Tynan, clothed in the hair-shirt of
co-sleeping martyrdom, claims that sharing beds with babies and children is not
only contentious but a ‘sure-fire lightening rod for parental judgement and
She writes that ‘it’s regarded as the genesis of dependent, needy children at best, with a potential to kill them at worst’.
To support this statement, she cherry-picks a case from the UK where a judge recently removed two children from a mother ostensibly for sharing a bed with her children. Certainly, the reporting of the case emphasised the bed-sharing aspects however tucked away in the fine print was the disclosure that the children were being physically abused.
Babies are never removed from parents simply on the basis of bed-sharing. Social workers do not prowl suburban streets waiting to pounce on parents who are sleeping with their children.
Tynan doesn’t say exactly who she’s referring to when she states that co-sleeping is considered ‘weak and mollycoddling, making a rod for our own backs by raising children who can’t cope without us’.
If co-sleeping is as contentious as Tynan thinks it is I suggest the contention mostly comes from extended family members or online mothers’ groups where baby sleep issues tend to be battlefields of opposing views driven by feeling and emotion rather than rationality and common sense.
Most health professionals understand that it’s up to parents
to make their own decisions about where their babies sleep.
This includes the first six months when health professionals, unlike journalists writing about their own experiences, have a duty of care to alert parents to the safety aspects of co-sleeping during this time.
We certainly never ‘push new mums to get their babies into their own rooms pronto’. For obvious reasons, the ‘the holy grail of sleeping through the night’ is something many mothers seek out, which I respect and understand, however most of us spend our working days explaining why ‘sleeping through the night’ is largely driven by the baby and can happen anytime between eight weeks and three years.
It may come a surprise for Tynan to know that the idea of down-the-corridor-with-the-door-shut is heaven for many parents. This does not make them bad parents. Nor does it turn their toddlers/children into maladjusted, unattached axe murderers.
Mothers who find the realty of co-sleeping off-putting – ‘not their cup of tea’ - could be forgiven for thinking that it’s a far riskier proposition to admit to not co-sleeping when confronted with the zealous promotion of the co-sleeping cheer squad, for example, the Australian Breastfeeding Association, Professor James McKenna, Dr William Sears, Dr Jack Newman et al.
The ‘bad parenting’ label Tynan claims she and like-minded
mothers are saddled with also hovers over everything the co-sleeping promoters
The co-sleeping perspective strongly implies that any other arrangement is a second-best compromise as is the quality of mothering by those who choose ‘solitary’ sleeping over co-sleeping.
A word about the research
It might be of comfort for mothers to know that the research cited to back up claims of positive lifelong consequences attributed to co-sleeping is based on qualitative behavioural science studies, which are far from definitive and clear-cut.
studies run risks of bias and are often interpreted in the light of the health
professional’s strongly-held beliefs.
The studies often involve self-reporting, which is notoriously unreliable.
Replicating them is difficult and the use of the words ‘suggest’ and ‘may’ when drawing conclusions is common.
Depending on your point of view, for every study of human behaviour that shows one thing, another can usually be found to show the opposite.
Studies into human behaviour are
important and have been instrumental in challenging many of our cherished
beliefs, however this doesn’t mean they shouldn’t be looked at with a critical
Analysing research is highly technical and something few
people have the expertise to do.
Using ‘research shows’ to emphasise and/or promote a point of view, doesn’t mean a great deal without close examination of the studies involved.
I acknowledge that I am as guilty as anyone of throwing in the 'research shows' phrase - it's difficult to resist - however I do endeavour to reserve it for research that provides definitive and clear-cut conclusions, for example, immunisation and the recommendations for the safe-sleeping of babies.
Claims that certain behaviours, such as co-sleeping, will influence how children function all the way from babyhood through to adolescence and adulthood should be taken with a big grain of salt.
A baby’s later-life outcome cannot be reliably predicted from a single experience such as co-sleeping and it is mischievous to try to convince parents that it does.
Co-sleeping: a bird's eye view
Having been professionally involved with families, babies and toddlers for decades I have a critical bird’s eye view of the history behind the pendulum-swinging advice on where baby should sleep.
In industrial societies (as opposed to traditional societies) sleeping babies and toddlers separately rather than with their parents has always been a combination of long-held ideas about baby discipline that have been difficult to shift, safety concerns, class, and personal choice as the standard of living improved and more space became available.
This remained the case until the
1980s when there was a big swing away from what was viewed as the rigid and
prescriptive advice of the time that had been inherited from the Victorian era
The growing body of research into human behaviour, particularly emotional, social and psychological development, as well as breastfeeding research, was a massive contribution to the big swing away from structure and routines.
This was largely positive. It gave mothers more options, encouraged health professionals to be more flexible, rethought inhumane policies and considered the needs of babies in ways that had been lacking in the past.
However, some of the emerging
theories (for example, what came to be known as ‘attachment parenting’ and its various
off-shoots such as the family bed and the continuum concept) were based on extreme
positions, personal opinion and subjective interpretations of the evidence supporting them.
Rather than freeing mothers up to follow their instinctive urges, this pathway to baby heaven caused a considerable number of them as much grief as trying to follow rigid versions of the routine approach.
Co-sleeping and discipline
There’s no doubt that co-sleeping
has been frowned upon down the ages for irrational disciplinary reasons. Until
relatively recently notions about spoiling baby and turning him into a little
tyrant who ruled the home were widespread.
Excessive crying was often viewed as naughtiness and a manipulative attention-seeking ploy ( if I cry for long enough they’ll pick me up ).
There was a feeling – that still persists – that baby had to be sorted (turned into a well-behaved little human) by the first three months so he wouldn’t turn into a juvenile delinquent and give his parents hell.
Baby-care booklets from the early
part of last century used blunt language that is unheard of today:
‘Regrets and heart-burnings on the parent’s part in after-years will not make amends for giving baby a bad start.’
‘All the wonders of modern medical science cannot wipe out a first year of bad handling’
‘Some fathers object to the infants (newborns) being allowed to cry, but how else can they be trained? And unless they are properly trained they will become a source of incessant trouble.’
And (the clincher)
Recipe for Healthy Baby
WAKE BABY, if necessary, in order to feed him REGULARLY
by the clock.
He must have NO NIGHT FEEDS after 10pm
He must SLEEP ALONE
Keep him OUT in the FRESH AIR as much as possible
Give him BOILED WATER daily
Give him SUN KICKS daily
Get up wind after feeding
Do NOT give a DUMMY
Our Babies, 1931, Office of the Director-General of Public Health, Sydney.
This advice should be put in the context of the times when the infant death rate was 103/1000 babies. Most deaths were preventable deaths caused by poverty, a general low standard of living, ignorance often due to a lack of education, poor hygiene and food, dirty water, doorstep milk and unsafe homes, furniture and baby equipment. The well-meaning but rigid advice of the era, aimed primarily at saving lives as much as teaching baby how to behave, contributed to the dramatic drop in the infant mortality rate to 27/1000 in the early 1940s as, of course, did the improvements in all aspects of obstetric and paediatric care and the general standard of living.
The dramatic decrease in infant deaths over the first half of the last century meant that an emotional, social and psychological approach more in tune with parents’ and babies’ needs slowly emerged in the second half of last century coming to full flower in the 1980s and 1990s. Co-sleeping was a big part of the swing away from routine and structure. It was offered up as the preferred choice for committed, caring parents who were told that ‘sharing sleep’ was a crucial part of ensuring optimum child development outcomes.
It must be noted that generations
of pre-war babies, war babies (I am one) and early baby boomers, many
of whose mothers followed the rigid advice system, have grown up into
well-balanced, useful adults firmly attached to their mothers, with happy
memories of their very stable childhoods.
It takes more to bend the twig than petty squabbles about the minutiae of child-care advice in the first three years.
Co-sleeping and safety
Safety concerns have frequently been behind what now seem like cruel and irrational policies of the past.
For example, banning or severely
restricting parents from visiting their sick children. This persisted until the
1970s long after the original reason of fear of infectious diseases – scarlet
fever, pertussis, influenza, cholera, diphtheria – being introduced into
hospital wards by visitors had clearly passed.
The policy went back to the mid-1800s when the causes of infection were not properly understood, there was no immunisation or antibiotics and rarely any handwashing let alone hygienically clean surroundings.
Forbidding parents to see their sick children in hospital also carried a large component of 'it's better for parents not to see their children as parents upset their children too much'.
Demonstrating an appalling ignorance of infant and child emotional development it was believed that the silent child was 'good' and the crying child 'badly behaved'.
James Robertson's and John Bowlby's 1952 film, A child goes to hospital
, was a breakthrough in demonstrating the cruelty of the restrictions, however it took another twenty years before free visiting was the norm in paediatric hospitals.
Similarly, keeping newborns in
nurseries away from visitors and, apart from feeding times their mothers as
well, was also related to infection fears dating back to times when it was
safer for mothers to have their babies in the street than in maternity
hospitals. In varying degrees of latitude, this practice also persisted until the 1970s, the beginning of the slow march towards the flexibility and suite of options that is now available to women giving birth.
As Tynan suggests, the outlawing
of co-sleeping several hundred years ago, based on the premise that mothers
were purposefully overlaying their babies as a form of infanticide, has
probably contributed to negative ramifications for co-sleeping down the
centuries – even perhaps until the 1980s.
(Goodness knows how the co-sleeping law was policed, or how many mothers took a blind bit of notice of it).
Records of infant deaths in the 19th and early 20th centuries show that the high numbers of infant deaths which persisted until the 1920s/30s were more down to congenital abnormalities, diseases, infection, failure-to-thrive, neglect, ignorance, and infanticide by drowning rather than being overlaid by their mothers.
Nevertheless, there have always
been risks associated with co-sleeping.
For example, the baby becoming trapped by the bedframe, headboard or footboard or getting stuck between the bed and the wall. Other risks include falling off the bed. Suffocation by pillows, blankets or quilts were also risks as was lying face down or being rolled on by an adult.
During the 1980s/90s co-sleeping was encouraged by breastfeeding promoters, midwives, many early childhood health professionals of varying disciplines, adherents of what is known as ‘attachment parenting’ and a mixed bag of others – anthropologists, psychologists, academics, mothers who loved it - extolling the rewards and joys of traditional-style mothering, a lá the baby-wearing !Kung of the Kalahari Desert or the Yequana Indians, whose firmly-attached babies, unlike the babies of Western mothers, never cried.
My recall as a hands-on practitioner during this period was rather than co-sleeping being frowned upon it was embraced by all and sundry, including health professionals like myself who found it a nice painless option for crying babies, breastfeeding difficulties, and sleep problems in older babies for parents who were open to the idea.
As the 90s progressed, casualty staff in paediatric hospitals were reporting small but significant numbers of fatal sleep accidents related to bed-sharing. Reports described the deaths as Sudden Infant Death Syndrome (SIDS, cause unknown) or as fatal sleep accidents when the cause was obviously down to the factors described above.
Around this time, additional risk factors such as cigarette smoking, obesity, parental drug and alcohol consumption, pets or siblings in the bed, squashy mattresses, doonas, waterbeds and pillows, which all had potentially serious negative effects on co-sleeping, were only just starting to be clearly identified.
The big breakthrough in SIDS
research came in the early 1990s with the firm recommendation to sleep babies
on their backs and not their tummies.
As tummy-sleeping was very common (a great way to help babies get to sleep) and had been standard practice for decades there was a lot resistance to the idea from health professionals and mothers, however as unequivocal statistical evidence mounted to support the recommendation, back-sleeping became a no-brainer. Other risk factors included cigarette smoking and any covering over babies’ heads and faces.
As we moved into the new millennium, the recommendations and
risk factors firmed up as a more accurate picture emerged. Guidelines for
co-sleeping, along with guidelines for separate sleeping, now include a list of
precautions and advice on how to do it safely, which has been tweaked at
various times according to the research.
Co-sleeping has never been on the
official list of recommendations as a protection against SIDS or Sudden
Unexpected Deaths in Infancy (SUDI) because the research supporting its
inclusion is weak to nil.
Nevertheless, it is recognised that there is much to recommend co-sleeping if the guidelines for safe co-sleeping are followed.
Throughout the 00s, many health
professionals and institutions continued to strongly support breastfeeding and
co-sleeping as significant factors in protecting babies from SIDS. Maternity
hospitals encouraged mothers to keep their babies beside them in their beds and
to continue the practice at home.
The Baby Friendly Initiative - https://www.midwives.org.au/baby-friendly-health-initiative-bfhi - launched in 1991 encouraged prolonged skin-to-skin contact and bed-sharing.
(Unlike co-sleeping, bed-sharing in this context refers to breastfeeding in bed but not necessarily sleeping with the baby following the feed).
Following a series of global infant deaths and near deaths
while bed-sharing in maternity hospitals – in Australia one death in 2005 and
another in 2008 – the practice of co-sleeping in maternity hospitals was
ceased. Since then, mothers are asked to put their babies in their cots beside
their beds after feeding.
This has nothing to do with ‘cultural conditioning’ but is a rational, commonsense change in policy to prevent tragedies.
The recommendations following extensive research into
SIDS in the last 25 years has resulted in the most significant benefit for the
welfare of healthy babies in my professional lifetime. Deaths from SIDS
(unknown cause) has dropped by 85%. As a health professional who regularly
witnessed the distressing event of the death of a healthy baby this is an
The whole body of research and all the recommendations has contributed to this but placing babies on their backs instead of their tummies or sides has been a major factor.
Deaths from SIDS has fallen so dramatically that it is
now a sub-group under Sudden Unexpected Deaths in Infants (SUDI), which covers
all deaths from known and unknown causes.
The reason for the recommendation against co-sleeping for the first six
months is for the following reason:
Even when it is carried out as advised and the numerous identified risk factors are factored out, there remains a greater risk of SUDI than if the baby is placed to sleep in a separate cot in the same room as the parents.
Certainly, the numbers are minuscule but the avoidable death of even one baby is a tragic event.
The idea that the philosophy behind this advice is, as Tynan puts it, ‘that sleeping mothers are potentially deadly to their nearby babies’ is offensive to conscientious health professionals who have a duty of care to fully inform the mothers they see, and the long line of dedicated researchers who have made such a remarkable contribution to the welfare of babies in the last 30 years.
Bruer John T, Ph.D, The Myth of the First Three Years , Free Press 2005, USA.
Hardyment Christina, Dream Babies, Childcare advice from John Locke to Gina Ford, Frances Lincoln 2007, United Kingdom
Jackson Deborah, Three in a Bed, Bloomsbury Publishing PLC; Revised ed 2003, United Kingdom.
Jean Liedloff, The Continuum Concept. Arkana, London, 1989