Sharing Sleep: A Bad Habit?

Are you worried about nursing your baby or toddler to sleep? Wondering if your child is ever going to sleep on his own? Are you being bombarded with dire warnings that your kid will never go to sleep on her own and will develop bad sleep habits if you help her to get sleep each night or bed-share?

It's overwhelming, I know. This is one of foremost hot topics I hear at breastfeeding support meetings - worry about whether frequent infant waking is normal or healthy, fear that nursing a baby or toddler to sleep creates "bad habits", and pressure from all sides of the "necessity" of getting infants/children to "sleep through the night" by themselves. Often mothers will have read some sleep guru's warning of horrible future consequences in their child's sleep habits and social and intellectual development if they nurse or comfort their child to sleep.

All I can say about that is...hogwash. These sleep "experts" who try to scare parents into not meeting their baby's and children's very real needs to be near their parents (especially their mother) very likely have no experience in the natural course of nursing and child development. Did these "experts" actually have the experience of nursing their child to sleep only to discover that their child never would stop? Never is a very long time and I'll go out on a limb here and say that the answer is probably not (and I bet they most likely did not breastfeed for long anyways, if at all). Did these "experts"' actually have the experience of comforting their children to sleep for years only to find out that they had to continue this same ritual all throughout adolescence and then maybe were faced with the fearsome possibility of having to share a dorm room with their offspring in order to comfort them to sleep during the college years? I highly doubt it. How many kids have they actually known who were comforted without limits until they outgrew the need that actually displayed the horrendous outcomes they predict? I bet they haven't met any. And if they don't have the personal experience with the supposed bad outcomes from actually doing what they are warning against - how does their argument even hold any merit? It doesn't, because they really don't know. The scenarios they warn about are driven by their imaginations and fears, based on pedagogical theories not experience. I highly doubt that their "expert" advice is based on any clinical trials, either. What you are getting from them is a big, loud, obnoxious opinion with nothing real to back it up.

I highly doubt that they they have solid evidence behind these dire predictions because I happen to know from personal experience (and from knowing other parents with similar experiences) that if one does nothing (by which I mean one is not pro-active at all about trying to get the kid to go to sleep by himself, "sleep through the night", etc) but nurses the kids to sleep until they outgrow the need and also lets them bed-share for years and years that the kids do - lo and behold - eventually grow up, sleep the expected "through the night" ideal and actually want to have their own space. Really and truly your little limpet that seems as if she will never stray from your side (or breast!) will eventually sleep eight hour (or more!) stretches at a time. Not only that, but your child will eventually want their own sleep space in their own time. This could be at three or four years, it could be at twelve years. Heck if I know when that might be. Each child is unique and has their own biological rhythm so I can't say at what age this definitively occurs. I can only assure you that, indeed, it will.

I'll share my personal story because I do have experience following a more relaxed and natural course - I'm kind of on one of the far ends of the breastfeeding and bed-sharing nighttime continuum here in the U.S. (although I may not be at the very farthest end, believe it or not). I nursed each my two daughters for around six years. We have had all sorts of musical bed arrangements, child/adult bed-sharing the norm for us. My oldest daughter I gently weaned over time, but she still slept next to me to go to sleep even though she was weaned. My second daughter is the one with whom I have the experience of complete natural weaning with no encouragement or pressure from me; she nursed to sleep until just before her seventh birthday. For many years my kids were very frequent wakers (especially my oldest daughter, even after weaning). Eventually, all on their own by their own biological time-clocks, they slept longer and longer stretches; yes, my daughters do now "sleep through the night" - beautifully by the way - without any forcing at any time on our part. We have always had an open bed policy for our children - they are welcome into our family bed at any time.  Yet they were very excited when we got bunk beds for their bedroom. My thirteen-year-old has been sleeping in her bunk for the last several years with only occasional visits to our room. I have noticed that in the last couple of years she has developed a really strong desire for her own space and a need for privacy; some nights she retires totally on her own and I have no idea she's gone to bed if she hasn't come to give me a kiss. This was not a goal - it just evolved over time. Kids really do grow up.

Now, I am in no way suggesting that anyone needs to nurse their kids until they are six plus years (that would be rather unrealistic, would it not?) - this just happened to unfold as part of my unique path which has allowed me to have a very full and varied experience of breastfeeding; and my kids happen to be on the far end of the nursing continuum (I wouldn't have believed anyone if they had told me I would nurse for that long and probably would have thought they were out of their mind if they had - in fact, when I first heard someone mentioning that their six-year-old still nursed when my first child was barely a year old I was completely disgusted; go figure.) I only share this experience with you because I am am sure many "experts" would have been shaking their heads and wagging their fingers with dire predictions for my daughters' future sleep habits, intellectual abilities and psychological soundness. Well, I am happy to report that all is more than well in our little household. My daughters have developed into loving, caring, intelligent and responsible human beings admired and well-loved by their peers and by other adults. So, I am glad I trusted my instincts and honored my daughters' needs.

Because I am a big believer in a mother following her instincts, I am not going to tell you exactly how you should put your kid to sleep, where your kid should sleep or how long to nurse, etc. I am not going to fill you with fear or dogma, but encourage you to follow your heart. Each family is unique with unique personalities, circumstances and needs. I do believe, though, that helping your child get to sleep can be found with methods that trust and respect the child and his needs. Methods that are gentle and loving. Actions that foster connection and positive communication. I think it helps for parents to know that it is absolutely normal for babies, young children and older children to want to be near their parents at night (and for babies and toddlers to want to nurse); there is nothing wrong with their child. Children are biologically wired to seek protection and safety during a time of vulnerability (of which sleeping is one.)

What really bothers and concerns me is that advisers abound who warn against comforting children to sleep and sharing sleep (these could be authors, sleep trainers, pediatricians, social workers, your mother-in-law or your neighbor); these same advisers like to point out how many hours a day a baby or child "should" sleep and give the impression that this type of sleep is to be solitary and achieved straight through like we expect of adults thereby inaccurately insinuating that your child has a "sleep problem" that needs to be "fixed." This is distorting facts. Babies do sleep a lot but at intervals throughout the day; babies are wired to want to sleep near their mothers and quite often will fall asleep after nursing - this is normal, not pathological. The wakeful sleep that infants have is also protective for their health as it may protect against SIDS. It is also normal for toddlers and young children to wake frequently at night and to seek the company of their parents (especially their mothers.) This is not pathological. There is nothing wrong with your child if your child is doing just as he was biologically designed. He will grow out of it. Truly. What is distorted are adult perceptions of what constitutes normal sleep for babies and children. The problem seems to be more one of attitude and ideology.

My blood especially boils when advisors use fear tactics to not only try to scare parents into not trusting their child's natural biological sleep patterns, but also to encourage parents to disengage from their child by ignoring their child's nighttime needs. Scaring parents from listening to their instincts and to their child's needs breaks positive and essential communication between the parent and child by undermining the very essence of healthy family relationships - trust, respect and love. I believe that we can trust our children when they tell us they need comforting to sleep and when they express their desire for our presence in the wee hours of the night. We can also respect their needs by finding a way to meet them. By doing this, we assure them that they are loved. We do not need to be afraid of love.

So does sleeping with your child create a bad habit? Well, let's put it this way: One man's trash is another man's treasure - or, it's all how you look at it. In our family, we are still very active in putting our youngest daughter to sleep. We still prepare her bath, brush and floss her teeth in the evening, read a story and lie next to her while she falls asleep. She wants us there while she falls asleep. I could view her desires as "manipulative"or as a "bad habit";  or I could just accept them at face value as her knowing what she needs to feel secure. Do I have to lie next to her to help her to fall asleep? No. I could just kiss her goodnight and stand firm that it's bed time right now and mommy has things to do. Actually, she's very understanding when I do have pressing things to do, but she prefers to have me or my husband there if at all possible. That's okay with us because we see how fleeting this time is. How this time is an opportunity to connect and bond with her. To find out secret dreams, listen to worries or hear confessions which seem to naturally arise during the moments before falling to sleep. My husband and I are very aware of how this time will one day not be there any more. We see it already with our adolescent - the time to connect in this specific way passes and that's it. That was your moment. So for us, no it's not a bad habit, but a wonderful good habit.

My life has been deeply enriched by meeting my daughters' nighttime needs. I understand my girls better and have a deeper connection with them because I chose to keep the lines of respect and communication open between us. My hope for other mothers and families is that they will trust their heart and trust their child. Children have all the information they need to grow well inside of them if we only would listen. We need listen during the day and we need to listen at night. This is a lot more work and sometimes inconvenient. But, in the end, our lives are made more whole by these experiences. They help give us wonderful relationships that are deep and rich as well as giving us precious memories to enjoy when our children grow beyond this time of intense need. Fear not the bad habit and doomsday predictions. Instead, enjoy the wonderful opportunity for creating a deep and lasting love in your life...

Safe Sleep Campaign Butchers Breastfeeding

So, breastfeeding got stabbed in the back this week with Milwaukee's launch of the new photos for its Safe Sleep Awareness Campaign. Perhaps you've seen the controversial photographs of babies sleeping in fluffy beds with big knives right next to them?

Gee, how subtle.

What I find particularly disturbing about this campaign is that by focusing on scaring people from co-sleeping the City of Milwaukee Health Department abdicates taking on the real issues contributing to infant deaths in their area. "Co-sleeping" is a easy scapegoat. Issues such as low rates of breastfeeding, alcohol and drug abuse, smoking, economic stress, poor pre-natal care, specifics of unsafe sleeping conditions, and lack of real support for mothers (especially single mothers) are swept aside. Instead, we get a one-size fits all blanket statement "Co-sleeping in a bed with your baby is as dangerous as your baby sleeping with a butcher's knife" = only a crazy, irresponsible parent would do that!

Really? This is the best solution they can come up with? How is this scare-tactic approach going to help mothers (and fathers) confronting the constant and relentless needs of their helpless infants? And it certainly does not aid the cause of increasing breastfeeding rates (which is a major public health concern) because breastfeeding success is intimately intertwined with infant nighttime needs. Simply put, babies are designed to breastfeed and they are also designed to wake frequently at night to nurse; this provides the best insurance for their growth and survival. Our babies are designed to sleep near their mothers.

Despite public health campaigns that promote crib sleeping for infants and malign bed-sharing, many mothers and babies end of sharing sleep at some point. This study investigates where babies in the U.S. really end up sleeping. When health care and government agencies fail to consider the very real needs of mothers and infants during the night, demonize bed-sharing and fail to educate parents about safe sleep conditions for bed-sharing they inadvertently put babies in greater danger. Desperate mothers in their attempt to avoid bed-sharing may accidentally fall asleep in far more dangerous places with their infants like arm chairs, rockers or sofas (which would still labeled as "co-sleeping" by our state agencies even though it's the very thing these moms are trying to avoid.)

Talk about co-sleeping invariably triggers strong emotional responses in people. In preparing to write this blog I got swept away reading people's emotion laden responses to this issue. When a baby dies, this is a heartbreaking tragedy; people rightly want to prevent this from happening. And when it comes to where babies sleep, people have strong feelings, partially from wanting to protect babies and partly from believing they know the "right way" that infants should sleep. I noticed people can be pretty judgmental about the whole thing.

The truth is we can't prevent all infant deaths - there is no absolute guarantee in any situation be it in an adult bed, a crib, a bassinet or a playpen. A mother whose infant dies in a crib is just as devastated as the mother whose baby dies in her arms or next to her. Each mother is going to wonder if she could have done something differently so that her baby could still be here. Each mother is doing her best to do the right thing. Somehow, though, society likes to point a more judgmental finger at the "co-sleeping" mom. I am not understanding the reason for this - this attitude is distinctly biased.

What would really be helpful for parents in order to decide where is the best and safest place for their infant to sleep is a good hard look at the science behind infant sleep and nighttime needs. And to give parents more accurate statistical risks of co-sleeping. We really aren't there yet as a society; misinformation abounds from popular parenting magazines and books to advice from medical caregivers. New parents are bombarded with messages that their infants should be "sleeping through the night" and often have absolutely no awareness of how normal and beneficial it is for babies to wake frequently at night. Babies wake at night frequently to nurse and to be near their mothers. This is normal. Really. And an honest and realistic discussion about what constitutes normal infant sleep and how families can meet their infant's needs is desperately needed.

Does this mean that mothers and babies have to bed-share? No. There are lots of possible sleeping arrangements, but many families are probably going to bed-share at some point even if it's just out of desperation to finally get some sleep one night. That's why anti-bed-sharing campaigns are not helpful and can even cause the very problems they are trying to stop. According to the health campaigns, this is a health issue, not a moral one, so let's really take a good look at the facts and reality. The issue is to prevent infant death by providing a safe sleeping environment. So, let's make sure sleep conditions are safe, but we also need to acknowledge the reality of infant nighttime needs.

Photo and sculpture: JeanetteRansing (Flickr)

With statements like this, "Infants may be brought into bed for nursing or comforting, but should be returned to their own safe space to sleep when the parent is ready to return to sleep," I have to truly wonder whether any of the staff at the Milwaukee Health Department are even parents who have ever cared for an infant. That statement just seems out of touch and unrealistic. The mother is the one who actually has to interact and care for her infant night after night after night after night; this care work is exhausting. Do you really think she isn't going to pass out from exhaustion at some point? Let's get real. Guidelines have got to be realistic and they've got to work. Since mothers will probably sleep with their infants at some point, let make sure everyone knows what the parameters are for safe co-sleeping or bed-sharing. That's being realistic.

And one of the ways we can make sharing sleep more safe in addition to spelling out the specifics of safe bed-sharing is by promoting, supporting and protecting breastfeeding. We really need to do more to make sure mothers and infants are able to breastfeed successfully and support this symbiotic and essential relationship. Breastfeeding is one of the major contributing factors towards preventing infant death.

In this Fox News story, "Is Sleeping with Your Infant Right or Wrong?", we see the Milwaukee Health Department's prior approach before the baby and knife photos with the same campaign using a headstone for the headboard bearing the same message - uh, it didn't really work the first round and if they are not addressing the real concerns (like not breastfeeding and how to safely meet an infant's needs) then I really don't see how it's going to have more success this time. The idea of making bed-sharing illegal strikes me as a truly frightening prospect; and warped, too - yeah, that's right, make breastfeeding next to impossible, continue policies that perpetuate a complete lack of support for families and then prosecute them when they are just trying to meet their baby's needs. Scary.

Families need support. Mothers especially need support. They need help making breastfeeding a success with public health and social policies that truly make nursing their infants possible. Not scare tactics, but real information and support services to help them make the decisions that are in the best interest of their family.

To simply admonish parents not to sleep with their infants, ever, under any circumstances, is unrealistic, quite possibly unethical, and does not provide the optimum in nutrition and sleep physiology.                                                Morgan et al. JOGNN 2006; 35: 685-691

Amen.