Co-sleeping or not co-sleeping. The Family Debate

Sleep science contributor, Sarah Christian, helps us understand the debates around co-sleeping and  what to consider so everyone gets a good night sleep.

Your Rockin’ Blinks Cheat Sheet:

• Co-sleeping is a very personal decision. There is no “right” or “wrong.”
• Healthy boundaries are important whether you co-sleep or not in order for everyone to be well rested.
• Safe sleep matters.
• There are alternatives to a family bed that still allow everyone to be close.
• What matters most is for everyone to be getting quality sleep.

Where should the baby sleep? In most of the United States, the baby might be in a bassinet or other small sleep location during the first few months, but eventually parents move their little one to a crib in a separate room. In sub-cultures within the United States and in other countries around the world, the norm is for parents, particularly the mother, to share a common bed or floor mat with the baby [1].

But is there an ideal location where the baby should sleep? Despite the impassioned arguments surrounding this topic, there is no simple answer. Here we’ll look at cultural expectations regarding co-sleeping, parental expectations, attachment, sleep quality, and how to make co-sleeping work if that’s your family’s choice.

Cultural expectations

In Italy, children are more central to the daily lives of their parents as compared to Dutch families. When it comes to sleep, this means that Italian children are much more likely to be up late at night, still involved in whatever the family as a whole is doing, and infants may simply fall asleep in a parent’s lap rather than be tucked into bed.

In a rural Kenyan people group, older siblings are expected to take care of younger ones, leaving the parents free to tend to livestock or farming responsibilities. These little ones on average sleep less than any other reported group. In both broad as well as subtle ways, the values of the culture become the values of the family, which in turn shape how and where everyone sleeps.

Human beings are hard-wired to want to belong. We begin imitating others early on, forming habits that are rooted in precedent rather than choice. When it comes to caring for a new baby, it may be surprising how difficult it is to go against your own personal experiences and those of the people closest to you.

Among a group of European American mothers where co-sleeping is discouraged, those who continued to co-sleep with their baby beyond 6 months of age were more likely to receive criticism and to experience anxiety and depression about their baby’s sleep behavior. This was true even among mothers who initially preferred this sleep arrangement.

And lest the guilt be placed solely on those who co-sleep against their society’s trends, the same burden also happens in reverse. A Korean proverb says, “A baby must not sleep in an empty room alone, and an adult must keep watch next to it.” American families abroad who choose to follow their home country’s independent sleep habits may experience the discomfort of going against the norm.

Parental expectations

As people who use language, we are always trying to make sense of what we are experiencing. We are constantly telling a story of who we are, what we’re doing and why. These narratives are based on a mixture of existing assumptions plus observation. So we might tell ourselves the story, ‘The baby is scrunching up his legs; he must be crying because his tummy hurts.’ or ‘She keeps chewing on her fists; I’m sure a tooth is about to pop through.’

Remarkably, the stories parents tell of who their child will be, even before the baby is born, are incredibly predictive of the child’s actual characteristics. Questions like, ‘How do you think your baby will react to being separated from you?’ or ‘Do you expect that your baby will be upset often?’ turn out to be pretty consistent with the child’s actual behavior at a year of age.

Even the question of whether a young child’s sleep is a problem or not is woven into the understanding a parent has of what is “normal.” Again, what a parent believes to be true even before the baby is born is predictive of the behavior that emerges. Expectant first-time parents were asked what they would do in various scenarios involving a crying baby. Some read the fictional stories and assumed that the distressed infant would require more external help to settle. Other parents-to-be read the stories and believed that the baby had an internal need that the baby could regulate with minimal outside assistance. These thought patterns persisted when the couples gave birth. The direct-helper parents were much more likely to actively help regulate their baby’s moods and transition to sleep, and as a result to have a frequently waking baby at 6 months of age compared with those who had an attentive and watchful approach to the baby’s own capability to regulate independently.

Co-sleeping and attachment

Attachment theory was developed in the 1960’s and 70’s by psychologists John Bowlby and Mary Ainsworth. It emphasizes the importance of a secure attachment to at least one primary caregiver for life-long social and emotional well-being.

Pediatrician Dr. William Sears and his wife Martha are known for their incorporation of attachment theory into the concept of attachment parenting. In attachment parenting, parents make every effort to offer comfort and security to their little ones by means of caregiving such as baby-wearing, breastfeeding, and co-sleeping. Anthropologist James McKenna argues that co-sleeping promotes frequent responsiveness between a breastfeeding mother and her baby that increases healthy attachment.

However, the nuances of attachment are much more complex than sharing a bed with your little one. As important as it is to be responsive to your baby, the reality is that our interactions are inconsistent: we may attend to a baby’s cry quickly and calmly in one moment, but in a hurried and frazzled way when we’re also trying to get dinner made while talking to the pediatrician on the phone. Evidence suggests that these mismatches to a baby’s cues are completely normal, and that even wonderful parents are only attuned to their little ones 30% of the time.

Perhaps it’s not surprising then that the research on attachment and co-sleeping is inconclusive. One of the most significant influences on a young child’s sleep quality is the parent’s emotional availability at bedtime, meaning the parent’s ability to be sensitive, set appropriate limits, non-intrusive (allowing the child the space to do what the child is capable of doing), and non-hostile (not displaying anger toward the child). Since it is possible for parents to show healthy emotional availability to their child in either a shared bed or a solitary sleeping arrangement, it follows that the child can be securely attached and sleep well regardless of the sleep location.

Sleep Quality

One final category that plays a large role in where a little one will sleep is the quality of that sleep, for both the child and the parent. Often parents say that they decided to share the bed with their little one because everyone sleeps better that way, but it’s important to determine what “better” means. Is there a threshold to know when a night’s sleep is of high enough quality that everyone is happier, healthier, and well-rested enough that no changes are needed to the sleep situation?

It’s important to note that the sleep of infants and young children is dramatically different from that of adults. Newborns spend roughly half of their sleep time in what is called “active” sleep. Prior to 4 months of age, this active sleep is when a baby is dreaming, and they truly are active and likely to move around. Around 4 months, babies begin to experience the paralysis during dream sleep that we experience for the rest of our lives, that is thought to keep us from acting out our dreams. This means that, even aside from waking to eat during the night, a newborn is likely to be a very disruptive bed partner.

However, since newborns do need to eat frequently, the close proximity between a breastfeeding mother and her baby may make it easier for mothers to feed the baby and return to sleep quickly. Some evidence supports the theory that breastfeeding mothers get more sleep when their baby is in bed next to them, while others find that mothers actually wake more often in this arrangement.

Beyond the newborn age, night waking and the need for infants to eat during the night drops off quickly. Among families who intentionally chose to co-sleep however, a different pattern emerges. At 3 months of age in one sample, 36% of bed-sharing infants were sleeping for at least 5 hours uninterrupted. At the same age, among solitary infants who were consistently given just one minute between when they woke and when they were fed at night (a time gap that didn’t exist for bed-sharing infants), almost 90% were sleeping for at least 5 hours.

Consider whether everyone is benefitting from co-sleeping, or if it’s time for an alternative. Do you wake in the morning feeling refreshed? Are you able to stay alert throughout the day, or do you find yourself unintentionally falling asleep–particularly in the early afternoon hours? Are you enjoying the closeness with your little one at night? Do you feel like you’re able to be the parent you want to be for your child?

How to Make Co-Sleeping Work

To be fair, most parents aren’t reading research literature when trying to make sense of their baby’s sleep patterns. They aren’t trying to predict what will work best for everyone in the long run. Parents are just trying to make it through another night so that they can function the next day. Often this means that whatever works to get everyone back to sleep will be the option that parents are most likely to choose. So what can parents do?

Make sure the sleep environment is safe.

Infants under one year of age are at risk for SIDS, particularly among infants four months and younger. For this reason, the American Academy of Pediatrics strongly recommends not bed sharing with infants younger than four months. If you might fall asleep while feeding your newborn in bed, make sure there are no loose blankets, pillows, or any other material that may cover your baby’s face. Older breastfeeding infants should sleep on their backs, next to the mother and not next to any older siblings. The mother needs to be able to wake easily, and so should not be taking any kind of sedatives, alcohol, drugs or medication that would prevent her from being aware of her infant. If you’re overly tired, put your baby in a separate sleep space: take no risks. Long hair needs to be tied back. And parents need to be aware that adult beds were not designed to protect an infant. Bottle-fed infants need to sleep on a separate sleep surface near but not in bed with the parent(s).

Have a plan.

Responding to your infant or young child’s frequent waking by co-sleeping is fully understandable, and parents should not be put under a burden of guilt for doing what it takes to be able to sleep. However, it’s important to recognize that this is a reactive way of coping with a sleep problem and not an intentional plan. If you have reluctantly added your breastfeeding baby or your scared-of-the-dark toddler to your bed, develop a plan to reduce night feedings (if that’s your goal) or to teach your child how to acknowledge and overcome her fears.

Make sure everyone is in agreement. It isn’t fair to leave dad out of the picture. Co-sleeping is related to lower marital satisfaction when parents reactively bring their young child into bed with them, as opposed to intentionally choosing this sleeping arrangement.

Look for alternatives.

A bassinet next to the crib may provide closeness for your baby at night while also offering greater safety than the adults’ bed. A toddler who enjoys snuggling in bed with mom and dad may learn to be content with a mat on the floor in the parents’ room instead. Gently and consistently enforce the boundaries you choose for your family.

Keep bedtime early and consistent.

Sleep is essential for healthy growth in little ones, and later and/or inconsistent bedtimes are strongly connected with insufficient sleep. When your child is sharing the room or bed with you, it can be tempting to shift their bedtime later to coincide closer to your own. Keeping bedtime earlier than 9pm will allow your child the opportunity to get the rest that he or she needs.

If everyone in your home is happy with the sleeping arrangement, sleeping safely, and you’re all feeling well rested each night, then enjoy! If the topic of sleep is a constant tension in your home though, then the most loving and healthy thing you can do is to make the change that meets everyone’s sleep needs.

Good sleep is essential for a happy healthy childhood and life. Book a consultation with us now!

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