Co sleeping and SIDS leaflet at doctors

[Rowanhart]

I was planning in co sleeping when our DD is born in three weeks.

I was at docs today waiting for whooping cough jab when saw a leaflet called Risks of co sleeping.

In it said that infant mortality due to co sleeping is high the area we live in and we should never co sleep.

Also had quotes from two mums whose babies had died due to co sleeping,

I thought it was recommended? Confused now but thinking co sleeping is a big no no...

I thought that as long as other 'at risk' variables were excluded (smoking, drinking, drugs, breastfed, enough ventilation, no risk of falling, safe bed - no duvet, tight sheet), then co-sleeping wasn't riskier than cot sleeping?

I thought it was risky when it was combined with other risk factors?

I used to feed DS1 whilst I was sat up in bed. I woke one night to find him lying between me and DH. I was upset, as I can't remember putting him down. Thankfully he either rolled off me or I let him go on the 'right' side. But I was shaken up.

With DS2, I made sure bed sheet was tightly on, I didn't use a duvet or a pillow, I breastfed on my side with my arm 'around' DS2, so I couldn't roll on him, bed pushed up against wall (no gaps), well ventilated room, DH slept in the spare room. I personally felt that was safer than feeding him through the night sat up.

The excellent UNICEF "Caring for your baby at night" leaflet, endorsed by FSID, Royal College of Midwives etc, came out last November and can be downloaded for free here: www.unicef.org.uk/BabyFriendly/Resources/Resources-for-parents/Caring-for-your-baby-at-night/, along with a useful accompanying leaflet for health professionals that has the rationale for all the recommendations, and all the references. It may be more relaxed about bed-sharing than you'd expect; for example previous versions cautioned against it if you weren't breastfeeding, but this version doesn't. Talking of references, the ISIS online sleep information site from Durham Uni Sleep lab is an excellent resource if you want to know the state of the art as far as infant sleep research is concerned: www.isisonline.org.uk/

No one is obliged to drive either. Peope survived for milennia without cars. Just move and live in London blah blah blah.

I think you are deliberately misconstruing many of my points. It's not that easy to move to London or do without a car for most people, and for many people, getting a baby to sleep without screaming is not easy either. Some people have babies that don't scream when in a cot, others can cope with the screaming, some people can't.

The point about cars is that people tolerate that risk, not the risk per se. We all know about it, the vast majority of us will know someone personally who was killed in a car or had their life otherwise destroyed (I personally know seven ) and yet we don't argue about it or suggest it should be outlawed or whatever or say "well, drive if you must but just remember IT COULD KILL YOU and how will you LIVE WITH YOURSELF if it does?". You said earlier in the thread that you think cosleepers minimise the risk to justify their actions. I would say that this applies to pretty much every risk we ever encounter. We will play up the importance of risks we choose to avoid and blithely skip over those that don't suit us.

I've said about a million times that I think discussion of risks is productive but saying that cosleeping is dangerous in the absence of other risk factors just doesn't seem to be warranted. Dangerous implies quite a bit of risk, I'm not seeing that here. I really do believe that if it had been proven to be dangerous that there would be a major campaign as there was with the Back to Sleep campaign to inform us of the risks and not, as in my earlier posts, campaigns based on "insight work" with targeted populations in one area with advice on safe sleeping in another. I think I've probably exhausted everything I have to say on the topic though. There may (or may not) be a slightly increased risk of SIDS among infants who cosleep but as most authorities internationally contend, the issue is complex and it is likely that there will be quite a bit of difference between what should be recommended for one family vs another. That crazy bipartisan group Unicef seems to think it's a pretty good idea, the NHS seems unclear, others think it's bad. Consensus really isn't the order of the day here.

Funnily enough, I don't have a car. I don't even live in London! Yet here I am, managing fine without that necessary evil. Wish I DID have a car, but that's another story!

We still co-sleep with DD at 3.5 and have done since she was born. I was in hospital for the first week and we co-slept there as well.

The HV and MW were very supportive for co-sleeping.

I'd read '3 In A Bed', all the Paul McKenna research I could find and I grew up in a country where co-sleeping was the norm and SIDS unheard of.

You do need to follow the rules though... you must be breast-feeding - the hormones will prevent you ever reaching the deepest stage of sleep and you will automatically lie in the 'safe' position: Arm above head so baby can't move up, knees bent under baby so they can't move down, body facing baby for easy feeding and other arm over baby to stop them rolling away. It's very similar to the recovery position and prevents you rolling onto the baby at any time either. A non-breast feeding mother will not automatically assume this sleeping position and there is much less protection for the baby plus they will sleep much more deeply.

Ads to that the whole no alcohol, smoking or drugs, must be a proper bed, absolutely no swaddling of the baby (lots of people don't realise that is a big no-no), light clothes for the baby, no pillows, duvets etc, no beds pushed up against walls, no father/baby co-sleeping, no older sibling co-sleeping.

We used a bed-bar with mesh to ensure there could be no falling out and that the surface was breathable (unlike most bumpers in cots). DD learnt to latch herself very quickly so I got lots of sleep because I wasn't having to get out of bed - most of the time I didn't even realise. DH has never had a night of disturbed sleep since she was born - she didn't need to cry as everything she needed was right there.

I also loved that I could wake up and know that my child was fine as I could feel both her heart-beat and breathing without having to move more than a finger. I would have been constantly checking on her in a cot in another room.

I feel it is the normal, natural way for a child to sleep. If cavewoman had left cavebaby 100 yards away on their own, they would have been sabre-toothed tiger food pretty quickly.

If we have another I will definitely co-sleep again.

It drives me crazy that falling asleep on a sofa is defined as co-sleeping, that suffocation or being rolled on gets classed as SIDS etc when neither are accurate. Also makes a mockery of the statistics. Would be so much better to give proper advice to people on safe co-sleeping.

jaynejoyce- Thanks for the links to the Unicef leaflets. Really informative, sensible and, of course, evidence- based.

It says in no circumstances should you co-sleep.

This is what I'm railing against. Not that their are no risks, more that it seems an entire country worth of experts seem to have collectively put their feet down and said "no way" instead of minimising the risk.

Are there leaflets and midwives etc telling people that they must not ever ride in a car but should always take the bus because it is safer, no matter how inconvenient? No, of course not.

Instead of the approach they have with cars i.e. if you drive your baby you

*should not be drunk or under the influence of drugs
*should not be smoking
*should strap them carefully in a well fitting approved car seats
etc etc

they do the equivalent of saying

*don't ever drive in a car

And the difference between safety in buses vs cars is very obvious, not 0.5%

For a slightly different angle on this!

I was never going to co-sleep, but ended up doing it with DD 3 years ago, for a couple of months, as i couldn't bear her to be so far away. (When DS was born 9 months ago, I couldn't bear him in the bed!)

DD spent every night lying on her back facing me, and from then on only ever slept facing right even though I tried to turn her head. Now at age nearly 2, her head tilts one way all the time and she's been referred to physio as a tilting head distorts the face shape in the end - i can already see this happening, she is very assymetrical. If I could turn back time I would never have had her in the bed with me, just for this reason, i feel quite sad that I have caused her this problem.

woowa, you have not caused it, your D would have probably slept like this in a cot as well. I have never heard of this condition of which you talk but both my kids co slept and I co slept too and this was never a problem, and I have never heard of it being a problem associated with co sleeping.

DD*

woowa, my friend's baby had this and she was in a cot.

Pyrrah, an excellent post.

I'm curious about the statistics that show that breastfeeding and co-sleeping rates are low in this country. How are these statistics derived? The only time I've ever been asked about how I'm feeding my babies is by the midwife immediately following the birth. I don't recall ever being asked where my babies slept. Do the midwives feed this information back into a central database? Otherwise if a sample is taken how can it be assumed to be representative? Agree with previous posters the lumping of sleeping in a chair or on a sofa with a baby in with safely breastfeeding in bed with none of the risk factors present skews the results of any such survey in such a way that in fact many babies may be at higher risk of sids in a cot than when co-sleeping.

With DS1 I never intentionally co-slept, (fell asleep a couple of times whilst BFing) with DS2 now 7 and a half months, I find I am having to co-sleep as he wakes up every hour for no reason at all and can't wont settle himself. There is only so much sleep deprivation one person can take so I end up giving in and putting him in bed next to me. I use a baby sleeping bag, so less chance of him rolling or wiggling down. It does worry me but he just WILL NOT sleep on his own at the moment. (I am working on it)

I am now on a medication that makes me drowsy so am going to really struggle but am determined to keep him in his cot. Wish me luck!!

My point is some babies just want and need to be close to mummy. As long as you are not drinking, smoking or taking drugs, prescribed or otherwise I personally think it is ok once baby is old enough to pull a cover away from themselves. Until there is a study which conclusively proves it to be unsafe IF you are following the guidelines then I would carry on with co-sleeping.

A good survey doesn't lump sleeping in a chair in with sleeping in a bed, the same as those babies who die due to suffocation or unexplained death. It's all broken down so you know if the baby was in a bed, cot or chair.

It also tells you if the parents smoked,drank, took drugs. Maternal age and if they were married, if they were bf/ ff, if the baby was prem or low birth weight. The month the baby died.

All of which they use to determine risk factors

People say they can't do without their cars so take greater risks every day driving - I'm not one, we lived without cars for many years in the UK, but people insist to me all the time they can't do without. Given people drive, love driving, love their cars and won't stop driving for anything, advice is given to minimise accidents. If babies can't 'do without' co-sleeping (something I don't agree with) in the same way, then I think you should be given advice to co-sleep more safely particularly in the first few months of life.

If you want to sleep close to baby and are worried about the risks, then you don't have to co-sleep in the strict sense: my very good friend who advocates attachement parenting always put her babies in a side cot attached to the bed. THis is just as safe as in a cot.

If health profs were to actively promote co-sleeping and how to do it safely I wonder what the real consquence would be. At the moment, most co-sleeping deaths (in fact most SIDS deaths) are associated with more than one risk factor. Co-sleeping SIDS deaths are linked to drinking/drugs even though these things are not recommended at all for parents of young babies. Even with good safety advice available, do you think if more people co-slept they would do so safely?

I co-slept with all three of mine, and never saw any evidence that it was risky. Quite the contrary.

I was also influenced by the fact that a friend's 5 month old died of SIDS. She died the first time she slept in her own room away from her parents. Maybe it was a coincidence, but my friend didn't think so.

NO WAY! this was neither an option with my 6 kids, might not have had the 2nd had i co slept! i was always happy to bunk in with a poorly/scared/upset baby/child but they weren't welcome in our bed as much as we love/d our kids. they have all turned out okay and i'm proud of them.

How absolutely awful for the parents claraschu

I never planned to co-sleep, and instead had DD's cot right up against my side of the bed, however on a few occasions whe DD was particulary ill or teething, I would co-sleep just to help her settle and get some sleep.

That said, I am an incredibly light sleeper, so when I had DD in bed with me, I didn't sleep, as she wiggles and snores.

Haycock, scientific adviser to the Foundation for the Study of Infant Deaths and emeritus professor of paediatrics, wrote the following on MN in 2009:

"Recent studies from Germany and the Netherlands suggest that following the guidelines 'to the letter' reduces but does not abolish the risk of bed sharing, especially in the youngest infants."

I hate posting primary literature as different studies with diff population/inclusion criteria/methods etc mean you get results that are not easily comparable and I don't want to get in a debate about the merits of each piece of research.

Ultimately, with an expert of the ilk of Haycock, someone who has a broad and deep understanding of the SIDS field that I don't (very few do) have, I trust what he says. There is plenty of primary research on Haycock's page for those interested in reading further. Needless to say claraschu, there is very good evidence that co-sleeping is risky in young babies.

What about the enormous benefits of co-sleeping? Not just that it supports breastfeeding and better sleep for parents, but the benefits to the baby? There are huge physiological and psychological advantages to the baby from shared sleep: more responsive parents, shorter nighttime wakenings, significantly less need for crying to arouse parents (therefore less cortisol flooding the brain), plus, the increased physical contact with parents promotes bonding.

Interestingly, co-sleeping has also been shown to lower testosterone levels in fathers, making them more responsive parents.

Co-sleeping, when done purposefully, ie: planning to bed share and arranging your sleep space accordingly, can be safe, and in my opinion is infinitely more beneficial short term AND long term, than separate sleep.

There are, of course, risks to almost anything, especially anything to do with child-rearing. After reading some of the responses to the OP, I feel very lucky to live close to one of the best research and teaching hospitals in the country, in an area where breastfeeding, co-sleeping and other baby-friendly practices are viewed sensibly in terms of short and long-term benefits, where parents are given information to reduce risks, and continue to make informed decisions.

But LeBFG it's so hard to keep a sense of perspective regarding SIDS as a mother isn't it ?

It seems to me from posts here that there may possibly be a slightly increased risk with co-sleeping but we can't be sure if the research has been rigorous and compared safe co-sleeping with safe cot sleeping practices ? And importantly any increased risk is a very small increase on something that is already unlikely for each individual baby.

Of course I want to see every possible reduction in these tragedies or I wouldn't be talking about it here. My Granny lost her first baby to SIDS, a baby who would have been my Mum's big sister and my Auntie. Still missed so many years later

Yes, Bagerina, it's exactly that: a balance of risks and benefits that only the individual can decide upon.

where parents are given information to reduce risks, and continue to make informed decisions. Yes, yes to this.

Moses basket by the side of the bed for ds1 and ds2

I did it but not all night iykwim and yes was very very careful. I did have a great bedside cot for DD2. Would never put baby in between me and someone else either. I am very light sleeper. You have to be careful and aware.