Throughout human
history, breast-feeding mothers sleeping alongside their infants
constituted a marvelously adaptive system in which both the
mothers' and infants' sleep physiology and health were connected
in beneficial ways. By sleeping next to its mother, the infant
receives protection, warmth, emotional reassurance, and breast
milk - in just the forms and quantities that nature intended.
This sleeping arrangement permits mothers (and fathers) to
respond quickly to the infant if it cries, chokes, or needs its
nasal passages cleared, its body cooled, warmed, caressed, rocked
or held. This arrangement thus helps to regulate the infant's
breathing, sleep state, arousal patterns, heart rates and body
temperature. The mother's proximity also stimulates the infant to
feed more frequently, thus receiving more antibodies to fight
disease. The increased nipple contact also causes changes in the
mother's hormone levels that help to prevent a new pregnancy
before the infant is ready to be weaned. In this way, the infant
regulates its mother's biology, too; increased breast-feeding
blocks ovulation, which helps to ensure that pregnancies will not
ordinarily occur until the mother's body is able to restore the
fat and iron reserves needed for optimal maternal health.
It is a curious fact that in Western societies the practice of
mothers, fathers and infants sleeping together came to be thought
of as strange, unhealthy and dangerous. Western parents are taught
that "co-sleeping" will make the infant too dependent on
them, or risk accidental suffocation. Such views are not supported
by human experience worldwide, however, where for perhaps millions
of years, infants as a matter of course slept next to at least one
caregiver, usually the mother, in order to survive. At some point
in recent history, infant separateness with low parental contact
during the night came to be advocated by child care specialists,
while infant-parent interdependence with high parental contact
came to be discouraged. In fact, the few psychological studies
which are available suggest that children who have
"co-slept" in a loving and safe environment become
better adjusted adults than those who were encouraged to sleep
without parental contact or reassurance.
The fear of suffocating infants has a long and complex cultural
history. Since before the middle ages "overlying" or
suffocating infants deliberately was common, particularly among
the poor in crowded cities. This form of infanticide led local
church authorities to make laws forbidding parents to let infants
sleep next to them. The practice of giving infants alcohol or
opiates to get them to sleep also became common; under such
conditions, babies often did not wake up, and it was presumed that
the mothers must have overlaid them. Also, in smoke-filled,
under-ventilated rooms, infants can easily succumb to asphyxia.
Unfortunately, health officials in some Western countries promote
the message that sleep contact between the mother and infant
increases the chances of the infant dying from sudden infant death
syndrome (SIDS). But the research on which this message is based
only indicates that bed-sharing can be dangerous when it occurs in
the context of extreme poverty or when the mother is a smoker.
Some researchers have attempted to export this message to other
cultures. However, in Japan, for example, where co-sleeping is the
norm, SIDS rates are among the lowest in the world, which suggests
that this arrangement may actually help to prevent SIDS.
Human infants need constant attention and contact with other
human beings because they are unable to look after themselves.
Unlike other mammals, they cannot keep themselves warm, move
about, or feed themselves until relatively late in life. It is
their extreme neurological immaturity at birth and slow maturation
that make the mother-infant relationship so important. The human
infant's brain is only about 25% of its adult weight at birth,
whereas most other mammals are born with 60-90% of their adult
brain size. The young of most other mammals become independent of
their parents within a year, whereas humans take 14 to 17 years to
become fully developed physically, and usually longer than that to
be fully independent.
Apart from being a natural characteristic of our species,
constant proximity to the mother during infancy is also made
necessary by the need to feed frequently. Human milk is composed
of relatively low amounts of protein and fat, and high amounts of
quickly absorbed and metabolized sugars. Therefore the infant's
hunger cycle is short, as is the time spent in deep sleep. All of
these factors seem to indicate that the custom of separating
infants from their parents during sleep time is more the result of
cultural history than of fundamental physiological or
psychological needs. Sleep laboratory studies have shown that
bed-sharing, instead of sleeping in separate rooms, almost doubled
the number of breast-feeding episodes and tripled the total
nightly duration of breast-feeding. Infants cried much less
frequently when sleeping next to their mothers, and spent less
time awake. We think that the more frequently infants are
breast-fed, the less likely they are to die from cot death.
Our scientific studies of mother and infants sleeping together
have shown how tightly bound together the physiological and social
aspects of the mother-infant relationship really are. Other
studies have shown that separation of the mother and infant has
adverse consequences. Anthropological considerations also suggest
that separation between the mother and infant should be minimal.
Western societies must consider carefully how far and under what
circumstances they want to push infants away from the loving and
protective co-sleeping environment. Infants' nutritional,
emotional and social needs as well as maternal responses to them
have evolved in this environment for millennia.