“As health care providers, our responsibility is not to tell parents how to parent their children, but to give them the knowledge and skill they need to parent effectively.” I love this statement!

So many people co-sleep at some point in time (70-80% of breastfed infants), yet how many parents will admit it because of a culturally-biased idea on what’s “right”? More people would safely co-sleep if they were given the information and allowed to make their own decisions.

Yee Hah! Great post! And way to go ABM… This is news we can use!

I certainly agree that parents whould be given the knowledge to parent their own children. I think it’s pretty universal that no one wants the role of bedroom police. However, as the individual who receives the death reports for Illinois infants that have died and talks with the grieving families, I don’t see the information being given. Further, there seems to be alot of moralizing from parents who successfully bedshare. Since THEIR baby didn’t die, those people who have experienced an infant death must be on drugs or drunk etc. That is not our experience. The people who have an infant death while bedsharing were caring, loving parents who simply were unaware that an infant cannot compete in the adult bed environment. Soft bedding is a serious health risk to infants. So is Dad and other siblings. The standard American adult bed is too soft, has too many pillows, blankets, comforters etc. for the newborn infant.

Breastfed babies do get suffocated in bed with loving parents. So do bottle fed babies. Why risk it? Bring baby into bed for snuggle and play and breastfeeding then place them in their own safe sleep place.

I certainly share your concern that parents are often not given the information they need to create safe sleep environments. And I encourage everyone who works with parents to address those deficiencies.

I don’t agree that the solution is simply to tell all parents not to share a bed with their child – a simplistic solution is seldom the answer to a complex problem. The leading cause of death in children after 1 year of age is car accidents, but no one would consider telling parents to never put their child in a car. Instead we educate parents about how to make car travel safe.

I can’t speak to the moralizing from parents who successfully bed-share – but like you I find the behavior disturbing. And I can’t begin to imagine the grief of a parent who has awakened to find a baby dead in the bed next to them, because I have never experienced that tragedy. But you are making the assumption that when a baby is found dead in an adult bed, bed-sharing is the cause of death. What about the babies who are found dead alone in a crib. Is the implication then, that they died because they slept alone?

In the absence of clear data on all the circumstances surrounding the episode of sleep immediately prior to death, it is often difficult to assign a cause of death. Sometimes no cause is found, hence the assignment of sudden infant death (SIDS) as the cause.

As health care professionals, we need to not only give parents the knowledge they need to parent their children well, but the confidence they need to deal with tragedy, should it occur.

How soft a bed is too soft, and how many pillows are too many? If anybody can point me toward specific recommendations for making the adult bed hospitable for an infant, I’d greatly appreciate it. Is one flat bedsheet over the parents and under the baby ok? Is one pillow under the parent’s head ok? I want to have my infant in bed with me because of positive early experiences from my own family and within our culture, as well as because of the benefits cited above with respect to breastfeeding. Without meaning to imply that other parents are horrible drunks, what I do know so far is that I should not drink, smoke, or take medications that might affect my sleep, and use a sleep-sack type pyjama if needed for warmth, rather than blankets or sheets, with no toys or pillows in the bed. It seems that the idea is to be able to sleep lightly enough to awaken easily, and not to have things in or on the bed that could obstruct the baby’s breathing. If there is evidence linking this kind of environment to infant mortality a link to a source would be great, so I can become better informed. Thanks!

Dr. James McKenna offers an excellent review of the data on co-sleeping [http://www.nd.edu/~jmckenn1/lab/articles/McKenna_why%20babies%20should%20n.pdf]. I found it extremely helpful.