I read an article recently about Milwaukee’s 2011 ad campaign on the dangers of co-sleeping.  The campaign pictures show sleeping babies in a bed with a large butcher knife laying beside them.  It explains co-sleeping is just as dangerous.  Eye-opening – absolutely.  The hope is that it drives the message of the risk of co-sleeping home.  A scare tactic that may work on some but not all.

I understand why Milwaukee ran the campaign.  According to the city’s 2013 Fetal Infant Mortality Review Report of 1,000 babies born, 10 die before their first birthday with nearly 15 percent of deaths being sleep related. While it’s not a huge percentage or number, it is something to talk about.  There is a need to bring safe sleep awareness to the city, this we can agree on.  And while I’m impressed by the magnitude of their campaign and all their work on promoting a safer sleep environment there is one major thing in my opinion that is being left out.

As a sleep professional I am a huge advocate of safe sleep and the ABC’s of safe sleep.  Babies should always be placed on their backs, alone, and in their cribs.  I will always recommend room sharing over bed sharing with my parents.  I am a sleep educator but I am also a realist.  We can scare parents all we want as to the dangers of co-sleeping but parents are still going to choose to do it.  It could be for religious reasons or because it’s something they choose as their parenting philosophy, so instead of us just telling them not doing it, we need to educate parents on how to do it safely.

If a parent chooses to co-sleep it needs to be a committed decision made between both parents as it’s going to be a complete lifestyle change.  When parents are co-sleeping out of sheer desperation for sleep, what I call reactive co-sleeping, that is when things can become very dangerous.  Parents need a plan.  They need to know what will be involved in safely preparing their sleep environment for co-sleeping and 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.  Absolutely no couch sleeping with mom or dad.
  • Eliminate all blankets, pillows, and stuffed animals.  Parents and child should be dressed accordingly to avoid having loose bedding or comforters.
  • Co-sleeping 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 co-sleeping until then.

I stand behind the American Academy of Pediatrics and the Canadian Pediatric Society, 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.  There is always a safer way of doing it and educating yourself is the first step. The city of Milwaukee has the best intentions at heart and they need to continue with their safe sleep campaign but they need to add ALL precautions parents can take that can possibly help reduce the risk, and that isn’t just eliminating it altogether.


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