Some analysis of the study behind today's anti-cosleeping media storm

[bluesuperted]

Really worth reading to get a better understanding of the study in question's limitations.

http://evolutionaryparenting.com/press-release-carpenter/

More information can be found here, from ISIS online which is a great resource on infant sleep in general.

http://www.isisonline.org.uk/news/

The headlines are scary and I hope that any cosleeping mums on here can be reassured by these analyses. Safe cosleeping amongst non-smoking breastfeeding mothers has a myriad of benefits for babies and the alternatives (being knackered and falling asleep on the sofa with baby because of a perceived view that cosleeping is wrong) are much more worrying.

[Saffron]

> Safe cosleeping amongst non-smoking

> breastfeeding mothers has a myriad of benefits for

> babies and the alternatives (being knackered and

> falling asleep on the sofa with baby because of a

> perceived view that cosleeping is wrong) are much

> more worrying.

Well said, Bluesuperted!

[Otta]

Surely the first 3 months is the period in which cosleeping is best for the baby.

[scareyt]

There's a good statement from UNICEF too that questions the way the results of the study are presented. I coslept with my tiny preemie as soon as we got home from hospital and would not have had it any other way. But of course was worried about it the whole time because of all the conflicting advice. :-(

http://www.unicef.org.uk/BabyFriendly/News-and-Research/News/UNICEF-UK-Baby-Friendly-Initiative-statement-on-new-bed-sharing-research/

[GinaG3]

I have co-slept for going on 4.5 years now with rare breaks when my daughter actually wanted to be in her own bed - past 21 months old. From the very first night we co-slept after I discharged us from hospital 15 hours after giving birth. I still remember the first night, I tried my hardest to stay awake the whole night, it was a weird sensation of her not being safe inside me but being in the world. She had a cot right next to our bed, it stayed there for until she was 2+ but she never wanted to go in it, I never wanted her to, it felt natural for her to always be close to me. I always remember instinctively waking what seemed like every 15 minutes for the first year of her life to check my pillow was away from her and the duvet wasn't near her. Our bed was wedged to the wall with a massive rolled up blanket stuffed down the side of the mattress filling a gap. Her dad was pushed right over to the 'unsafe side' then I would be in the middle always facing her with my body cocooned around her. She was always in a gro-bag until 18 months old when she graduated to being allowed a pillow too but still loved her gro-bag, so no duvet. I would ALWAYS co-sleep. I hadn't read up on it, I wasn't informed, it was just a natural choice. I don't think a single child in my family has ever slept in a cot until at least 18 months old..

[bluesuperted]

The UNICEF link is great scareyt, thanks.

Cosleeping (along with breastfeeding and slings) has defined how I parent and I don't know where we'd be without it actually! We currently have a family bed set up and everyone gets loads of sleep - even with a newborn. In fact I love nighttime, it's really relaxing (ask me again when teething starts...). It also feels so natural to me and in many ways I feel it's safer than baby elsewhere, just last week I found myself jumping out of bed with baby who was promptly sick on the floor (I'd heard the gurgles and was able to react instantly). And in the past I've been glad to hear coughs/reach over to feel for a temp from next to my son rather than hearing on the monitor or doing constant across the hall nighttime checks. I know it doesn't suit all families, but for us, done safely and carefully, it's been wonderful and continues to be so.

[snowboarder]

And for anyone who is nervous about co sleeping (like me!) the nct bednest bedside crib is just amazing. It lasted my youngest son until he was 7m old, and gives you a totally safe little area for the baby - you can even pull both sides up for the early evening when you might be downstairs. I thought it was great - I don't sleep very well myself when worrying about rolling onto babies etc - it made the first 7 months of baby 2 much easier than baby 1 who was in a moses basket then his own room...

[bluesuperted]

Second that SB, I've got a Baby Bay (fab, similar) as I got a bargain price from a French company via a family friend out there - although mine was primarily bought to give us extra space and sometimes baby is happy to sleep in there between feeds, sometimes right next to me. The NCT also now do a 6 month rental plan of the bednest which is a great idea - new mattress but loan of the rest. Can't remember exact cost but it's definitely cheaper than buying. I got the BabyBay instead as I'd love at least one more baby :)

[buggie]

Feel it should be mentioned that official advice is to have baby v v close by but not co-sleeping. However, advise on minimising risks is given to families wanting to co-sleep & when working and giving advice professionally, my own personal views as expressed below are not touched upon (although if asked "what I would do" I would explain the what & not as much on the why).

Unfortunately when working in A&E I did see deaths of babies who had been in bed with parents - including ones who were breast fed & whose parents thought they were safe.

I'm not wanting to sound alarmist, and know that all commenting here take every precaution that they can, understandably feel it's best and have no reason to doubt that, but, the guidelines are there because deaths do occur, and having had to help families in the immediate aftermath of these incidents, I felt uncomfortable trying this myself when Bugglet was tiny (once she found her elbows/wiggle/could climb in of her own accord it's occasionally a different story!!).

Bugglet was a v low birth wt (bit of a surprise) which anyway would have contraindicated co-sleeping, but by having her within touching distance right by my bedside, I didn't feel I missed much as had lots of baby wearing daytime snuggles and get lots of morning snuggles with her now. No2 is now due in Nov, and even if its bigger than its (now) big sister, I'll still do the same.

[LondonMix]

Buggie was that a smothering death or SIDS (which are different)?

I find the debate on SIDS problematic just like breast feeding. The popular press have a difficult time contextualising the risk. Of nearly 700,000 births, only 300 babies now die of SIDS in this country since the guidelines changed regarding sleeping position. This includes babies that are at greater risk because of smoking parents etc. The risk of SIDS (smothering again is a different matter) is very, very low. If you don't have any of the risk factors its much lower (though more if you co-sleep). UNICEF already take the position that the safest place for a baby is in a cot in the room of the parents (and have had that position for quite some time as its well established). However, they don't believe the risks are great enough to tell parents without other risk factors not to co-sleep and they don't believe this study makes the case strongly enough which may or may not be an accurate assessment.

Every baby's death is tragic and parents should be given all the information as we all want to take informed risks. However, co-sleeping isn't a reckless choice.

[buggie]

To answer LondonMix (apologies for the tangent). Is difficult to confirm which they were as being frontline we would rarely get full feedback/the chance to fully follow up what happened in individual cases - there would be multi-disciplinary meetings, as there are regarding any child death, but A&E would only be involved in the initial stages as our piece of the jigsaw was comparatively small compared to the police child protection team (who investigate on behalf of the coroner) and even information from previous medical notes/HV's - important even in SIDS/?smothering to exclude other potential reasons.

I would say I'm pretty sure I saw at least 1 x smothering (due to their appearance on arrival), but, weren't a party to the details of the ongoing investigation/outcome to be able to say out & out.

I've said I wouldn't personally do it (and I hope explained why), but I haven't called it reckless & take issue if you're suggesting I did. I've made it clear that I respect the views of parents that choose to co-sleep & would give he appropriate advice to make it as safe as possible. I'd hope that those I know further up the thread know me well enough to know that & that on the basis of open discussion it is useful to have other opinions expressed/debated.

[LondonMix]

I don't do it either and wasn't suggesting you thought it was reckless so sorry if it came across that way. I was saying the media discussion of it didn't contextualise the risk very well. Thanks for letting me know about the case you dealt with. Very, very sad.

[Saffron]

The media and other popular discussions (and unfortunately even some scientific works!) have a major problem in correctly applying terminology, particularly when discussing risk, as not all risk factors are the same. Therefore the progression of the associated increased risk being equated to an actual contraindication for co-sleeping is not necessarily a given from the observed scientific literature.

For example, consider smoking as a risk in the context of infant sleep. http://www.sciencedirect.com/science/article/pii/S0378378207001296 Parental smoking is linked to increased perinatal death. Therefore if you smoke, co-sleeping is contraindicated. This is due to the inherent toxic effect of the chemicals produced by smoking. So that makes sense.

Now consider different risk factors. Consider low-birth weight or bottle-feeding, which are also associated with an increased risk for perinatal death. However, low-birth weight or bottle-feeding alone do not necessarily contraindicate co-sleeping. This is because these factors individually are not inherently toxic conditions in otherwise healthy babies with no associated risk factors. Nevertheless it may be seen as advisable that low weight babies or bottle-fed babies sleep separately, in so far as this may make it easier for the parents to identify and control associated risk factors, such as sleeping position, etc.

http://img2.timg.co.il/forums/1_147673444.pdf

http://adc.bmj.com/content/91/2/101.short

While consideration of risks in context is obviously important, delineation of types of co-sleeping and effect on perinatal outcomes don't always seem to be well-defined. Indeed in some cases co-sleeping is being defined to include co-sleeping on any surface (bed, chair, sofa). This is not really correct methodology scientifically speaking, because it does not allow for accurate separation of risk factors associated with different sleep surfaces. Attempts have been made to correct for this, for example, by defining co-sleeping and bed-sharing separately. However, this is still problematic. Not all bed-sharing styles are equal, eg positioning in bed, security of placement, placement between adults, mattress and bedding type, and whether or not co-sleeping is the usual arrangement or a one-off, etc.

http://adc.bmj.com/content/85/2/108.short

http://adc.bmj.com/content/91/4/318.short

So before we can lump co-sleeping into a category as to whether or not it's inherently risky or contraindicated, we'd have to be better able to define and study co-sleeping styles. Therefore the default position medically has been (understandably) to advise the use of other sleep styles which have been better defined in terms of risk. That's not the same thing as saying co-sleeping is inherently not safe.

While Carpenter et al (2013) is an interesting study that does attempt to pick apart some of these issue, it is by no means black-and-white. http://www.west-info.eu/files/BMJ-Open1.pdf

IMHO, instead of taking an outright stance against bed-sharing, we should be investigating ways to make it safer. And in so doing, we would likely learn how to make sleep safer for all babies regardless of sleep style.