update: Please see the AAP and CPS joint statement on safe sleep updated in 2021
I remember when the twins where infants and my husband and I were in survival mode. Knowing that our 3.5 year old wouldn’t be letting us sleep in most mornings, getting our sleep throughout the night was critical to be able to function well enough to care for these three little ones, as well as care for us. But having a new baby (or babies in my case) means you are going to be up throughout the night. It’s going to happen, as it should, and sometimes as parents we make decisions throughout the night just to get that extra hour of sleep. Decisions that could potentially be harmful to our baby.
That’s me – sleeping on the couch with my son.
And I knew better.
But I needed that hour of sleep.
When I speak to new parents one of the first questions I ask is “who co-sleeps?” I then correct myself and ask “who is making the lifestyle decision to bed share and whom is reactively bed sharing?” Most hands sheepishly raise for the latter. When I look at these pictures of myself so many what-ifs enter my mind but I was reactively finding a solution to my sleep deprived situation and it was the most dangerous route I could have taken.
Don’t be me.
In 2016, The American Academy of Pediatrics released an updated report on their safe sleep environment recommendations. Included in the report are their previous recommendations of the ABC’s of safe sleep:
- Place infant Alone, on their Backs, in their Cribs.
- They also recommend room sharing until your infant is at least 6 months of age.
- Practice crib hygiene. Use a certified standard crib with firm mattress and fitted crib sheet. Remove any stuffed animals, blankets, pillows, and bumpers.
As a sleep professional I do follow the guidelines and sleep recommendations of the AAP on lowering the risk of SIDS and other sleep-related infant deaths with my client’s, as does my team. We leave the duration of room sharing up to parents and have helped many families sleep train while continuing to safely room share.
What’s now included in the AAP’s recommendation are safe sleep practices if choosing to bed share because here’s the thing – even though organizations like the AAP or Good Night Sleep Site recommend not sharing an unsafe sleep environment with your infant, parents are exhausted. And when you are exhausted, you may make unsafe decisions like falling asleep on the couch while breastfeeding. The AAP now recognizes that rather than say ‘don’t do it, it’s unsafe’, they should educate parents on the safest route to take if bed-share is going to happen. It is a lifestyle decision, and one that needs a plan with both partners on board. If you are going to fall asleep while breastfeeding do it in the safest way possible.
How To Safely Prepare A Sleep Environment For Bed Sharing
Everything needs to be implemented to the fullest extent before the baby is ever in bed with either parent.
- Both parents need to agree to the plan of bed sharing and be comfortable with the decision. The baby should be placed beside mom at the edge of the bed and there should be no one else in the bed.
- To eliminate risks of falls and entrapment parents should move their mattress (the ideal size for co-sleeping is a firm king size mattress) on the floor in the middle of the room.
- Eliminate all blankets, pillows, and stuffed animals. Parents and child should be dressed accordingly to avoid having loose bedding or comforters.
- Bed sharing should only be considered with breastfed babies.
- There should be no use of cigarettes, alcohol, drugs, or sedating medications.
- Babies should always be placed on their back to sleep.
- The risk of SIDS drops at 4 months of age and a better decision would be holding off on bed sharing until then.
I stand behind the American Academy of Pediatrics and choose room sharing as the safer route but I also feel it’s my responsibility to educate parents on the safest steps of whichever sleep environment is chosen.
Don’t be me.
There is always a safer way of doing it and educating yourself is the first step.
Alanna McGinn is a Certified Sleep Consultant and Founder of Good Night Sleep Site – a Global Pediatric and Family Sleep Team. She provides free child and family sleep support through Facebook, Twitter, and Instagram. She invites you to join her sleep community as she works towards Good Night Sleep Site’s mission of a healthier rested family unit. For more sleep tips, subscribe to our newsletter and visit Good Night Sleep Site.