Co-Sleeping with Baby - New Warnings on Risks, Dangers - Precautions Required
Co sleeping is a controversial subject with many conflicting arguments and research findings. There is no definitive review or advice for parents because there are many circumstances that contribute to the dangers of co-sleeping and also for babies sleeping alone.
These circumstances complicate the analysis of the research data, but they provide a list of do's and dont's for parents to consider.
In Australia, the Victorian Coroner, John Olle has warmed that parents should avoid sleeping with their young babies for a period of least the first six months after they were born.
He also advised that health authorities and nurses should give new parents consistent and clear warnings of the risks involved in co sleeping and the ways to reduce those risks.
In Victoria, a court study of a total 72 infant deaths in Victoria from 2008 to 2010 found that 33 infants (46%) died in circumstances where the babies were co sleeping with parents.
The coronal investigation of five of these deaths, in 2011, heard evidence that a range of circumstances contributed to the dangers:
- maternal smoking,
- placing infants on pillows,
- sleeping with adults other than the mother,
- sleeping with mothers that were exhausted,
- alcohol or drug use, including prescription drugs.
Yeliena Baber, a pathologist based at the Institute of Forensic Medicine in Victoria, gave evidence at the inquiry that for 4 of the 5 cases, there was evidence that the babies that died had been exposed to smoke. She also reported that for 70 % of sudden infant death syndrome cases, there was exposure to maternal smoking.
Dr Baber also stated that major epidemiological studies had reported that sleeping in the same room as an infant could reduce the risk of SIDS (Sudden Infant Death Syndrome) by as much as 50 % and that not leaving a baby to sleep alone in a room was advocated for the first six to 12 months. However co-sleeping with parents was an inherently risky. She said that the recommended sleeping environment for young infants was:
- a cot fitted with firm mattress,
- no use of soft bumpers or pillows
- the infant should be position in a supine position (facing upwards) rather than a side-sleeping or prone position (facing downwards).
- the recommended bedding was a sheet with a one or more lightweight blankets, which could be tucked in at the sides.
- The sleeping area should be neither too cold or too hot (about 16-18 degrees C) with adequate ventilation.
The Public Advocate for the City of New York in the September 2005 report entitled “A Patten of Preventable Deaths, 2004 Child Fatality Report”, found that the prominent cause of preventable deaths of infants was inappropriate positions when sleeping and most of these deaths were associated with co-sleeping. The study found that 15 children has died in 2004 as a result of co-sleeping.
The American Academy of Pediatrics (AAP) specifically advocates that young infants up to 12 months old should be placed on their backs to sleep; care should be taken to ensure that the baby's head remains uncovered during sleep; the infant should not be bundled in clothing and blankets; overheating the infant should be avoided; and the child should sleep in a safe, properly approved crib.
The AAP does not specifically recommend against co-sleeping or bed-sharing. However the AAP has warned that this practice increases the risk of the infant being suffocated by overlying especially where the co-sleeping adult is in a depressed state of consciousness induced by alcohol or mind-altering drugs. AAP also recommends against co-sleeping on a sofa.
The New York State Office of Children and Family Services (OCFS) also suggested that caretakers and parents should avoid co-sleeping if they were very tired or were using prescribed on no-prescribed medication, illegal drugs or alcohol. (see: "Child Abuse Prevention Section: Back to Sleep and Safe to Sleep" at www.ocfs.state.ny.us).
Below is a summary of various precautions, do's and dont's that should be considered for co sleeping.
© 2011 Dr. John Anderson
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