Benefits and Controversies Associated With Co-Sleeping

Introduction

Mother’s own milk (MOM) is considered the best form of nutrition for babies and breastfeeding practices are encouraged worldwide. The increasing progress in current breastfeeding methods also initiates debates on do’s and don'ts related to breastfeeding. Any recommendations or doubts that impede breastfeeding and infant care are carefully assessed and scientifically reviewed for the benefit of the infants, their mothers, and the community as a whole.

Co-sleeping and breastfeeding are one such aspect of infant care that has received mixed interpretations in recent years, especially in western countries. The practice of co-sleeping is diversified around the world and has various benefits. It also involves few potential risks and hence certain medical authorities are discouraging co-sleeping. To overcome these setbacks, some of the worldwide organizations like the academy of breastfeeding medicine, which promotes and supports human lactation, have formulated guidelines for safe co-sleeping practices.

What Is Meant by Co-sleeping?

The term co-sleeping is often vaguely described and misinterpreted with the term bed-sharing. Co-sleeping, in scientific literature, is defined as the diverse methods of the infant sleeping in close physical and social contact with a care provider (commonly the mother, but also includes the father or guardian). Also, this functional definition includes a baby sleeping along with a parent in a different piece of furniture or object as well as known unsafe practices like sharing a recliner or a sofa. On the other hand, bed-sharing is one of the methods of co-sleeping which refers to where a baby and care provider use the same sleeping surface. Some of the facts associated with co-sleeping are as follows -

• Ethnic Influences in Co-sleeping - in Asian cultures co-sleeping is a common practice and it reduces the occurrence of SIDS (sudden infant death syndrome) deaths.

• Reassuring safe physical contact and touch are needed for the proper physiological and normal cognitive development of human infants.

• Most infants around the world experience such safe physical contact and touch during co-sleeping with their mother or care provider.

How Does Co-sleeping Help in Breastfeeding?

Scientific research and clinical studies progressively prove the strong relationship that exists between breastfeeding and co-sleeping. Some of the established positive effects of co-sleeping during breastfeeding are as follows -

• Infants who frequently co-sleep with their mothers are breastfed for a longer duration (nearly three times longer) during the night when compared to infants who sleep separately.

• The number of breastfeeding episodes increases by twofold during co-sleeping with an extended duration of breastfeeding.

• The proximity in co-sleeping enhances sensory contact between the mother and the baby. This facilitates readiness to breastfeed the baby and also ensures psychological reassurance to both the infant and the parents.

• Breastfeeding considerably reduces the risk of SIDS (sudden infant death syndrome) in babies, particularly during exclusive breastfeeding in the initial three to four months of the neonate’s life. This is because breastfeeding mothers are more likely to co-sleep with infants to respond to their hungry cues.

What Are the Benefits of Co-sleeping?

Co-sleeping is a multilayer familial phenomenon that includes various benefits in promoting infant care along with improving breastfeeding. Some of the benefits of co-sleeping are as follows -

• Co-sleeping protects the infant physically against cold and improves the survival chances, especially in preterm babies and neonates.

• In endemic areas that are prone to malaria infections, co-sleeping is advised for the efficient use of mosquito-repellent methods such as bed-nets utility. Indoor insect traps are available online and they can be used to trap insects.

• Co-sleeping is also followed in geographic areas where there are inadequate spaces for bedding and housing.

• Co-sleeping practices encourage ‘attachment parenting’ that facilitates sensitive as well as responsive caregiving and provides a natural platform for maternal-infant physiological regulation.

• Infants who co-sleep with their mothers experience frequent sleep arousals which reduces the duration of very deep sleep (stage 3 and stage 4 sleep).

• This phenomenon protects the infant from SIDS because deep periods of sleep and delayed arousals are risk factors for the occurrence of SIDS.

What Are the Controversies Associated With Co-sleeping?

Bed sharing along with certain forms of co-sleeping is considered controversial in the recent medical literature and also has received negative feedback. Some public health authorities also discourage parents from bed-sharing practices. Below are some of the reasons for these controversial speculations.

• The primary concern regarding bed-sharing is that it is considered a risk factor for infant mortality through mechanical suffocation (asphyxiation risk) and sudden infant death syndrome (SIDS risk).

• Asphyxiation commonly occurs when babies sleep in unsafe environments (soft surfaces, sofa, recliner, under duvets, near pillows) and are accidentally entrapped in the sleep surfaces or get overlaid by an oversleeping adult or elder child.

• The prone (face down) sleeping position of the baby is one of the most potent risk factors for SIDS.

• Intoxicated co-sleeping adults (use of unauthorized drugs or alcohol) also increases the risk of infant mortality.

• Smoking done by an adult in the same room as the babies also increases the occurrence of SIDS.

How to Ensure Safe Co-sleeping?

It is evident that co-sleeping as such is not a risk factor for SIDS. There are other factors like the positioning of the baby, the state of intoxication of the co-sleeping person, and sleeping surfaces that influence SIDS occurrences. Practicing co-sleeping and breastfeeding eliminating the risk factors for SIDS increases maternal reassurance, effective breastfeeding, and prompt maternal responses. This increased mother-baby interaction proves to be protective.

Some of the guidelines and safety measures suggested by worldwide organizations to reduce the risks associated with co-sleeping are as follows -

• Avoiding known unsafe sleeping environments like sofas, bean bags, couches, armchairs, waterbeds, and upholstered chairs reduces the chance of rolling over and entrapment of babies.

• The safest recommended position is co-sleeping at arm’s length of the mother on a firm sleeping surface without heavy pillows or duvets nearby.

• Proper positioning of the infant during co-sleeping decreases SIDS risks. The supine (face up) position is the recommended sleeping position.

• Co-sleeping parents should not take alcohol or other drugs that cause intoxication. Smoking should be avoided while sleeping with the baby in the same room.

• Mothers or co-sleeping infant care providers should form a safe ‘C’ shape around the baby. The baby is kept at the level of the adult’s breast with an arm between the head of the baby and the pillow.

• Bending the legs by the mother makes a protective and safe space around the infant. This prevents the rolling of another person over the baby.

Conclusion

Co-sleeping and breastfeeding contribute to effective infant care and progressive child development. Following proper co-sleeping practices, reduces its potential risks and enhances the safety of the infants.