|Infants and parents sleeping together or in proximity to
one another is the way that the nutritional, transportation, social-emotional, and
thermal needs of human infants continue to be met worldwide. This includes Japan,
where the rates of SIDS are the lowest in the world. In most cultures, parent-infant
contact is considered to be as important during the night as it is during the day. In
contrast, the industrial western world's accepted model of "normal" and
"healthy" infant sleep assumes that it is best for the infant to sleep in
isolation with minimal parental intervention. But infants were designed to sleep next
to their mothers for night-time breastfeeding, so solitary infant sleep represents a
novel, if not alien experience, for which not all infants, we contend, are equally
prepared. Our work challenges western assumptions on "normal" infant sleep
with the hope of uncovering hidden environmental factors heretofore not considered to
be relevant to some types of SIDS.
We do not suggest that sleeping with an infant can prevent SIDS or that it is
perfectly safe. Indeed, where there are factors such as drug use in the family,
maternal smoking, and a lack of knowledge about infant safety, co-sleeping might
increase rather than decrease dangers to the infant. However, the circumstances
mentioned above should not be confused with all co-sleeping situations. The
sensory exchange that co-sleeping provides an infant, i.e., heat, sound, smell,
touches, and movement, are sensory stimuli that the infant is designed to respond to
in a positive way. Co-sleeping requires that specific precautions be taken to assure
infant safety; this should not be mistaken for an argument against the potential
benefits to infants, any more than a concern for crib design safety has been an
argument against an infant sleeping alone.
With the generous support of the National Institutes of Child and Human
Development, Drs. Sarah Mosko, Christopher Richards and I are presently exploring the
effects of mother-infant pairs sleeping apart and together over successive nights in a
sleep laboratory. Our studies show that while co-sleeping, infants breastfeed more
frequently and for longer total duration; they have more arousals, many of which are
induced by the mother's movements or sounds, and that the infants spend less time in
the deep stage of sleep from which some infants have difficulty arousing (apnea).
We have been impressed with both the mother's and infant's acute responsiveness to the
other's activities, all of which seem to change the infant's physiology in ways that
look potentially helpful in resisting a SIDS event, although we cannot prove this at
In answer to the question, "Is it safe to sleep with your baby?", under
most circumstances, co-sleeping is likely to be very safe and beneficial; but it
depends on how it is done. If the parent(s) smoke or take drugs, co-sleeping is risky.
Sleeping with an infant on a waterbed, couch, soft bed, or any bed that has gaps or
ledges into which the infant can fall, can be risky for the infant. It is more ideal
to sleep on a firm mattress, and to limit the use of pillows and blankets.
With regard to the second question, we do not yet know if co-sleeping can reduce
the risk of SIDS. It is clear that our research is yielding important insights into
the limitations of defining the species-wide co-sleeping arrangement as
"abnormal" while labeling the culturally recent preference for solitary
infant sleeping as "normal" and always "healthy". We hope someday
to be able to use our data to contemplate new models of healthy infant sleep to serve
as a scientific beginning to help combat SIDS.