Here’s how to co-sleep as safely as possible, according to experts

After months of breastfeeding around the clock and eagerly trying to put her infant son to sleep in his bassinet, Toronto mom Kate Galt was bone tired. Nothing worked anymore. When Elliot outgrew the bassinet at three months old, Galt tried to teach him how to do it sleeps in his own bed, but he always seemed to end up in bed with her at some point during the night. It was there that he seemed happiest and most relaxed.

The truth is, Galt liked sleeping next to Elliot, too. “Sleeping with him at night makes me feel closer to him,” she says. As a child she shared a bed with her sister and it is natural for her to snuggle up to her loved ones at night. “I’ve always slept with people,” she says. “It feels sad to put a baby to bed alone. I don’t want to sleep alone either!”

But North American experts and doctors strongly advise against sleeping with a baby. Both the Canadian Pediatric Society (CPS) and the American Academy of Pediatrics (AAP) have long discouraged new parents from sharing beds, warning that it is dangerous and poses risks of suffocation, along with a higher risk of sudden death infant death syndrome (SIDS). .

But when parents desperately need just a few hours of sleep, there are times when they share a bed. Anyone who has put their baby to bed for breastfeeding at 3am knows how easy it is to doze off while breastfeeding with your baby in your arms, whether you want it or not.

A recently updated joint statement on safe infant sleep, published by CPS and Health Canada last month, confirms what many parents have experienced firsthand: a third of Canadian mothers say they share beds regularly, and another third say they do so occasionally. A majority of Canadian parents will eventually sleep together, despite advice and despite the best of intentions. The new statement reflects this reality.

“We knew we had to address the elephant in the room,” says April Kam, a CPS counselor and pediatrician in Hamilton, Ontario.

Ultimately, Kam says the safest place to sleep for toddlers is in a crib, crib or bassinet, as sharing the bed increases the risk of suffocation and overheating. It’s the CPS’s role to make it clear where the risks of SIDS lie, says Kam, but it’s up to parents to decide what works best for their families, and the more information parents have, the better. Because of this, the joint statement has been updated on what behaviors and what family circumstances can cause babies to fail most in danger. According to the new statement, these risks are “particularly high for infants under four months of age or if the infant was born prematurely or with a low birth weight.” But IIf you do go to bed anyway, there are steps you can take to mitigate the risks.

If possible, breastfeed for at least two months

Research shows that breastfeeding has been shown to reduce the risk of SIDS, Kam says. “Breastfeeding for at least two months is protective, and the longer you breastfeed, the more protective it is up to a point.” However, when it comes to co-sleeping, Kam says the benefits of breastfeeding vs breast feeding do not completely negate the higher risks of bed sharing.

James McKenna, California-based anthropologist and author of the book Safe baby sleep, says mothers sleeping next to their infants can be perfectly safe and even good for the baby as long as parents are careful. McKenna, who founded the Mother-Baby Behavioral Sleep Laboratory at the University of Notre Dame, studies the physiology and behavior of co-sleeping mothers and infants. His research has led him to conclude that “the safest sleeping environment is one in which a breastfeeding mother is involved”. He doesn’t agree Shame on those who cannot breastfeed, or choosing not to breastfeed — it has more to do with the science of a baby’s sleep and wakefulness.

During the first trimester, when babies are most susceptible to SIDS, all babies are prone to periods of sleep apnea, during which they temporarily stop breathing, he explains. That is normal. When breastfed babies sleep next to their mother, “they wake up all night and practice waking up to breathe,” he explains. “You’re getting really good at it.” In contrast, McKenna and his colleagues found that babies who slept alone were less likely to wake up to interrupt these episodes of sleep apnea.

“There’s this whole notion that the ‘good babe is the baby who sleeps through the night and sleeps soundly, and that’s not true,” says McKenna. “What makes the interaction between mother and child so important is a constant alternation between sleep phases and arousal mechanisms that oxygenate the baby.”

Beyond this excitation mechanism, McKenna and his researchers observed this breastfeeding mothers Sleep in what is called a C-position.

“Many mothers sleep on the side with the baby under the triceps at chest level and tuck their legs under the baby’s feet,” says McKenna. This arrangement provides protection from movement compared to non-breastfed babies who tend to sleep higher up towards the pillow and not necessarily facing their mother. (Note that pillows should actually be removed from the bed altogether.)

Stay sober and smoke free

Exposure to second-hand cigarette smoke during pregnancy and postpartum is not only frowned upon — it has a very real impact on how your baby’s brain works, McKenna explains. The chemicals in smoke damage the excitation sites in the brain that allow the baby to learn to breathe properly overnight, and this increases the risk of SIDS.

“Smoking and bed-sharing appear to have a synergistic effect,” the CPS statement said. “The risk of SIDS is significantly higher for infants who share the bed with a smoking adult or if their mother smoked during pregnancy.”

The new statement also notes that prenatal and ongoing alcohol consumption, Opioids and other substances (not just nicotine) are all associated with an increased risk of SIDS, particularly when sharing beds. “Both the mother and father should avoid drug or alcohol desensitization,” says McKenna.

If you sleep together, make it a safe place to sleep

Kam emphasizes the importance of never putting a baby to sleep on a soft surface with loose bedding, which most typical adult beds include. That means no blankets, no pillows, no duvets, no nursing pillows and no bumpers. A firm mattress with a tight-fitting sheet is the only option. (No waterbeds, no air mattresses, and no pillow-top mattresses either.)

Sidecar beds that attach to the bed or rollaway beds that fold down are also not recommended, as small children can become trapped in the gaps between the bed, mattress and rollaway bed. (In fact, these types of products are largely unavailable in Canada.)

And avoid the whole “family bed” concept, too, Kam adds. Sharing a bed with other adults, older children, and pets further increases the risk of cot death. The safest way to co-sleep is to confine the bed to just parents and baby.

When Galt first decided to do it Hug co-sleepingShe wanted to make sure she did it as safely as possible. “I read everything and made sure nothing is dangerous. We never drank or smoked weed. Elliot slept with no pillows, no blankets, and so did I,” she says.

Finally, don’t sleep on a couch or in a chair with your baby in your arms, on your chest, or next to you. “Sleeping together on a couch or a lounge chair is always dangerous,” says McKenna.

What about co-sleeping with a swaddled infant?

A well-fitting sleeping bag is fine for co-sleeping, but never the bed with a swaddled baby. This is also underlined by the updated statement of the CPS wrap does not reduce the risk of SIDS. In fact, Kam says swaddling can be dangerous under certain circumstances.

Regardless of where you put your baby to sleep, “don’t put a swaddled child on their side or tummy, and stop wrapping when the child shows signs of turning over,” says Kam. The wrap should also be rolled away from the baby’s mouth or nose, closer to the shoulders and away from the chin or face. If you use one Blanket as a wrap, choose a light one so as not to overheat the baby.

Can pacifiers help protect co-sleeping babies?

Yes, you can. There is evidence that pacifiers can help keep babies secure once breastfeeding is established because sucking triggers the breathing reflex and reduces these periods of neonatal apnea, Kam says.

Is room sharing safer than bed sharing?

Room sharing is a good, protective option that keeps toddlers close to their parents overnight, but not in the same bed, says Kam. (You can do this with a bassinet, travel bed or a regular cot if you have space in your bedroom. Or some parents prefer to sleep in the child’s room next to the cot on an adult-size mattress.) Sharing a room is associated with a lower risk of SIDS and is recommended for the first six months of life.

As the SIDS risks peak in between two and four months, and is less common between 6 and 12 months, parents can relax a bit as their babies grow older.

“As with most aspects of parenting, as the child ages, you can continue to modify and adapt to their developmental stages,” says Kam. For example, once your baby has learned to roll over, you can worry less about him sleeping on his back – let him sleep on his stomach if he got there on his own.

Ultimately, there are myriad factors that affect safety and increase or decrease the risks to the baby. It’s certainly possible to make bed sharing safer, but it still carries an increased risk of SIDS. Remember that the safest co-sleeping arrangement is between a sober and smoke-free nursing mother and her infant in a firm bed with no loose linens. Any deviation from this increases the risk of sudden infant death, says Kam.

She likes to use a bike safety analogy: “Think of all the protective layers we wear on our bikes. Maybe we’d only be safe with some of them, and maybe we wouldn’t make it with any of them. But it makes sense to protect ourselves as best we can.” She says parents need to do their best every day, and her job is simply to make sure they are as informed as possible about the risk factors.

Baby Elliot is now almost two years old and still shares his mother’s bed. “I only see him for an hour or two in the morning and night, so a lot of the days sleeping is the longest we have together,” says Galt. She is now totally hooked on co-sleeping and will definitely continue with future babies. “I know it’s taboo,” she says. “I thought we do sleep training because that’s ‘right.’ But those first few months are hell. And if you do all the research on co-sleeping, I think it can be done safely and lead to a better rest for everyone.”

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