Herbie Murray
The arrival of a newborn baby can be a joyous but challenging time for couples. One of the most significant adjustments is learning to sleep with a newborn in the house. Newborns have a different sleep pattern from adults, waking up every few hours to feed, and this can be exhausting for new parents. Co-sleeping or bed-sharing with a newborn is a common practice, with some cultural traditions even considering it cruel to separate a mother and baby at night. However, it is important to be aware of the risks associated with co-sleeping, including sudden infant death syndrome (SIDS) and accidental suffocation or strangulation. While co-sleeping can have benefits, such as convenience and bonding, creating a safe sleep environment for the baby is crucial. This includes ensuring the baby sleeps on their back on a firm, flat, and clear surface, keeping soft objects and loose bedding away from the baby, and avoiding co-sleeping if anyone in the bed has consumed alcohol or smoked.
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What You'll Learn
Co-sleeping risks: SIDS, suffocation, strangulation, and accidents
Co-sleeping, or bed-sharing, is a common practice among parents and their newborn babies. While some parents choose to co-sleep to facilitate breastfeeding and bonding, it is important to be aware of the potential risks involved, including sudden infant death syndrome (SIDS), suffocation, strangulation, and accidents.
Sudden Infant Death Syndrome (SIDS):
SIDS is an unexpected and unexplained death of an infant that is often associated with sleep. While the exact causes of SIDS are unknown, certain factors can increase the risk. Bed-sharing, especially with parents who smoke, drink alcohol, or use drugs, has been linked to an increased risk of SIDS. Studies have found that a baby sleeping next to a parent who has been drinking is significantly more likely to die of SIDS. Additionally, babies who are born prematurely or are underweight are at a higher risk of SIDS when co-sleeping.
Suffocation:
Suffocation is a significant risk when co-sleeping with a newborn. Soft surfaces, such as waterbeds, lamb's wool underlays, folded blankets, or pillows, can obstruct a baby's airways and lead to suffocation. Sleeping on sofas or couches is particularly dangerous, as babies can become trapped between the cushions or between the parent and the sofa. It is recommended to keep the baby's sleep space clear of any loose bedding, pillows, or soft toys that could cover their head and face, obstructing their airways.
Strangulation:
Strangulation is another risk associated with co-sleeping. Jewellery, teething necklaces, dummy chains, and long hair can pose strangulation hazards for newborns. It is crucial to keep these items away from the baby's sleep environment to minimise the risk of accidental strangulation.
Accidents:
Co-sleeping can also lead to accidental injuries, such as falling out of bed or being accidentally rolled over by a parent. To reduce the risk of accidents, it is recommended to place the baby on their back, away from the edge of the bed, and next to only one parent. Ensuring that the mattress is firm, flat, and level can also help create a safer sleep environment for the baby.
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Safe co-sleeping practices: sleep positioning, bedding, and environment
The decision to co-sleep with a newborn is a personal one and should be made keeping in mind the safety and comfort of all involved. While co-sleeping has been a tradition in many cultures, it is not recommended by the American Academy of Pediatrics, which advises against bed-sharing "at all times". However, if you choose to co-sleep, here are some safe co-sleeping practices to consider:
Sleep Positioning
It is recommended that infants always sleep on their backs, on firm, clean, and flat surfaces. The bed should be free of stuffed animals, pillows, soft bedding, sheepskins, or other fluffy materials, as these can pose a risk of suffocation. Ensure that the mattress fits the bed frame tightly to avoid gaps or spaces that the infant could fall into.
Bedding
Use light and comfortable blanketing, and avoid over-bundling the infant. The infant's head should not be covered, and they should not be placed to sleep on top of a pillow or soft mattress, such as a beanbag.
Environment
The sleeping environment should be free of secondhand smoke, as breathing hazards are a significant risk factor for Sudden Infant Death Syndrome (SIDS). Waterbeds and couches/sofas are especially dangerous for infants due to the risk of suffocation. It is also important to note that bed-sharing should only be done by committed, non-smoking adults who are comfortable with the decision and aware of the potential risks.
While co-sleeping can provide benefits such as increased sleep for breastfeeding mothers and closeness with the infant, it is essential to prioritize the infant's safety by following safe sleep practices and eliminating potential hazards.
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Cultural differences: bed-sharing in different cultures
Bed-sharing, or co-sleeping, is a common practice in many cultures around the world. However, the cultural acceptance and norms surrounding bed-sharing can vary significantly between different societies.
Western Cultures
Western cultures, including the United States and Europe, have a long history of separating mothers and babies at night. This practice dates back to ancient Roman times, when wealthy families had rocking cradles and bassinets, and continued into the Middle Ages, when the Catholic Church banned infants from the parental bed. Today, countries like the United States prioritize infant independence, with solitary sleep considered a form of "independence training." As a result, bed-sharing is often discouraged by healthcare providers and is not socially accepted by a large portion of the population. However, it is important to note that bed-sharing is still practiced by many American families, with studies showing that it is more common than most people believe.
Asian Cultures
In Asian countries like Japan, bed-sharing is a common practice. The traditional sleeping arrangement is referred to as "kawa no ji," or "river," where the mother and father are represented by the longer lines of the river, and the child sleeping between them is the water. Japanese mothers have expressed that sleeping alone is considered "merciless" and can force independence on infants. While Japan is an industrialized country, its cultural values differ significantly from Western societies when it comes to bed-sharing.
Other Cultures
In many other parts of the world, including Southern Europe, Latin America, Asia, Africa, and Central and South America, bed-sharing is the norm. In these cultures, mothers and babies routinely share sleep, and in some cases, this practice continues long after weaning. For example, in Sweden, an established Western country, co-sleeping is considered a normal family activity, with 72% of families in one study co-sleeping with their children. Similarly, indigenous people in the Amazon sleep in individual hammocks, separating even married couples, while in Vietnam, parents sleep with their babies in hammocks next to the bed.
Overall, the cultural norms and practices surrounding bed-sharing vary widely across different societies. While some cultures prioritize infant independence and solitary sleep, others view bed-sharing as a natural and essential part of family life. Environmental factors, cultural values, and kinship also play a significant role in shaping these sleeping arrangements.
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Newborn sleep patterns: how much sleep and when
Newborns sleep for 14 to 17 hours in a 24-hour period, according to the National Sleep Foundation. Some newborns may sleep for as many as 18 to 19 hours a day. However, they do not know the difference between day and night and do not have established sleep-wake rhythms. They sleep in short bursts, known as sleep cycles, which are usually around 20 to 50 minutes long.
Newborns wake up frequently during the night, often because they need to be fed or changed. They wake up every couple of hours to eat. Breastfed babies feed about every 2 to 3 hours, while bottle-fed babies feed less often, about every 3 to 4 hours. Newborns who sleep for longer stretches should be awakened to feed. Wake your baby every 3 to 4 hours to eat until they show good weight gain, which usually happens within the first couple of weeks. After that, it's okay to let your baby sleep for longer periods at night.
Newborns also go through a stage of increased crying, which will be at its worst at 6 to 8 weeks of age. Crying is a late sign of hunger in newborns. They may also cry because they need to be changed or settled so they can get back to sleep.
Sleep cycles have four stages:
- Stage 1: drowsiness, eyes droop, may open and close, dozing
- Stage 2: light sleep, the baby moves and may startle or jump with sounds
- Stage 3: deep sleep, the baby is quiet and does not move
- Stage 4: very deep sleep, the baby is quiet and does not move
At the end of the sleep cycle, there is typically a quiet alert phase. This is when the baby is very still, but awake and taking in the environment. They may look or stare at objects, and respond to sounds and motion. This phase usually progresses to the active alert phase, where the baby is attentive to sounds and sights, and moves actively. After this is the crying phase, where the baby's body moves erratically, and they may cry loudly.
It is important to create positive sleep associations for your newborn. Some settling techniques may be hard to maintain in the long term, such as holding your baby until they fall asleep. These can create a negative sleep association, resulting in them needing to be held to fall asleep. Instead, you can help your baby sleep by knowing the signs of sleep readiness, teaching them to fall asleep on their own, and providing the right environment for comfortable and safe sleep.
To make co-sleeping safer, place your baby on their back, on the side of the bed, away from the edge and next to one parent. Make sure the mattress is firm, flat, and level, and big enough to fit everyone with room for a clear space around your baby. Keep your baby's sleep space clear and free of pillows, sheets, blankets, toys, and other items that could create a strangulation risk.
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Breastfeeding and co-sleeping: benefits and considerations
Co-sleeping, or sharing a bed with a baby, has been practised for over 200,000 years, and continues to be common around the world. In the US, the practice has grown from 6% of parents in 1993 to 24% in 2015. Co-sleeping can be intentional, such as when parents bring their babies into bed, or unintentional, such as when parents fall asleep while holding their baby.
Co-sleeping can have benefits for breastfeeding and bonding. It can make it easier for parents to breastfeed during the night, as they don't have to leave their bed, and can help parents get more sleep. It can also support bonding between parents and babies, as well as potentially improving milk supply.
However, there are also considerations and potential risks to be aware of when co-sleeping with a newborn. The American Academy of Pediatrics recommends that parents avoid bed-sharing with their baby, and instead practise room-sharing for at least the first six months. They should sleep in the same room as the baby, but on a separate sleep surface, such as a bassinet or crib.
To reduce the risks of co-sleeping, it's important to create a safe sleep environment. This includes making sure the baby sleeps on their back, on a firm, flat, and level surface, in a clear space that is not too hot and is smoke-free. It's also recommended that parents don't co-sleep if they smoke, use alcohol or drugs, or are extremely tired or unwell.
While co-sleeping can have benefits, it's important for parents to be aware of the potential risks and take steps to create a safe sleep environment for their newborn.
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Frequently asked questions
Co-sleeping with a newborn is not recommended by doctors and leading health organizations due to the risk of suffocation, sudden infant death syndrome (SIDS), and fatal sleep accidents. However, some parents still choose to do it for perceived benefits like bonding and convenience. If you choose to co-sleep, it is recommended to place the baby on their back, on a firm, flat, and level surface, away from the edge of the bed and next to only one parent.
To make co-sleeping safer, keep the baby on a firm, flat, and level surface, away from pillows, blankets, and other objects that may cover their head and face. Remove any headboards, and ensure the baby cannot be trapped in the bed frame or between the mattress and the wall. Avoid co-sleeping if anyone in the bed smokes, consumes alcohol, or takes medicines that cause heavy sleep.
Newborns typically need 14-17 hours of sleep over a 24-hour period, with some sleeping up to 18-19 hours per day. They wake up frequently to feed, approximately every 2-4 hours, depending on whether they are breastfed or bottle-fed.
