From Wikipedia, the free encyclopedia
Co-sleeping, also called the family bed, is a practice in which babies and young children sleep with one or both parents, as opposed to a separate infant bed. It is standard practice in many parts of the world, and is practiced by a significant minority in countries where infant beds are also used. There are conflicting views on its safety and health compared to using a separate infant bed.
Co-sleeping is standard practice in many parts of the world outside of North America, Europe and Australia, and even in the latter areas a significant minority of children have shared a bed with their parents at some point in childhood. One 2006 study of children age 3–10 in India reported 93% of children co-sleeping.
Co-sleeping was widely practiced in all areas up until the 19th century, until the advent of giving the child his or her own room and the crib. In many parts of the world, co-sleeping simply has the practical benefit of keeping the child warm at night. Co-sleeping has been relatively recently re-introduced into Western culture by practitioners of attachment parenting. A 2006 study of children in Kentucky in the United States reported 15% of infants and toddlers 2 weeks to 2 years engage in co-sleeping.
Proponents hold that co-sleeping saves babies' lives (especially in conjunction with nursing), promotes bonding, lets the parents get more sleep and facilitates breastfeeding. Older babies can breastfeed during the night without waking their mother.
Opponents claim that co-sleeping is stressful for the child when they are not co-sleeping. They also cite concerns that a parent may smother the child or promote an unhealthy dependence of the child on the parent(s). In addition, they contend that this practice may interfere with the parents' own relationship, by reducing both communication and sexual intercourse at bedtime, and argue that modern-day bedding is not safe for co-sleeping. Furthermore, the American Academy of Pediatrics has amended its policy statement regarding SIDS prevention, and has come out against sharing a bed with small babies (though it does encourage room-sharing). The U.S. Consumer Product Safety Commission also warns against co-sleeping. 
Safety and health
Health care professionals disagree about co-sleeping techniques, effectiveness and ethics. The U.S. Consumer Product Safety Commission warns against practicing it with babies, but many pediatricians, breast-feeding advocates, and others have criticized this recommendation.
One study reported mothers getting more sleep by co-sleeping and breastfeeding than by other arrangements.
It has been argued that co-sleeping evolved over five million years, that it alters the infant's sleep experience and the number of maternal inspections of the infant, and that it provides a beginning point for considering possibly unconventional ways of helping reduce the risk of sudden infant death syndrome (SIDS).
Stress hormones are lower in mothers and babies who co-sleep, specifically the balance of the stress hormone cortisol, the control of which is essential for a baby's healthy growth.
In studies with animals, infants who stayed close to their mothers had higher levels of growth hormones and enzymes necessary for brain and heart growth.
The physiology of co-sleeping babies is more stable, including more stable temperatures, more regular heart rhythms, and fewer long pauses in breathing than babies who sleep alone.
Co-sleeping may promote long-term emotional health. In long-term follow-up studies of infants who slept with their parents and those who slept alone, the children who co-slept were happier, less anxious, had higher self-esteem, were less likely to be afraid of sleep, had fewer behavioral problems, tended to be more comfortable with intimacy, and were generally more independent as adults. However, a recent study (see below under precautions) found different results if co-sleeping was initiated only after nighttime awakenings.
Co-sleeping is known to be dangerous for any child when a parent smokes, but there are other risk factors as well. Some common advice given is to keep a baby on its back, not its stomach, that a child should never sleep with a parent who smokes, is taking drugs (including alcohol) that impede alertness, or is obese. It is also recommended that the bed should be firm, and should not be a waterbed or couch; and that heavy quilts, comforters, and pillows should not be used. Young children should never sleep next to babies under nine months of age. It is often recommended that a baby should never be left unattended in an adult bed even if the bed surface itself is no more dangerous than a crib surface. There is also the risk of the baby falling to a hard floor. Parents who roll over during their sleep could inadvertently crush and/or suffocate their child, especially if they are heavy sleepers and/or obese.
A recent report explored the relationship between ad hoc parental behaviors similar to traditional co-sleeping methodology, though the study's subjects typically utilized cribs and other paraphernalia counter to co-sleeping models. While babies who had been exposed to behaviors reminiscent of co-sleeping had significant problems with sleep later in life, the study concluded that the parental behaviors were a reaction to already-present sleep difficulties. Most relationships between parental behavior and sleeping trouble were not statistically significant when controlled for those preexisting conditions. Further, typical co-sleeping parental behavior, like maternal presence at onset of sleep, were found to be protective factors against sleep problems. 
Products for infants
There are several products that can be used to facilitate safe co-sleeping with an infant.
- bassinets that attach to the side of an adult bed, and which have barriers on three sides, but are open to the parent's side.
- bed top co-sleeping products designed to prevent baby from rolling off the adult bed and to absorb breastmilk and other night time leaks.
- side rails to prevent the child from rolling off the adult bed.
- co-sleeping infant enclosures which are placed directly in the adult bed.
A study of a small population in Northeast England showed a variety of nighttime parenting strategies and that 65% of the sample had bedshared, 95% of them having done so with both parents. The study reported that some of the parents found bedsharing effective, yet were covert in their practices, fearing disapproval of health professionals and relatives. A National Center for Health Statistics survey from 1991 to 1999 found that 25% of American families always, or almost always, slept with their baby in bed, 42% slept with their baby "sometimes", and 32% never co-slept with their baby.
- ^ Bharti B, Patterns and problems of sleep in school going children Indian Pediatr. 2006 Jan;43(1):35-8
- ^ Montgomery-Downs HE, Sleep habits and risk factors for sleep-disordered breathing in infants and young toddlers in Louisville, Kentucky. Sleep Med. 2006 Apr;7(3):211-9. Epub 2006 Mar 27.
- ^ McKenna JJ, Why babies should never sleep alone: a review of the co-sleeping controversy in relation to SIDS, bedsharing and breast feeding, Paediatr Respir Rev. 2005 Jun;6(2):134-52.
- ^ Hunsley, M. The sleep of co-sleeping infants when they are not co-sleeping: evidence that co-sleeping is stressful. Dev Psychobiol. 2002 Jan;40(1):14-22.
- ^ Kemp, James S. et al. (2000) Unsafe Sleep Practices and an Analysis of Bedsharing Among Infants Dying Suddenly and Unexpectedly: Results of a Four-Year, Population-Based, Death-Scene Investigation Study of Sudden Infant Death Syndrome and Related Deaths. PEDIATRICS Vol. 106 No. 3 September 2000, p. e41
- ^ CPSC Warns Against Placing Babies in Adult Beds; Study finds 64 deaths each year from suffocation and strangulation, Consumer Product Safety Commission, September 29 1999
- ^ a b Mace, S. Where should babies sleep? Community Pract. 2006 Jun;79(6):180-3.
- ^ Consumer Product Safety Commission
- ^ MedicineNet.com
- ^ Quillin, SI, Interaction between feeding method and co-sleeping on maternal-newborn sleep. J Obstet Gynecol Neonatal Nurs. 2004 Sep-Oct;33(5):580-8.
- ^ McKenna J, Experimental studies of infant-parent co-sleeping: mutual physiological and behavioral influences and their relevance to SIDS (sudden infant death syndrome). Early Hum Dev. 1994 Sep 15;38(3):187-201.
- ^ McKenna, J., and T. McDade, "Why babies should never sleep alone: A review of the co-sleeping controversy in relation to SIDS, bed sharing, and breastfeeding", Paediatric Respiratory Review 6, 2005, p. 134-152
- ^ Coe, C.L., et al., "Endocrine and immune responses to separation and maternal loss in non-human primates", The Psychology of Attachment and Separation, New York Academic Press, 1985, p. 163-199
- ^ Hofer, M., "The mother-infant interactionas a regulator of infant physiology and behavior", Sympiosis in Parent-Offspring Interactions, New York: Plenum, 1983
- ^ Hofer, M., "Some thoughts on the tranduction of experience from a developmental perspective", Psychosomatic Medicine, 44:19, 1982
- ^ Hofer, M. and H. Shair, "Control of sleep-wake states in the infant rat, by features of the mother-infant relationship", Developmental Psychobiology, 1982, p 229-243
- ^ Butler, S.R., et al., "Maternal behavior as a regulator of polyamine biosynthesis in brain and heart of developing rat pups", Science, 1978, p 445-447
- ^ Kuhn, C.M., et al., "Selective depression of serum growth hormone during maternal deprivation in rat pups", Science, 1978, p. 1035-1036
- ^ Field, T., Touch in early development, N.J.: Lawrence Earlbaum and Assoc., 1995
- ^ Reite, M. and J.P. Capitanio, "On the nature of social separation and social attachment", The psychobiology of attachment and separation, New York: Academic Press, 1985, p. 228-238
- ^ Crawford, M., "Parenting practices in the Basque Country: Implications of infant and child-hood sleeping location for personality development", Ethos, 1994, 22, 1: 42-82.
- ^ Forbes, J.F., et al., "The cosleeping habits of military children", Military medicine, 1992, p. 196-200
- ^ Heron, P., "Non-reactive cosleeping and child behavior: Getting a good night's sleep all night, every night", Master's thesis, Department of Psychology, University of Bristol, 1994
- ^ Keller, M.A., and W.A. Goldberg (2004). "Co-sleeping: Help or hindrance for young children's independence?". Infant and Child Development 13 (December): 369–388. doi:10.1002/icd.365.
- ^ MedicineNet.com IParenting.com.
- ^ Sears, William M.D. et al., The Baby Sleep Book, Brown, Little & Company, 2005, p. 131
- ^ Simard, V., et al. (2008). The Predictive Role of Maladaptive Parental Behaviors, Early Sleep Problems, and Child/Mother Psychological Factors. Archives of Pediatric and Adolescent Medicine
- ^ Hooker, F., Sleeping like a baby: attitudes and experiences of bedsharing in northeast England. Med Anthropol. 2001;19(3):203-22.
- ^ Sears, William M.D. et al.,ibid, p. 107
- Jackson, Deborah. Three in a Bed: The Benefits of Sharing Your Bed with Your Baby, New York: Bloomsbury, 1999.
- McKenna, James J. Sleeping with Your Baby, Washington, D.C.: Platypus Media, 2007.
- Morelli, G.A., Rogoff, B., Oppenheim, D., & Goldsmith, D. (1992). Cultural variation in infant's sleeping arrangements: Questions of Independence. Developmental Psychology, Vol. 28, No. 4, 604-613.
- Thevenin, Tine. The Family Bed, New Jersey: Avery Publishing Group, 1987.
- Simard, V., et al. (2008). The Predictive Role of Maladaptive Parental Behaviors, Early Sleep Problems, and Child/Mother Psychological Factors. Archives of Pediatric and Adolescent Medicine Available at: http://archpedi.ama-assn.org/cgi/content/short/162/4/360