Co-Sleeping is Safe and Natural

I posted earlier about a “public [dis]service announcement” from the State of New York, against co-sleeping. This campaign did not educate about sleeping safely or even just “warn about the dangers of co-sleeping,” as the response stated. Rather, it showed a frightening image of a woman smothering her baby by accident with a voice-over that “babies sleep safest alone,” a statement NOT supported by the latest research.

I took some time to calm down and write a letter to my state. If you live in New York and wish to contact the department, you may do so here.

They responded, and I answered again. The state’s response is essentially that there were an alarming number of infant deaths in which co-sleeping was a factor. They do not take into account whether co-sleeping was a contributing or primary factor, nor do they compare this number with the number of infant deaths in cribs. Their reaction (scaring parents into not co-sleeping) is akin to saying that babies die in cars so, instead of promoting vehicular safety, they will launch a campaign discouraging parents from taking their baby in a car at all, ever.

In searching for the campaign online, I discovered that many other states have similar campaigns. Please be on the lookout to see if there is a campaign in your state and let me know in the comments. I will be posting a list of states that have these campaigns as I find them. If you write to your state, please share your letter in the comments and/or a link to your letter on your own blog.

Even if you are not a co-sleeper, please support the right of others to do so!

Other States With Campaigns (with links to the department to which you may address your concerns)

Florida, Indiana (news stories; looking for the link), Michigan, Minnesota, Missouri (found the St. Louis link, working on the state link), New York

Open Letter to New York State Office of Children Services

Dear New York State Office of Children and Family Services,

I expect official offices of my state government to use my tax dollars and launch helpful, well-researched campaigns only when necessary. So, I was dismayed to see your television “public service announcement” claiming that “babies sleep safer alone.”

Perhaps whatever committee approve this advertisement is unaware that co-sleeping, when done safely, has a whole host of benefits. Not only do parents and children who co-sleep have the opportunity to bond and get more sleep and thrive, co-sleeping, when done safely, also reduces the risk of SIDS.

Dr. Sears, a prominent pediatric authority, has written a well-researched and clear article about the benefits of co-sleeping, including its possible effect on reducing SIDS. Theories about this aspect of co-sleeping include the idea that babies who co-sleep sleep lighter and therefore wake up more easily in case of a problem, mothers are more attuned to their baby’s sleep patterns when sharing a bed, and that the parents’ heart and breathing rhythms may even help form baby’s.

Before I continue, I assure you I am no zealot. I firmly believe each family should choose the arrangement that works best for its circumstances. Personally, I did not begin co-sleeping with my daughter until she was already close to a year old, and then only part of the night.

What concerns me is that your campaign of misinformation will scare parents into making decisions that may not be right for their families.

A far more honest campaign would discuss sleep safety in general. As with most parenting, co-sleepers must plan ahead and be drug-free to ensure their baby’s safety.

Baby’s sleep space, whether a crib or an adult bed, should be firm and free from excess clutter and fabric. If you choose to co-sleep, remove all heavy blankets and excess pillows from the bed. If you use recreational or prescription drugs that may affect your sleep patterns, baby may be safer in a crib. Consult your physician if you have concerns about prescription medications.

New and exciting research is getting us that much closer to understanding and preventing SIDS. We now know that placing baby on his back, ensuring a smoke free environment, and eliminating suffocation hazards are all actions that reduce SIDS deaths. For the time being, however, we cannot explain SIDS deaths. What we do know is that there are key ways that parents can better ensure infant sleep safety.

Instead of wasting money on factually suspect scare tactics, spend our tax dollars on a campaign that reflects the best science and educates parents to make the right decisions for their children.

Their Response

Thank you for contacting the New York State Office of Children and Family Services (OCFS) on June 29, 2008.

The statewide Babies Sleep Safest Alone campaign was developed as a result of an alarming number in fatalities reported to the New York Statewide Central Register of Child Abuse and Maltreatment (SCR), where co-sleeping was a factor listed in the narrative of the report. Since
2006, 89 deaths were reported to the SCR in this category. Out of that number, 68 deaths involved infants between 0 and 3 months old, and 17 involved babies between 4-12 months old. The remainder fell in the 1 to 5 years old category.

Our campaign materials alert parents about the dangers of co-sleeping and the factors that can cause an infant’s death while sharing a bed with an adult or an older sibling. We are aware that co-sleeping is a controversial topic and are confident that educated parents will take
the necessary precautions to prevent an accidental death, which is the goal of this multilingual statewide campaign.

Our Babies Sleep Safest Alone campaign supports the American Academy of Pediatrics strong stance against co-sleeping and recognizes the risk factors that can potentially harm your child.

Thank you again for your input and concern.

My Response

Your campaign fails to take into account the latest research. The AAP is not the final word. Look at the research available and you will see that co-sleeping SIDS deaths are a tiny number compared to crib SIDS deaths.

First, consider whether co-sleeping was actually happening in these reports–ie a baby in an bed, with an adult, without excess bedding. Eliminate falls from babies sleeping alone on a bed,”couch” co-sleeping, and deaths that are actually drug or alcohol related and you’ll have a different number.

Then, compare that number to SIDS deaths in cribs.

Tell me, how many babies died of SIDS in their cribs in New York?

I think you’ll find that co-sleeping safely is even safer than crib sleeping safely.

Your campaign does not discuss any of these issues. It makes a blanket statement that “Babies Sleep Safest Alone,” which isn’t true, and shows an image of a mother accidentally smothering her child, which is not what happens.

Tax dollars should not be spent on a campaign that uses scary images to take an irresponsible stand, which does not reflect the best research, on a controversial topic.

Put the money towards a campaign for safe sleep spaces, whether that be a crib or a bed, and I would be 100% behind that campaign.

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19 comments

  1. modmom says:

    yay! mama saga!
    co-sleeping is the best, most natural way for the infant + mother.
    the father, though should be on the other side of the mom. they don’t have the hormone sensitivity like mom’s do, to be alert to the baby, even when they’re asleep. i mean the mom should sleep in the middle of the baby + dad, or the dad should go to a different bed

  2. Judy says:

    One of my thesis advisor’s at Pomona College now has a huge mother and baby sleep clinic at Notre Dame. James McKenna is a great advocate of co-sleeping based on anthropological data and on his own sleep study research.
    Here is a link to an article and to his site at Notre Dame.

    He is also a sweet man.

    http://www.nd.edu/~jmckenn1/lab/index.html

    http://www.nd.edu/~jmckenn1/lab/articles/McKenna_why%20babies%20should%20n.pdf

    Also, my college roommate is now an infant sleep specialist in Philadelphia whose mentor is often on the Today show. She is helping us get our 9 month old to sleep thru the night and stop night feedings (for my mental health and so I can start ovulating again) and we are doing it in conjunction with co-sleeping to make things transition smoothly for the baby. Not just forcing him into his own be for the sake of my sleep needs. It can be done. Western lifestyle can work with co-sleeping or a modified version of it.

    (I don’t know how to make a cool link that works, just the cut and paste kind. )

  3. Nora Bee says:

    Thanks for this post. Co-sleeping has been a great choice for our family, and it makes me sad to see that campaign against it.

  4. Debbie says:

    Your letter was great, and I agree with you. Co-sleeping, done correctly, is extremely safe. However, I spent some time volunteering in the Foster Care system. Many of these parents aren’t “co-sleeping” safely. In fact, they aren’t even following the Dr. Sears definition of co-sleeping. Rather they keep their babies in bed with them even when they drink or take drugs. And I saw several cases where babies had broken limbs falling out of bed– where they were left unattended. (Yes…I know you would never leave Baby Diva alone in bed. But many moms aren’t as responsible as you are.) Sadly, these parents I saw in Foster Care did not have the money to buy a crib. So they could have used your tutorial on how to co-sleep safely. I 100% agree with you there.

    But I really must defend the State of NY in this case. When they run Public Service campaigns like this one, they aren’t seeking to reach highly-educated women like you who spend hours reading books and articles online to learn the safe way to co-sleep. They have to find a way to simplify the message. And let’s face it: it’s harder to explain all the nuances of co-sleeping than it is to create a simple scare tactic ad. Remember that “this is your brain on drugs?” ad with the egg and the frying pan? It wasn’t nuanced, but that’s why it was effective.Moms like you won’t be harmed by the ad since you’ll do your research and co-sleep anyhow. So if the State of New York’s scare tactic ad saves 89 lives a year, I’m ok with it.

  5. Mama Luxe says:

    Thanks to all who are commenting and e-mailing and sending in links.

    Debbie–

    But if they save 89 lives and another 200 babies die of SIDS in their cribs, then it really isn’t effective. Co-sleeping done safely may be saving lives.

    Parents who do not create a safe sleeping environment for baby won’t create a safe sleeping environment in a crib OR in an adult bed.

    Co-sleeping does not cause deaths. Alcohol, drugs, and carelessness cause deaths. And they cause those deaths in or out of cribs.

    It is like running a campaign telling people not to drive because some people drive under the influence and get into accidents. You post a PSA, “Don’t drink and drive,” not “Don’t drive.”

    But I guess the auto manufacturers would be up in arms against a campaign against driving.

    With co-sleeping, what powerful industry will speak for the parents who co-sleep? *crickets*

    I understand campaigns are targeted to the lowest common denominator. That doesn’t excuse vilifying a valid, perhaps even safer, parenting technique.

    There is a vast middle ground between people who are as stubborn as I am (and have the time and energy to research the issues) and the people who are careless enough to do heavy drugs and abuse alcohol while they should be caring for their child (who won’t pay attention to PSAs anyway). And that majority is the people who might actually listen to a PSA and make decisions based on that PSA.

    In this case, the “simplification” is just plain factually wrong and potentially harmful.

  6. Mama P says:

    Wanted to thank you for your comment at BabyCenter about encouraging our children. You won’t find a bigger cheerleader or teacher than me – I’m for that. My post was simply pointing out that we don’t have to do it so loudly. It’s a personal choice, and maybe I’m wrong. Like the co-sleeping. Not my thing at all, but who is to say anyone else is wrong? It’s working for you, and that’s great. Super letter, by the way. Best of luck – great post.

  7. Debbie says:

    Mama Luxe-

    I am not against co-sleeping. I think it is a wonderful, natural thing.

    But before I attack the State of NY on this issue, I would want to see the research that says you could potentially lose 200 children to SIDS by putting them in their cribs vs saving 89 lives by asking parents not to sleep with their children in their bed. (Note that I’m not calling it co-sleeping as people who know the term co-sleeping also generally know how to do it safely.)

    If the research really shows that lives wouldn’t be saved by warning mothers to use a crib instead of sleeping with baby, then I will join you in writing a letter to NY about this campaign. However, if the research shows that more children will die or be injured (broken limbs, head injury) if they are in the bed with the mother than if they are in a crib, then I would support the State of NY in their PSA.

    Do I think it’s right for them to scare some mothers who are safely co-sleeping? No. I don’t. But it is my hope that those mothers would take the time to research co-sleeping and to speak to their doctors about it. The PSA wouldn’t prevent them from co-sleeping or make it illegal. However, it could potentially save lives. And if the PSA saves just one child’s life, I personally think it is worth it.

    Also, I should note from my time in the Foster Care system that I was a part of investigations into injuries (e.g. baby breaking a limb by falling out of the bed). In many cases, the mother was not abusive. She was a good person who wanted the best for her child, but she wasn’t as careful as you are or as educated about potential risks. Those mothers would be positively helped by the PSA campaign.

    My final 2 cents on the issue: I don’t actually think PSAs are a good use of tax dollars as they have not proven effective in raising awareness. I would prefer if the State of NY took the money it invested in the PSA and instead provided educational parenting classes or free cribs to needy mothers.

  8. Mama Luxe says:

    Debbie, 200 is a made-up number (though you’ll see below that it is an approximation based on the info I do have)–and we obviously don’t have any numbers yet on how many be influenced by this campaign.

    However, what the research is showing is that oo-sleeping IS SAFER than crib sleeping, that co-sleeping reduces SIDS (just click the links in my post), AND that SIDS causes far more deaths than even these adult-bed or couch “co-sleeping” stats.

    For example in 1992, New York reported 241 SIDS deaths. That means the cause was unknown (otherwise it would not be listed as SIDS), so these are totally unrelated to overlaying while co-sleeping or falling out of an adult bed.

    How many of those babies wouldn’t have died if their parents were co-sleeping safely with them, I don’t think we can say. However, SIDS deaths generally only happen in cribs.

    So, while there is a risk that people who do not co-sleep properly can carelessly or accidentally cause the death of their child, a person who co-sleeps properly will not cause the death of their child and may prevent a SIDS death.

    The PSA is scary and it will affect those who are co-sleeping safely. Despite my research, I still felt uneasy initially co-sleeping with my baby BECAUSE of scare tactics like this. You know as a mom that it is very easy to play on our fears about our babies.

    The mothers of whom you speak would benefit far more from an honest campaign that talked about baby sleeping safety–whether in a crib or in a bed with a parent. Many of the same issues apply. Parents who put baby in their bed with lots of loose bedding will put them in a crib with suffocation hazards, too.

    I don’t think it is ever alright for the government to make false statements for the purpose of scaring people and vilifying a valid practice.

    And you also know there are a large number of people who believe that the government is a trusted source. These people will listen to the government PSAs and will make a choice that may increase SIDS deaths instead of reducing out-of-crib deaths.

  9. Jenny says:

    I just saw your comment on Mama Is and decided to come over and add my two cents.

    About a month ago I was out shopping, can’t remember where, and was insulted when I looked at the checkout counter and saw a bunch of leaflets from DHEC outlining how to “prevent SIDS.” These people should not bring their stupid fliers into places I shop, nor should the shop owners allow it! A few days later I was HORRIFIED when I was leaving the mom-baby boutique where I work (it’s in a hospital) and saw the same idiot brochures on OUR counter! I was at once incensed, embarrassed, and insulted. Not sure who put them there, but we threw them away. What had me REALLY ticked was when I was reading over their (mis)information it had all the standard stuff but nowhere did it say that breastfeeding helps prevent SIDS. No, I’m sure they wouldn’t want to say that, because then moms might not buy the FORMULA, whose companies give them free stuff!

    As others have pointed out, there are certainly stupid people out there who drink, smoke, do drugs, etc and then sleep with their babies. I see them frequently at work. But really, those people are bound to hurt their kids one way or another. Some of them flat-out neglect their babies or even harm (sometimes kill) them deliberately when they are high. There are babies being raised amidst meth labs, in clouds of cigarette smoke, and in piles of garbage. With these people, airing a little ad on how to sleep safely with your baby is like peeing in the ocean; it gets the attention of people who are actually trying to be good parents. And I DO think the ad hurts some “educated” women. I have a college degree and it’s still hard for me to ignore the advice of these so-called experts. I can only do it because I’ve had such wonderful support from friends with experience in this area! Before I met them I was doing whatever the pediatrician said and was wondering why it felt so wrong.

  10. Sarah V. says:

    Hi. I just found this post from the link at PhDinParenting.

    I find that, because this is such an emotive and controversial issue, there is a huge amount of distortion and misrepresentation of the facts from people on BOTH sides of the divide. This most definitely includes Linda Folden Palmer, the woman whose webpage on the issue you linked to. I have read the studies on the issue and the plain fact is that, out of all the studies that have compared bedsharing rates in SIDS babies and surviving babies, *none* have shown bedsharing to be associated with a decrease in SIDS rates. In fact, some studies show bedsharing in the first few months to be associated with an increased risk, though it’s fair to say that many other studies haven’t shown that increased risk and so it’s hard to know whether or not that’s the case. Safe bedsharing after the first few months does indeed seem to be *as* safe as safe crib sleeping, but the evidence does not support claims that it is safer.

    I’ve spent a lot of time looking through Linda Folden Palmer’s webpage and trying to figure out where she gets her claim that bedsharing is safer (the way she reports on studies is quite disorganised, so it’s really hard to work out). As far as I can see, it’s from comparing safe bedsharing to unsafe crib sleeping, which certainly doesn’t show us anything about whether either is safer when done according to proper guidelines.

  11. Mama Luxe says:

    Sarah V. — You seem to be better acquainted with the studies than I am so I will have to trust you that they are flawed until I can find time to give the actual studies a thorough read.

    However, I would like to point out that:

    1. SIDS refers to deaths when the cause is unknown. So, if a child was smothered due to unsafe crib conditions, then it would have been a smothering death, not a SIDS death.

    2. As per above, a death due to overlaying or falling out of the bed is not a SIDS death.

    3. Babies are found to have died in cribs for no apparent cause, whereas that does not happen anywhere nearly as often in a bed sharing situation, according to Dr. Sears’ site and the site I listed. If you can link to a study or summary of a study that shows otherwise, please do.

    So, while babies do sometimes die from unsafe sleeping conditions both in the family bed and in the crib, it seems to be in the crib where they are at the greatest risk of unexplained deaths.

  12. Sarah V. says:

    I agree that it’s worth being clear about whether any given discussion of infant deaths is about SIDS, smothering, or deaths generally. I’ve tried to separate the two issues in this list of links.

    As far as I can find, there are seven reasonable-quality studies comparing bedsharing rates among SIDS infants with bedsharing rates among non-SIDS infants. Four of them are available to the general public on line for free, and I’ve given links to those. For the other three, I’ve given links to the abstracts on PubMed.

    http://pediatrics.aappublications.org/cgi/content/full/111/5/S1/1207

    http://www.bmj.com/cgi/content/full/319/7223/1457

    http://www.bmj.com/cgi/content/full/311/7015/1269

    http://www.bmj.com/cgi/reprint/307/6915/1312

    http://tinyurl.com/yt3xq8

    http://tinyurl.com/yp52w2

    http://tinyurl.com/395fs7

    There are other studies, but I’ve stuck to those as they’re the ones that do a reasonably good job of controlling for other factors. The first four found no difference between bedsharing rates in SIDS babies and non-SIDS babies once factors such as smoking and sofa sleeping were allowed for. The last three found an association between SIDS and bedsharing for babies in the first few months (in other words, they suggest that SIDS risk may be *increased* for babies who bedshare in the first few months of life) but no difference in rates for babies older than that. In other words, it’s not correct to say that risk of unexplained death seems to be higher in a crib – it seems to be at least as low in a crib as bedsharing, and lower for some babies (babies whose parents smoke, and possibly babies in the first few months of life).

    I’ve found one study that looks at rates of suffocation deaths:
    http://pediatrics.aappublications.org/cgi/content/full/112/4/883
    This showed far higher suffocation risks among the bedsharing babies. Of course, nearly all these deaths were due to unsafe forms of sleeping (unsafe bedsharing or unsafe crib sleeping) and so we can only guess at what the rates would be like in safe bedsharers as compared to safe crib sleepers. However, looking at the list of causes, it does look as though it would be easier to eliminate all of the risks associated with crib sleeping than those associated with bedsharing, because cribs are specifically designed in order to minimise the risk of a baby getting wedged or suffocated and adult beds aren’t, plus adults are likely to be using some kind of soft bedding that could cover a baby’s face.

    Hope that helps. If I can find time, I’ll try to comment in more detail on what Dr Sears & Linda Folden Palmer say in the webpages you’ve linked to.

  13. Mama Luxe says:

    Sarah V. — The last three are the ones that are your evidence but I only have the abstracts to go on. From the abstracts, I do not draw the same conclusions you draw.

    I noticed that only the first of these last three studies mentioned breastfeeding–something which Dr. Sears urges parents consider co-sleeping. I would be interested in seeing full studies comparing breastfeeding infants in cribs to breastfeeding infants in a family bed.

    Since you have read the studies, can you explain the term “found” in the parental bed? My question is, were these babies sleeping in the parental bed alone? Or in between two sober, non-smoking parents, or a mother and the wall?

    I think these distinctions are important because I agree that if you cannot share sleep safely, you are better off with a crib. The question is whether or not bedsharing can cause SIDS in and of itself OR whether excess bedding, overheating, poor maternal nutrition during pregnancy, low birth weight, and parental smoking and inebriation can cause SIDS and that bedsharing can sometimes exacerbate these factors?

    I would argue, even after looking through your studies, that it is the later.

    And if parents are to make an educated decision, they need to know about the risks and benefits in their own case.

    I have to read the full studies you linked, but just checking the abstracts, it does seem that infants who sleep in separate rooms are at increased risk for SIDS, which is something that even the AAP admits.

  14. Sarah V. says:

    Actually, my main point was that bedsharing doesn’t reduce SIDS risk. All seven of the studies I listed on the topic back that up.

    With regard to your question about the last three studies, two of them look at whether or not there were parents in bed with the baby, and one of them looks at the baby’s position relative to the parents. Sleeping between two parents was found to be associated with increased SIDS risk. I couldn’t see anything on whether sleeping between a mother and the wall affected SIDS risk (though, of course, it’s associated with increased suffocation risk due to the wedging risk).

    One other study has been done on breastfeeding and bedsharing, and found breastfeeding did not modify any risk associated with SIDS. The abstract is at http://tinyurl.com/9vya6v. (Although it also found an overall increased risk with bedsharing, I don’t think that result is very valid because the study controlled for so few other factors; hence I didn’t include it in the list of studies I gave you before. However, the information on breastfeeding is still useful, because failure to control for other factors would bias the results towards showing *increased* safety with breastfeeding (since breastfeeding is associated with factors that reduce SIDS death), and, thus, since the result showed there was no increase in safety of breastfeeding with bedsharing, I think it’s fair to take that as a genuine result.)

    I agree that bedsharing only seems to increase SIDS risk in some groups of babies. However, those groups are still important, and it’s worrying how often discussions of safe co-sleeping seem to omit mention of the fact that it’s unsafe if the parents are smokers and that it may be more risky in the early months of life.

    There’s also the potential suffocation risk, and we don’t know whether it’s possible to exclude that altogether. And, given that bedsharing does *not* in fact appear to reduce SIDS for any groups of babies, any increased risk from suffocation is going to mean an increased risk overall.

    BTW, I’ve just written a long comment on Linda Folden Palmer’s work on another blog, in case you’re interested. It’s at http://northtexasnaturalfamily.com/index.php/2009/01/12/sleeping-safely-with-your-baby/#comment-166.

    Totally other topic – I’m really surprised to see you’ve got Weissbluth’s ‘Healthy Sleep Habits, Happy Child’ advertised on your blog. Wouldn’t have expected to see that one on an AP blog! Or do you not have a say in what gets put in the advertising?

  15. Sarah–I understand that is your point, so I’m not sure where the breakdown is there.

    Only the last three you post, however, talk of “increased risk.”

    And I find all these studies suspect on the subject of alcohol and smoking as it relies on self-reporting where I would expect that to be very unreliable.

    Breaking this down, even the AAP talks of sleeping in the same room as being beneficial.

    So, assuming a firm, flat surface, drug/smoke-free and sober parents, lack of excess bedding, and a breastfeeding mother–do you have anything that shows that spontaneously and *without known cause* a baby is more likely to die than in a crib? That the mere *presence* of a sleeping mother increases the risk?

    Co-sleeping may exacerbate certain risk factors, but nothing you link proves co-sleeping is a risk factor in itself. They show a certain correlation in SOME circumstances…but absolutely no causation.

    I think we can agree that SOME parents should NOT co-sleep…and I believe I’ve said that from the start. If you cannot abstain from smoking, drinking, etc. If you cannot live without five pillows and a giant comforter…

    As to Healthy Sleep–this is NOT an AP blog. It is just my personal blog and I happen to generally align with AP practices.

    Although I disagree with Weissbluths recommendations, I found his data absolutely invaluable when dealing with my colicky babe. I personally find he’s very clear that there are at least three ways to deal with sleep issues and that all three can “work” given enough emotional/social resources. I don’t agree with his ultimate assessment that many parents of colicky infants will have to use CIO, but that doesn’t change the usefulness of the rest of the data on sleep needs, approximate nap cycles, etc.

  16. Just to clarify…what I mean by unreliable is I expect under-reporting of the use of alcohol/smoking when there has been an infant death would skew results.

  17. Sarah V. says:

    The other studies showed no increased *SIDS* risk with bedsharing. As you pointed out, there’s also suffocation risk to take into account. That means you’re likely to be looking at at least some increased risk overall. This would be very slight indeed with correct precautions; but, as Debbie pointed out, lots of people aren’t going to take correct precautions.

    Self-reports of smoking and alcohol use can certainly be unreliable. However, it’s hard to see why parents who put their babies in cribs would be more likely to underreport their smoking habits than parents who bedshare, so I think the difference in risk shown by the studies is likely to be a genuine one.

    The McGarvey et al study (can’t actually remember which of the last three links that was, but it was one of the three that showed increased risk with bedsharing in the early months) controlled for all the factors you asked about apart from breastfeeding, which has been shown from other studies not to affect bedsharing risk.

    I think it’s a bit of a semantic quibble to debate whether something that exacerbates other risk factors is or isn’t a risk factor in itself. In practice, it’s going to increase the risk. Yes, I do think it’s interesting to speculate on whether the possible increased risk with co-sleeping with very small babies is inherent in bedsharing itself or whether it’s something we could eliminate completely if we could control enough other risk factors, but I also think that it’s ultimately a moot point. I mean, formula use in itself doesn’t cause increased infections; germs cause increased infections, and formula use is just one factor among many that can make a baby more vulnerable. And the studies showing increased risk of various illnesses with formula use don’t generally look at whether the mothers in question use the formula properly with adequate sterilisation of everything they use in mixing and feeding it; probably quite a lot of the excess risk shown with formula is due to risky formula-feeding practices. But the practical result, at the end of all this, is that feeding babies on formula puts them at increased risk of some illnesses. We don’t respond to that data by quibbling about the precise details of whether formula is a risk factor in itself or merely exacerbates other risk factors; we respond by advising women to breastfeed, because, in practice, that appears to be the healthiest way to do things regardless of why.

    As for Weissbluth, if you liked him, then great; I was just surprised to see his book on a blog I’d thought to be AP. I do have to say that, although the book does indeed have a lot of useful information, I found it scary and misleading and wouldn’t recommend it to anyone. I found his superficially even-handed stance in discussing the different methods of getting babies to sleep to be quite deceptive – there was such a strong underlying attitude of “Yes, you could use any of these other methods – but, really, why bother? They won’t work and you’ll only end up having to use full-on cold turkey CIO anyway.” And it took me a long (and worrying) time before I consciously identified this, and longer to feel I could reject it. I don’t like that at all. Not because I object to CIO, but because I object to experts giving parents the message that there’s only one right way to do things.

  18. Re: Weissbluth: he does say that all three methods “work”–he just believes that many parents today don’t have the support and time to do the non-CIO.

    Regardless, if there were another book that had more AP-consistent methods AND Weissbluth’s sleep information, I would recommend that other book. Pantley’s new nap book comes close to being a complete resource, but I still find Weissbluth’s info useful.

    Re: Co-sleeping

    I think it is very easy to see why parents whose babies died in bed with them would be more likely to underreport their smoking habits than parents who bedshare.
    I don’t think these other studies showed that breastfeeding did not affect risk. You can’t piece together bits and pieces from one study here or there. You need a complete study.

    And no, I disagree that it is a quibble. It matters very much as to whether it is bed sharing or something else from the perspective of a parent trying to make an informed decision.

    I need to know what my risks are, not what yours are or hers are, etc.

    And frankly the idea that somehow being next to me during sleep puts my baby at risk is somewhat absurd. A high bed, loose linens, drinking, smoking…these may all put my baby at risk, but I would be shocked if anyone could prove that my mere presence on a safe sleep surface actually put my baby at risk.

    We do try to figure out what exactly it is about breastfeeding or formula feeding that helps or harms…there are all sorts of theories that are explored. We should do the same with all health issues, rather than blindly make scary PSAs.