Today’s Podcast

129:  Co-sleeping and room sharing

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 Episode 129     Co-sleeping and  room sharing

Last week we talking about co-sleeping and bed sharing and room sharing.  This is always such a hot topic for parents who are deciding what is right for them and what is the safest for the baby, along with how they can get the best sleep possible.  In keeping with this topic, I wanted to expand on a few things that were covered in last weeks show.

All 3 of my babies slept with me.  It was never a big deal and whenever I did talk about it, I just said, oh yeah, they sleep with me.  I did not use the terms co-sleeping or bed sharing or room sharing.  I have to be careful now to make that distinction as it is important to this discussion.  Feel free to go back and listen to Episode #126 so you can hear the discussion that came before todays discussion on this same topic.  Just in case you are new to the show or do not know the difference, here we go.

Co-sleeping is a practice in which babies and young children sleep close to one or both parents, as opposed to in a separate room. This is often referred to as room sharing.

Bed sharing is having the babies sleep in the same bed as the adults.  This is what I did.when my kids were young. I didn’t know it at the time because it just seemed right and it helped me get some much needed rest, however,   Bed sharing was very common up to the 19th century.  People use to sleep in very close quarters to each other, places were small, sleeping with each other kept people warm at night.  What changed?    Houses got bigger, babies were given their own room, the baby crib industry grew and more and more babies were put in their own crib.  In the scheme of things, meaning bed sharing has been happening since the beginning of time,  This nightime habit is relatively news.  Bed sharing and co-sleeping has been shown to save babies lives, promotes bonding,and enables parents to get more sleep.  It facilitates breastfeeding and enables a mom to breastfeed longer than she might otherwise have done because as newborns get older, they get good at breastfeeding during the night without waking their mother.  Opponents argue that this practice is cause for concern that a parent may smother a child, or promote an unhealthy dependence of the child on their parents.  The research has shown that  the opponents need not worry. There are safe sleep routines that parents can put into practice, in the same way parents do when following car seat safety, and infant carrier safety and high chair safety  I will put a link to the research and studies in the show notes.

A few weeks ago, I worked closely with a mom who was so upset because her baby was not breastfeeding at all.  Bottles had been given to baby in the hospital. Pacifier use was rampant in the unit she was on.  This mom was told that since her baby would not latch on, she would need to begin pumping.  It is of no surprise that the first pumping did not get the volume the hospital staff felt baby should get, so this baby got bottles of formula for the first day.  When I met with this mom, we will call her Claire, her baby was 16 days old and fought and screamed and kicked and punched at the breast.

In working with her, what worked best was her sitting upright, using firm pillows, extra blankets rolled up for additional support under her wrist and babies head.  Sharing some techniques that seemed to work well for her baby, she left the consult with having latched her baby on twice herself.  This was a huge feat because it took almost the whole consult to get to this point.  Claire worked closely with her baby girl and 5 days later she emailed me saying that her baby was breastfeeding all the time now and her supply was great.  Three weeks later, she scheduled another appointment, this time in her home because she was glad her baby was breastfeeding, however, she told me that she could not sustain late night and middle of the night feedings.  Getting up, out into the cold air, putting on a light, getting herself set up, baby feeding and 1 hour and 15 minutes later she was crawling into bed again.  I was incredibly saddened by the fact that she had come so far, but was ready to give up on nighttime breastfeeding.

She definitely needed the support in the first week or so following our initial consult, but now her daughter was great at latch, practically flying onto the breast all by herself.  We spent our full visit working on positions that would allow her to rest in bed while her baby fed.  Side lying worked the best and by the time I left, Claire was talking about how she would just have to get her husband to be okay with nighttime bed sharing because she was all for it now.  I am convinced that the breastfeeding would have gone downhill, not just at night, but during the daytime too, had we not had the opportunity to work together and for Claire to master nighttime bed sharing and breastfeeding.

Most recently the AAP has updated their policy statement.  They stated that stated More than 3,500 babies in the U.S. die suddenly and unexpectedly every year while sleeping, often due to sudden infant death syndrome (SIDS) or accidental deaths from suffocation or strangulation.

In an effort to reduce the risk of all sleep-related infant deaths, the American Academy of Pediatrics’ (AAP) updated policy statement and technical report includes new evidence that supports skin-to-skin care for newborn infants; addresses the use of bedside and in-bed sleepers; and adds to recommendations on how to create a safe sleep environment

Room share—keep baby’s sleep area in the same room where you sleep for the first 6 months or, ideally, for the first year. Place your baby’s crib, bassinet, portable crib, or play yard in your bedroom, close to your bed. The AAP recommends room sharing because it can decrease the risk of SIDS by as much as 50% and is much safer than bed sharing. In addition, room sharing will make it easier for you to feed, comfort, and watch your baby.

Bedsharing and other forms of cosleeping are also increasing in popularity, making it even more important to inform parents how to safely bedshare. This  approach has been endorsed by organizations such as The Academy of Breastfeeding Medicine,17 and the Royal Australasian College of Physician and Surgeons, Pediatrics and Child Health Division.

You will want to check out the link in the show notes for the specific website for Safe Bedsharing, however, I wanted to highlight two common concerns that I see all the time.

I had mentioned that you do not want to overheat your baby when laying them down to sleep.  The medical recommendations from the AAP and other organizations that study infants and sleep, all say that you should not put anything more on your baby, then what you would dress yourself in when you lay under the covers to sleep. This somewhat general recommendation is because the definition of overheating varies, so we need to talk generally, and I think in common sense terms.

You do not want to swaddle a baby when laying them down to sleep because this takes away their natural ability to move their arms and legs about if someone or something gets too close to them, to their face or obstructs them in any other way.  You do not want to wrap them in blankets especially if you are not wrapping yourself in multiple blankets or put hats on them because that is not how you would be sleeping.

A few other thoughts about cosleeping and bedsharing.

I would like to add that this info needs to be give to other family members.  Parents need to educate themselves.  And don’t just keep this info to yourself.

Everything that you know, you will want your caregivers to know too.  We sometimes forget that it is not good enough for just us to know this information if our child is being left in the care of babysitters, childcare providers, grandparents.  This education is for all people who care for infants.

You may not smoke around your baby and you may not take medication, however, if your baby is sleeping at someone else’s place overnight, you really need to have this discussion.  Grandparents can take medication that can make them particularly drowsy.  They may be putting your baby into a place to sleep that is not as safe as it could be. It is not uncommon to find grandparents or other providers who are using cribs that are not deemed the safest.  They may be holding and soothing your baby in a lazyboy chair and fall asleep.  They may have d one this with you when you were a baby and think it is just fine.  After all, you survived, they will say.  The best I have to say to this is that they are correct.  We did survive.  I also say, that when we know better, we strive to do better.

You heard me tell the story about Claire earlier and how bedsharing and cosleeping can affect breastfeeding.  Let’s look at co-sleeping and bed sharing from other angles as it pertains to breastfeeding.

We know that moms who sleep with their babies in close proximity tend to breastfeed longer and are less likely to force habits of sleeping longer and longer upon their babies.  Studies have shown that parents who safely sleep with their babies next to them or in close proximity such as a Arms reach crib,   actually get more sleep or they perceive themselves as getting more sleep.  They are not having to get up and out of bed. Parents who have a baby waking up to feed and have to get out of the bed, have to Get themselves set up in chairs with pillows, turn on lights and stay awake the whole feeding time and perhaps a god hour or so are climbing back to bed. When you sleep with your baby in your bed, you can feed your baby and sleep at the same time.   Babies tummies are very small, the size of a small marble.  Human milk goes through their system in about 90 minutes.  Their little bodies are so efficient it takes/absorbs what it needs and it gets rid of the rest through peeing and pooping.  Then in a very short time, they are ready to fill up again.  One of the biggest difficulties we have as parents, as new parents of a newborn is getting enough sleep.

We also have created this problem in our culture the belief that infant’s sleep habits should be just like adults sleep habits, which by and large, that adults “sleep through the night.”  This is a goal, an important milestone that parents want to see happen sooner rather than later.  Being so incredibly tired is one motivating factor.  The other is the belief that this is just what babies should do.  This also frequently means that you have a good baby.  When a mom is asked if her baby sleep through the night, she can almost feel that if she can say Yes, that her baby will be talked about as being a “good baby.”  And if she says No.. well what does that mean?  No mother wants to think that her baby is bad…  So much pressure.  Not only is mom tired and wishes her baby would sleep longer, she is getting the vibes that her baby is bad if he/she does not follow adult sleeping patterns

The problem with this whole idea is that it is a  huge misunderstanding of normal infant sleep, and this misinformation is responsible for a lot of suffering in households with newborns, infants, toddlers and young children.  There is so much to learn in this area, however, I will cover two pieces of information that I would like for us to think about.  A baby’s brain is only one quarter of the adult size at birth, this makes human babies being the least capable and the most dependent on parental care then any other species. Our babies cannot get up and walk to the refrigerator and get themselves something to eat.  They cannot get something to drink if they wake up parched in the middle of the night.  Our babies need us to take care of them. during the daytime and at nighttime.  I have a lot of sayings, some of them humorous some of them sad and some of them just meant to make us think.  Well, in the case of feeding for calories for hydration – my response to parents is – whoever told you that parenting ends at 9 pm and does not begin again until 7 am.  You must take care of your babies needs in the middle of the night too!

What is it about parents that so carefully tend to their babies every  need during the daytime and then at nighttime want to shut it down.  It just does not work that way.  And if you try and ignore a baby, they are built with this nervous system that will signal what for them is life threatening danger, the lack of food and loss of contact with another human being.   They come already programmed through millions of years of evolution to protest through crying. They are begging for you to pick them up, hold them close, make physical contact with them.  Otherwise their crying continues.  If separation from their parent is prolonged and when babies cries are ignored, most do eventually stop crying.  This is the sign of a baby shutting down, the quiet that is followed by being ignored.  What is really happening is emotional and physical withdrawal on the part of the baby. Their system releases the stress hormone cortisol.  High levels of cortisol has been known to lead to permanent changes in important brain structures.  Our babies are affected by separation and by not being fed and hydrated at night.

And why does this happen?  Noone is ignoring their babies during the day.  But they are at night?  And why?  In the interest of a good  nights sleep, combined w ith the thinking that babies should learn to self soothe and be able to go long periods of time without food or water. I hear parents say that they need to teach their baby good habits early on otherwise they will never learn how to sleep on their own and through the night.  We need for our newborns and babies, be newborns and babies.  To help further understand the importance of this mindset, I recommend a good breastfeeding class and also a good childhood development class.  You will learn what newborns, infants, toddlers and children are capable of doing at the various ages and developmental stages they are at.  I find that this helps many parents understand their children better.

Links:

https://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/American-Academy-of-Pediatrics-Announces-New-Safe-Sleep-Recommendations-to-Protect-Against-SIDS.aspx

http://cosleeping.nd.edu/mckenna-biography/

http://cosleeping.nd.edu/safe-co-sleeping-guidelines/

The Continuum Concept, by Jean Liedloff

Sleeping with Your Baby: A Parent’s Guide to Cosleeping Paperback – January 1, 2007 by James J. McKenna

The Family Bed Paperback – January 1, 2001 by Tine Thevenin

The No-Cry Sleep Solution: Gentle Ways to Help Your Baby Sleep Through the NightApr 18, 2002 by Elizabeth Pantley and William Sears

 

 

Lori J. Isenstadt, IBCLC

Lori j Isenstadt, IBCLCLori Jill Isenstadt, IBCLC  has spent much  of her adult life working in the maternal health field. Once she became turned on to birth and became a childbirth educator, there was no stopping her love of working with families during their childbearing years.  Lori became a Birth doula and a Postpartum doula and soon became a lactation consultant.   Lori founded her private practice, All About Breastfeeding where she meets with moms one on one to help solve their breastfeeding challenges.  Her membership site, All About Mothering helps moms navigate their journey from pregnancy through their postpartum days. She is an international speaker, book author and the host of the  popular itunes podcast, All About Breastfeeding, the place where the girls hang out.  You can reach Lori by email at: [email protected] or contact her at:  allaboutbreastfeeding.biz and allaboutmothering.biz

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