human history. The practice of training children to sleep alone
through the night is approximately two centuries old. Prior to the
late 1700s cosleeping was the norm in all societies (Davies,
1995). Today in many cultures the practice of cosleeping
continues, with babies seen as natural extensions of their mothers
for the first one or two years of life, spending both waking and
sleeping hours by her side. Cosleeping is taken for granted in
such cultures as best for both babies and mothers, and the western
pattern of placing small infants alone in rooms of their own is
seen as aberrant (Thevenin, 1987). Comprehensive studies of
western nonreactive cosleeping, defined as family cosleeping from
birth as a custom, rather than as the result of childhood sleep
disturbances, are not yet available. However medical and
anthropological evidence suggests the western movement to solitary
infant sleeping in the past two centuries may have consequences in
the areas of attachment security and physical safety.
Attachment and sleeping environment
Early work by John Bowlby noted that the mother and baby pair
who were continuously together would have a secure attachment
relationship (Bowlby, 1953 cited in Davies, 1995). It is believed
that the emotional security of the baby benefits from skin-to-skin
contact during the night (Davies, 1995). In a study of early
childhood cosleeping by Hayes, Roberts, and Stowe (1996) it was
found that infants and children who were solitary sleepers had a
much stronger attachment to a security object and were more likely
to be disturbed by that object's absence than cosleepers. In a
1992 study of soft object and pacifier attachments in children
(Lehman, Denham, Moser, & Reeves) 40% of children with dual
soft object and pacifier attachments, and 80% of children with
attachments to pacifiers alone were rated as having an insecure
attachment relationship with their mothers by 19 months.
Attachment benefits of cosleeping are not limited to mother and
child; fathers also report enjoying additional time to bond with
the baby as a direct result of sharing a sleeping area (Davies,
1995; Seabrook, 1999; Thevenin, 1987). Fathers who share the
family bed are likely to experience less disturbed sleep, because
babies do not have to awake fully and cry to get their needs met.
Anthropological evidence of cosleeping societies is abundant.
In reviews of literature on cosleeping societies Thevenin (1987)
and Lozoff and Brittenham (1979) noted classic studies which
included nearly 200 cultures, all of which practiced mother-infant
cosleeping even if in some cultures the sleeping location of the
father was separate. Examples of cultures included in the studies
were the Japanese, the Korean, the Phillipino, the Eskimo Indian,
the !Kung San of Africa, and the natives of Okinowa (Lozoff &
Brittenham, 1979; Thevenin, 1987). The description of the Okinowan
Indian culture included observations both of parent-child
cosleeping until the age of six and unrestricted breastfeeding, as
well as of characteristics of adult behavior that are very
consistent with secure attachment histories (Thevenin, 1987).
Cosleeping is the cultural norm for approximately 90% of the
world's population (Young, 1998).
An interesting contrast to the abundant anthropological
evidence of cosleeping is the Israeli kibbutz practice of communal
nurseries. In Israeli traditional kibbutz communities, infants are
raised sleeping in communal nurseries starting at age six weeks.
In a study of the influence on such a sleeping arrangement on
infant-mother attachment Sagi, van Ijzendoorn, Aviezer, Donnell,
and Mayseless (1994) found the rate of secure attachment was
diminished significantly by infants sleeping in kibbutz infant
houses instead of in their parents' homes. In their study of 48
healthy infants, all infants spent nine hours a day, six days a
week in small groups with a professional caregiver. All infants
also went home for four hours during dinner time, from
approximately 4 to 8 P.M. The infants in the kibbutzim with
home-based sleeping would then spend the overnight hours in the
care of their parents while the communal sleeping kibbutzim babies
were returned to the infant houses to be put to sleep and watched
overnight by two women who were monitoring several children's
houses from a central location and were responsible for upwards of
50 children between the ages of 6 weeks and 12 years. These
"watchwomen" were kibbutz community members who served
in this capacity for one week every six months on a rotating basis
and were thus never consistently familiar to the infants.
Background data with regards to quality of day care experiences,
mothers' biographical characteristics, mothers' job satisfaction
levels, and infants characteristics were considered essentially
the same in both groups. The sole difference tested was the
kibbutz sleeping arrangements. Within the kibbutz home-based
infants, 80% were classified as having secure attachment
relationships with their mothers, while among the
communally-sleeping infants, only 48% demonstrated secure
attachment relationship with their mothers. Although this has no
direct relationship to cosleeping per se, it is likely that the
primary reason the home-based babies had a higher rate of security
was because of the consistency of their caregiver, who was by
definition more able to respond to them quickly than the
In May 1999, the Consumer Product Safety Commission [CPSC]
released a warning against cosleeping or putting babies to sleep
on adult beds that was based on a study of death reports of
children under the age of two who had died from 1980 to 1997.
Among the 2,178 deaths by unintentional strangulation in the
Commission's study were 180 young children who had died from being
overlain on a sofa or bed. In another analysis of CPSC data it was
found that of 515 deaths in an adult bed, 121 of these were the
result of overlying and 394 children died as a result of
entrapment in the structure of the bed (Heinig, 2000). The CPSC
statistics resulted in a media frenzy discouraging cosleeping
which, instead of educating the public on how to share sleep
safely, chose to alarm parents. Neither media announcement
mentioned the 2,700 infants that died in the final year of that
study of Sudden Infant Death Syndrome [SIDS], formerly called
"crib death"; the vast majority of those infants died
alone in their cribs (Seabrook, 1999). Meanwhile, it is
interesting to note that the CPSC media announcements did not
release data regarding risk factors other than sleeping location,
such as whether the overlying adult was under the influence of
alcohol or drugs or whether the sleeping surface was appropriate;
79 of the 515 deaths occurred on waterbeds (Seabrook, 1999).
Parents must observe safety guidelines for cosleeping, just as
they would for picking out a crib.
Safety while cosleeping is of utmost importance. Parents should
take very seriously the importance of providing their babies with
a safe sleeping environment. There are many guidelines, most of
which are common sense (Sears, 1995b; Thevenin, 1987). To start
with, the bed must be arranged in such a way as to eliminate the
possibility of the child falling out. This can be done using a
mesh guardrail, a special cosleeper crib (with three sides), or by
pushing the bed flush against the wall, making sure there are no
crevices which could entrap the baby. Next, in the early months,
parents must be sure to place the baby next to the mother rather
than between the parents as fathers are not usually as aware of
their infants as the mothers are at first. Cosleepers should use a
large bed or a sidecar arrangement, with a three-sided crib
clamped flush to the mother's side of the bed and the mattresses
set to the same level. They should avoid using heavy comforters or
pillows near the infant. Babies should not be overdressed as the
warmth of the mother will be shared with the child. Infants who
cosleep are usually breastfed throughout the night; this is to be
encouraged. Waterbeds, sofas, and other soft surfaces should not
be the location for cosleeping (Heinig, 2000; Sears, 1995b;
Thevenin, 1987). Most importantly, parents should not cosleep if
they are seriously sleep-deprived or under the influence of drugs
or alcohol. Parents who are smokers should not cosleep as
secondary smoke greatly increases the risk of death from SIDS
(McKenna et al., 1993; Sears, 1995b).
Sudden Infant Death Syndrome
Research on cosleeping and SIDS has resulted in remarkable new
body of knowledge which many view as affirming the decision of
parents to opt for the family bed. Virtually all SIDS-related
infant sleep research prior to the 1980s was conducted on isolated
infants in sleep laboratories. In contrast to these studies, James
McKenna, a medical anthropologist, has conducted several research
studies of mother-infant cosleeping. McKenna postulated that
infant sleep physiology evolved in the context of cosleeping and
that infant sleep cannot be fully understood without studying the
infant in its normative cosleeping environment (McKenna et al.,
Within Dr. McKenna's research, cosleeping is defined as the
child sleeping close enough to another to "access, respond to
or exchange sensory stimuli such as sound, movement, touch,
vision, gas, olfactory stimuli, CO2, and/or temperature"
(McKenna et al., 1993, p. 264). McKenna believes that cosleeping
also alters other risk factors of SIDS, such as dangerous bedding,
environmental temperature, and infant sleeping position. Using
established polysomnographic recording guidelines, McKenna
recorded the sleep, breathing, and arousal patterns of mothers and
their two to four month old infants cosleeping in a laboratory and
also recorded the same information for infants and mothers
sleeping alone in adjacent rooms for two nights and then sleeping
together for a third night (McKenna et al., 1994). Preliminary
findings of cosleeping research indicated that cosleeping mothers
and infants had a significantly higher levels of
partner-influenced arousal overlap and synchronous sleep patterns.
Since there is a suspected relationship between arousal deficits
in infants and some deaths from SIDS (McKenna et al., 1993; Sears,
1995b), McKenna's hypothesis that the influence of cosleeping on
the infant's respiratory patterns, central nervous system, and
cardiovascular systems may have a protective effect seems quite
Intriguingly, in a 1994 study in the United Kingdom of
physiological development, infant sleeping, and SIDS risk in Asian
infants, Petersen and Wailoo found that although the Asian babies
had several increased physiological risk factors for SIDS, the
SIDS rate is much lower in this population. The authors note that
perhaps this is due to the increased stimulation the infants
receive as a result of Asian infant care practices. These
practices include cosleeping, carrying, and other activities which
involve the child more in household life (Petersen & Wailoo,
1994). SIDS rates in Asian countries, where cosleeping is often
the norm, are significantly lower than those in western society
Attitudes toward cosleeping
Cosleeping from birth is recommended by La Leche League
International, the world's leading breastfeeding organization
(LLLI, 1997), as well as by many professional lactation
consultants (Heinig, 2000). The benefits of cosleeping to the
nursing couple include increased access to nursing with less
disturbance of sleep for both mother and infant. According to
sleep lab studies, cosleeping mothers actually nurse their infants
more frequently throughout the night, but upon awaking for the
morning have little recollection of those interactions. Despite
frequent arousals during the cosleeping studies, the mothers
reported that they got more sleep cosleeping than they did
sleeping apart from their babies (McKenna et al., 1994). An
additional benefit of cosleeping and unrestricted night nursing is
natural child spacing, as the return to fertility for a nursing
woman whose child nurses exclusively and cosleeps, can often be
delayed up to a year after the birth. Cosleeping is also reported
to lead to a reduction in night fears and to the fulfillment of
the maternal protective instinct (Medoff & Schaefer, 1993).
Many cosleeping advocates also believe that cosleeping, as a
component of natural, or attachment, parenting ultimately leads to
more confident and independent children (Sears, 1995a; Thevenin,
Pediatric experts in decades past have described children
sleeping in the "parental bed" as having serious
negative consequences on both parents and children. Child care
authors and experts such as Dr. Spock, Dr. Brazelton, and Dr.
Ferber admonished parents who coslept that they would be creating
negative habits or sleep disorders in their children, and
fostering unhealthy childhood dependency, and that cosleeping
would be harmful to the parents' marriages (Ball, Hooker, &
Kelly, 1999). A misunderstanding of the nonreactive custom of
cosleeping from birth compared to the reactive use of cosleeping
to solve problems with older children seem to be at the root of
these anti-cosleeping positions. Studies of reactive cosleeping
(Lozoff, Wolf, & Davis, 1984; Rath & Okum, 1995) have
found correlations between cosleeping and childhood sleep
disorders and family stress, however cultural differences in Black
family cosleeping and that of whites and Hispanics were
significant. In the 1984 study by Lozoff, Wolf, and Davis, a
representative sample of 150 mothers of six-month-old to
four-year-old children were interviewed. The rate of reported
sleep problems for white cosleeping children was three times that
of the solitary sleepers, but the opposite was true for Black
cosleepers, who had a lower rate of sleep problems than Black
solitary sleepers. Cosleeping was "routine and recent"
in 70% of the Black families and 35% of the white families. The
results of such studies have failed to show a causal relationship
between cosleeping and sleep disorders (Medoff & Schaefer,
1993). Also, the fact that the cosleeping white and Hispanic
children were older than the cosleeping Black children in the
Lozoff, Wolf, Davis (1984) study, suggests that there is a
cultural difference in the use of cosleeping; namely the Black
families were more likely to engage in nonreactive cosleeping than
the white and Hispanic populations. Although significant,
peer-reviewed, studies of nonreactive cosleeping are not yet
available, anthropological evidence (Lozoff & Brittenham,
1979; Thevenin, 1987) and research by both Dr. McKenna (1994) and
Dr. Sears (1995b) appears to support the validity of cosleeping as
a worthwhile custom, especially if the mother and child are
In an article in the popular magazine The New Yorker,
John Seabrook (1999) describes his journey with his wife and
newborn son, into the experience of cosleeping. His wife, who
coslept with her own parents and who is nursing their son,
intuitively desires to cosleep. The author, however, feels more
comfortable following the anti-cosleeping experts. After months of
sleep deprivation and many tries at teaching the baby to sleep
alone, the father relents. He has, in the course of this time,
visited the infamous Dr. Richard Ferber, whose sleep-training
method is a Pavlovian, incremental, cry-it-out system that
promises the reward of solitary all-night sleep from babies once
they are "ferberized." In the course of the interview,
the author asks Dr. Ferber about cosleeping, and Dr. Ferber, who
criticizes cosleeping in his widely popular 1985 book, Solve
Your Child's Sleep Problems, recants, instead saying that
"there's plenty of examples of cosleeping where it works out
just fine" (Seabrook, 1999, p. 64). After this the father
begins to recognize that the primary reasons most experts give for
their anti-cosleeping stances is parental convenience and a vague
idea about the importance of infant independence. Mr. Seabrook
learns to respect the sleep patterns of his young child and he
adapts, allowing the cosleeping relationship to blossom into a
bonding experience which the whole family can enjoy.
Ball, Hooker, and Kelly (1999) conducted a study in the United
Kingdom to determine a baseline of nonreactive cosleeping among
British parents. It was believed that although cosleeping is not
part of the mainstream of parenting ideology in Britain or
America, and although the literature in the field is a mess of
reactive and cross-cultural juxtapositions, this study would open
the door to a valid discussion of the attitudes and practices of
nighttime parenting. The study was conducted by enlisting
expectant parents in an economically depressed community in
Northern England. Parents were interviewed about expectations of
infant care practices prior to the birth and then about actual
infant care practices when the baby was expected to be two to four
months old. Forty families completed both interviews. Both new and
experienced parents were interviewed. None of the new parents
anticipated cosleeping with the child although 70% of them
actually did end up cosleeping with their infants at least
occasionally. Mothers being interviewed following the births
frequently cited the ease of breastfeeding while lying down in bed
and the ease of caring for the child while cosleeping. Not
surprisingly the experienced parents were more realistic in their
expectations, with 35% anticipating cosleeping and 59% actually
participating in cosleeping. The vast majority of the first-time
mothers who coslept and all of the experienced mothers who
coslept, were also breastfeeding their infants. The study revealed
that despite preconceptions of cosleeping as a dangerous and rare
practice, these mainstream British parents consider it an
effective infant care technique and commonly engage in it.
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2001 Tami E. Breazeale
Excerpted with permission of the author from "Attachment
Parenting: A Practical Approach for the Reduction of Attachment
Disorders and the Promotion of Emotionally Secure Children",
Master's thesis, Bethel College, February, 2001.