Safe Sleep Is A Choice

by Tamara

 
Last week, on my Facebook Page I posted a link to an article by the Milwaukee Journal Sentinel about the City of Milwaukee’s new safe sleep advertising campaign.
 

City of Milwaukee Safe Sleep Campaign


 
I wondered, at the time, if the ad campaign was too disturbing and would alienate those that bedshare, instead of convincing them that bedsharing has significant risks to a baby.
 
I’ve been reading follow up articles, the posts on facebook, blog posts, forum posts and this has become a pretty heated debate with a very “us vs them” mentality. The good news is… bedsharing is getting a lot of attention in the national media. Hopefully, that in itself will save lives.
 
Let me say that my personal stance on bedsharing is that it can, most definitely, be dangerous and baby is safest in a crib, on their back, with nothing in the crib and in the same room. I also think, that prior to 6 months of age, bedsharing should be avoided.
 
However!! I DO understand why mothers sleep with their babies. My son slept attached to me from age 8 to 13 months. He was too old to swaddle and he was waking constantly during the night. Bedsharing was the only thing that was going to get us decent stretches of sleep.
 
I see more and more encouraging of bedsharing with newborns and young infants in the online community. I see a lot of misinformation about what makes it “safe”. There seems to be this idea that as long as you breastfeed and don’t use drugs or alcohol, bedsharing with your newborn/ young infant is safer than putting them in a crib next to them, and that’s just not true.
 
Let’s move past the propaganda of both sides and consider just plain old common sense for a minute. Most likely, the greatest risk of bedsharing is that baby will suffocate or asphyxiate. Take SIDS out of the argument because until they truly know what causes real SIDS, nothing can prevent it. Studies can pinpoint what may reduce the risk, but as of now, there is no actual prevention.
 
Now consider just how small a newborn’s face, nose and mouth are. I’ve breastfed three children as newborns. Covering the entire nose and mouth would take just the smallest shift in position while sleeping. You don’t have to roll onto a baby to cut off the air supply. You don’t even have to completely cover the face for rebreathing to become an issue. You don’t have to be overweight, or on drugs, or drunk, or overtired to accidentally suffocate a baby. All that needs to happen is to be just a little too close, for a little too long, in the wrong position.
 
I’ve read a lot of “Well I don’t drink or do drugs and I breastfeed, so my baby is safe.” I’ve also read a lot of posts in the bedsharing community describing the conditions under which they bedshare. Quite a significant portion are not bedsharing safely. They are using pillows, blankets, pillowtop mattresses, have a headboard or footboard hazard, other children and adults are in the bed..etc and so on. I’ve even read about a baby being placed on a pillow to sleep between the parents. I’ve broken a few of the safe bedsharing rules myself.
 
Something else I see a lot of is what I call “breastfeeding-voodoo-magic”. Make no mistake, breastmilk is an absolutely amazing substance. It helps keep our babies healthy, it nourishes them, grows them and comforts them. But what it will not do, is magically keep a baby’s airway clear of obstacles that may inhibit their breathing. Just ask a sober mom at a healthy weight that lost her breastfed baby to a bedsharing tragedy.
 
On the opposite side of the argument, some believe there is no such thing as safe bedsharing. Can bedsharing be as safe as a crib? Hard to say, as even with nothing in the crib, baby placed on their back, no bumpers, etc.. a baby could roll over and suffocation or rebreathing is still a risk. Probably not as likely, but besides putting our children in perfectly constructed bubbles, there are always risks.
 
Safe sleep recommendations for cribs aren’t followed all the time either. Babies are put to bed on their stomachs, with a lovey, rolled up blankets, loose blankets, stuffed animals and those cute crib bumpers can be hard to resist. I’ve broken a few of those rules at one time or another as well.
 
Leave the emotion of the bedsharing vs crib sleeping debate out of the picture and just step back and take a good honest look at your baby’s sleeping environment. Are you following the guidelines for safe sleep to the best of your ability and in the way that you feel is best for your family? Whether baby is in a crib or in the bed, we all get to choose safe sleep.
 
Latest Safe Sleep Recommendations from the American Academy of Pediatrics
 
Bed Sharing Safety Checklist
 
 
~Tamara
 
 

{ 3 comments… read them below or add one }

Melissa Vose December 17, 2011 at 9:01 am

Great post! I agree that the safest spot is in a crib next to the parents’ bed; logically and according to research. Sometimes the natural minded community can get into some muddy water when defending cobedding. However, I think also that the parent bed can be a safe place for even young infants to sleep in. Not ‘safest’~but then, the safest mode of transportation is on foot rather than in a vehicle. But that’s not super practical. Same with the crib idea; the safest choice, but not always the most practical. So we make the more practical, less ‘safe’ mode as safe as we can. We use carseats, buckle up as well as we can, avoid puffy clothing or jackets, etc. We avoid sharing blankets, refrain from smoking/drugs/alcohol, etc, put baby to sleep on her back, and keep them separate from siblings. And if parents don’t follow ‘all the rules’ all of the time, they do in general try and make a safe spot for baby in the bed.
I think, also, that if my breast were to obscure my baby’s airway, whether we were in bed or not, she would pull back and fling out her arms and legs in alarm. She has done this on many occasions since my breasts are quite large. I think the logical conclusion is that if this happened while you were sleeping, it would wake you up because mom and baby are well attuned.
I’m not sure how well that would play out in reality, but it does seem logical. And with an older baby they have defenses to get out from under an unwieldy breast; they roll over or push off. I have not encountered this problem in my bedsharing experience myself so far (4 kids).

I think it is absolutely true though, what you have pointed out, to a T. It is safest to room share and have separate sleeping beds. And that lots of unsafe cobedding is going on. And lots of unsafe crib sleeping!! But lots of good things are happening too, and it helps to look at safety as a continuum rather than a black or white safe vs. unsafe situation.

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Tamara December 17, 2011 at 8:36 pm

Thank you for your comment Melissa! As parents we all want to do what’s best for our kids, but like you pointed out, sometimes there is a meeting in the middle between what is “safest” and practical.

All of us could improve in some way or another.. whether it’s child-proofing, car seats, sleeping situations or what we feed our kids.

What frustrates me about this campaign is it has turned a really important issue into an “I’m a good parent and you’re a bad parent because _____” instead of self examination as to what we could do to improve.

If I knew back when my son was sleeping with us some of what I know now, I absolutely would have made some changes to our sleeping arrangements!

There is another audience to that campaign though… they aren’t on the internet and seeing the pictures or the coverage on the news might be the only way they learn that the way they are sleeping with their baby could be dangerous. Whether the result is they put baby in a crib or dig a bit deeper to try to find a safer bedsharing alternative, I’m hopeful for a positive outcome and that less babies are lost!

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Melissa Vose December 19, 2011 at 1:12 pm

Yes, I think you are right, about the polarizing effect of Milwaukee’s campaign. Rather than empower parents in any fashion, it simply tosses them into a good/bad category. Particularly because falling asleep with your baby happens so naturally, with oxytocin flying around for both of you, and sleep deprivation to boot! It’s fighting nature to stay awake sometimes! =) But hopefully like you say, more thought will spring out of it and those who are cosleeping will do it more safely.
I’m surprised, too, at some of the unsafe cosleeping examples out there. But I also think that natural minded parents (the ones more likely in my mind to endorse cosleeping) object in general to institutionalization or being told what to do. Being presented with information and being left open the intellectual space to make their own decision seems to be pretty fundamentally important.

I was also thinking, after I left my initial comment, that I have robust babies. In the 9 and 10 lb range. So they come out pretty strong for their age and holding their heads up really soon after birth, rolling over at 2 months, etc, so this probably affects how I view infant bedsharing safety. ykwim? I forget that most other babies are smaller and more vulnerable, and maybe more likely to get into trouble and not be able to communicate that to a sleeping parent!

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