How Bad Is Co-Sleeping, Really?
Welcome to Ask Dr. Harvey Karp, our fatherhood advice column, where the author of The Happiest Baby on the Block and creator of the SNOO answers your burning questions about parenting. Got a query? Drop us a line in the comments!
It’s clear: New parents are tired. Their bump-into-walls-level of exhaustion has even become a running joke that’s spawned thousands of Instagram memes and sitcom gags, like dads brushing their teeth with sunscreen, pouring orange juice into their coffee, or dozing off at a red light.
But the reality of severe sleep deprivation is no joke. It can lead to devastating mistakes, like forgetting your child in the backseat of a car or forgetting to turn off the stove. Deep fatigue is a major issue that new parents face daily. It can trigger irritability, depression, intrusive thoughts, and much more.
In their desperation for sleep, parents often turn to risky choices that increase the chances of Sudden Unexpected Infant Death (SUID), such as bed-sharing, stomach sleeping, and using soft toys or bulky bedding in the baby’s sleep space. Despite decades of public health campaigns advocating the ABC’s of safe sleep (Alone, on the Back, in a Crib), the frequency of these tragedies is stuck at 3,400 deaths per year with no improvement in over 25 years!
While efforts to educate parents have led to fewer babies being placed on the stomach at bedtime, another risk, bed-sharing, has increased by 200 to 300% in recent years. One study found that 30% of breastfeeding moms start the night bed-sharing but by morning, 60% of babies end up in their beds.
This brings us to the question: Does co-sleeping foster closeness or can it be a danger?
Most bedsharing babies do fine, but tragically, thousands don’t. So, what can parents do to eliminate bedsharing risks? Of course, you can eliminate pillows and bulky bedding that can cause suffocation, forbid cigarette smoking, keep extra people out of the bed, avoid overheating, and never bedshare if you are drunk or high. But things still can go awry, even after eliminating risks.
New Zealand researchers did a study videotaping 80 infants—half in cribs and half bedsharing. They found that for nearly one hour per night the faces of the bedsharing babies were covered by a blanket (usually above the eyes). Bedsharing babies also spent 5.7 hours a night, lying on their sides, not safely on their backs.
Even if you strip the bed bare, there is still one more risk that’s almost impossible to remove, your exhaustion. Exhaustion causes a very similar brain impairment to being drunk! A study by the National Highway Safety Commission found that sleeping less than 6 hours—just one night—doubled the risk of a serious car accident the next day. And sleeping fewer than 4 hours raised the risk 11-fold! Imagine how many “sleep-drunk” parents are driving to work each day and making risky decisions without even realizing it.
When you’re sleep deprived, you might just roll over a little, and that’s when accidents can happen. A pediatrician recently told me that he and his wife fell asleep in bed with their baby, only to wake up when their daughter started to scream. She had rolled off the bed and ended up with a skull fracture.
Parents take these risks out of desperation, not negligence. Sleep deprivation is used by the military to train our special forces to endure torture. Moms and dads are exhausted and single parents and those with multiples are especially vulnerable. All parents deserve help from family and friends so they can avoid making bad decisions out of deep fatigue, but few have that type of support anymore.
So, what can you do to get sleep and keep your baby safe? Here are some tips:
Keep your baby close, but in their own safe space. The American Academy of Pediatrics recommends room-sharing for at least the first six months, and having your little one’s bassinet nearby makes it so much easier to pop them back in after feeding. You’ll both sleep better when you know they’re in a safe spot.
Share the overnight load. If you’re partnered, come up with a plan to spread the ZZZs. That might mean alternating nights where one parent is “on” and the other is “off.” Or it could be splitting the night into shifts (one parent is on-call through Baby’s first wakeup, the other is on-call for the rest of the night.) Or if Mom is exclusively breastfeeding, then Dad can do burping, diaper changes, and getting Baby to sleep. Also, a family member who can stay overnight, a doula, or night nurse can be tremendously helpful.
Boost your baby’s sleep. A recent medical study concluded that to reduce SUID we need to teach parents ways to improve infant sleep. The best ways to boost the ZZZs is by using sound, motion, and snug swaddling. But you have to do those safely. For example, white noise should be kept under 65-70 dB (measured next to the baby’s head); motion is only safe for babies on a flat surface; and swaddling needs to be done correctly (no overheating, not tight around the hips, and stopped once the baby can roll over. Stomach sleeping when swaddled raises the baby’s risk of SUID).
Consider SNOO. One way that is proven to improve infant sleep is by using a SNOO. It safely soothes babies with gentle womb-like motions, snug swaddling, and calming white noise. Research shows that SNOO babies quickly get an extra hour of sleep each night. By 2 to 3 months of age, SNOO babies average 6.5 to 7 hours of continuous, unbroken sleep/night, and by 6 months, most can transition seamlessly to a crib. Plus, SNOO is the only FDA De Novo authorized baby bed that secures sleeping babies safely on the back all night.
While the temptation to co-sleep is understandable, parents shouldn’t have to choose between their baby’s safety and their own need for sleep. With the right support, we can prevent exhaustion from leading good parents to making risky decisions.
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