Nursing Your Kids

A Utah couple recently lost their second child. Their first child died in 2003 after accidental asphyxiation while sleeping in her parent’s bed. The second child, whose cause of death was undetermined, died in the night sleeping between his parents. The couple is being charged with child-abuse homicide. According to court documents, the couple was warned against co-sleeping by their pediatrician the day before their child’s death. From the Salt Lake Tribune:

Prosecutors and health officials say the case should serve as a reminder to parents to put their kids to bed in a crib, in part because studies have found connections between bedsharing and SIDS, sudden infant death syndrome.

“If you do it safely, the risks are so low. The fear is really taken out of it,” said Melissa Knighton, a Salt Lake City mother who sleeps with her 19-month-old daughter, Abigail, and uses a crib to store toys. “By just saying, ‘The child died of co-sleeping,’ that doesn’t tell us anything at all. There’s dangerous ways to crib sleep, too.”

I don’t know what to make of this. First of all, I can’t imagine the grief this family must be feeling. But I’m not sure about whether it’s right to prosecute them for parenting. I don’t know the circumstances of how they slept. I don’t know if the parents are drug or alcohol users/abusers, if they sleep in a fluffy bed full of pillows, down comforters and feather beds, if they’re obese or if they’ve just been the victims of misfortune. Without knowing more details about the sleeping arrangements it’s difficult to determine whether this was a form of child-abuse homicide.

Salt Lake County District Attorney Lohra Miller - who said she nursed her children and occasionally fell asleep, only to startle awake - said her office is not out to prosecute co-sleeping parents when deaths occur.

The couple were reportedly heavy sleepers, and advocates advise against co-sleeping in such cases.

We co-slept off and on for the first year of Sam’s life. I didn’t want to at first because I was terrified of SIDS, but nighttime nursing sessions inevitably ended up with both of us falling asleep. I’d startle awake and transfer him to the pack n play beside our bed six or seven times a night. But then I found myself startling awake to check to make sure he was breathing. If I couldn’t hear him or couldn’t feel his little chest rise and fall I’d panic and hover above him looking for signs of movement. As sleep deprivation took its toll it became easier to just adjust his swaddle and put him on his back beside me. Then I read some arguments in favor of co-sleeping.

Here are the preliminary findings based on mother-infant pairs studied in the sleep-sharing arrangement versus the solitary-sleeping arrangement (Elias 1986, McKenna 1993, Fleming 1994; Mosko 1994):

Even though these studies are being conducted in sleep laboratories instead of the natural home environment, it’s likely that within a few years enough mother-infant pairs will be studied to scientifically validate what insightful mothers have long known: something good and healthful occurs when mothers and babies share sleep. (read the full article at Dr. Sears’ website)

Dr. Sears and other co-sleeping advocates made me feel better about my choice to keep Sam in bed beside me. We took all precautions, making sure that no pillows or blankets were close to Sam and always placed him on his back. Nighttime wakings were frequent, but rolling over to nurse became second nature and I no longer had to fully awaken. When he started sleeping for longer, six-hour stretches when he was about four or five months old we moved him to a crib in his own room, next door to ours. Each night when he’d wake up to nurse I’d bring him into bed with me where he’d stay until morning. We kept this arrangement up until he was close to a year old and no longer slept well in bed beside me.

I truly believe that co-sleeping is beneficial for mothers and babies when done safely.

The research on bedsharing and infant death is mixed. A 2005 study of SIDS deaths in Scotland found the largest risk occurred when parents slept with infants on a couch and when the baby was less than 11 weeks old. Other studies have found a higher risk of SIDS with infants of low birth weights, among mothers who smoked, among parents have consumed alcohol or are overtired.

Supporters of co-sleeping often cite James McKenna, director of the Mother-Baby Behavioral Sleep Laboratory at the University of Notre Dame. He says a blanket admonishment is simplistic and confuses “normal, healthy human behavior” with pathology.

I’m sure that co-sleeping is dangerous if you’re drunk or stoned or on a soft, fluffy couch. But for the parents who aren’t reckless, for parents who sleep together with their child mindfully and safely, co-sleeping allows for a good night’s sleep and provides bonding time for working parents who don’t always have the luxury of spending time with their baby during the day.

To sleep safely with your child:

For more information on co-sleeping safely, the benefits of co-sleeping and the risks, Sleeping with Your Baby is an excellent resource.