The Benefits of Co-Sleeping
by Macall Gordon (From the API News - Spring 2002. © 2002
Attachment Parenting International - www.attachmentparenting.org)
When it comes to research about co-sleeping, there's good news
and there's bad news. The good news is that there is research to
suggest that there are benefits to parents and infants who share
a bed (or room) through the night. The bad news is that, beyond
the research into the connection between co-sleeping and SIDS prevention,
there's not much being done which inquires into its qualitative
or long-term aspects. Until this type of research is done, we must
continue to draw from the good work that is being done within the
American culture, as well as from studies conducted in other cultures
abroad.
What Research Shows
Benefits for infants
Co-sleeping promotes physiological regulation.
The proximity of the parent may help the infant’s immature
nervous system learn to self-regulate during sleep (Farooqi, 1994;
Mitchell, 1997; Mosko, 1996; Nelson, 1996; Skragg, 1996). It may
also help prevent SIDS by preventing the infant from entering into
sleep states that are too deep. In addition, the parents’ own
breathing may help the infant to "remember" to breathe
(McKenna, 1990; Mosko, 1996; Richard, 1998).
Parents and infants sleep better.
Because of the proximity of the mother, babies do not have to fully
wake and cry to get a response. As a result, mothers can tend to
the infant before either of them are fully awake (McKenna). As a
result, mothers were more likely to have positive evaluations of
their nighttime experiences (McKenna, 1994) because they tended
to sleep better and wake less fully (McKenna & Mosko, 1997).
Babies get more caregiving.
Co-sleeping increases breastfeeding (Clements, 1997; McKenna, 1994;
Richard et al., 1996). Even the conservative American Academy of
Pediatrics (AAP) admits to the breastfeeding advantages of co-sleeping
(Hauck, 1998). Mothers who co-sleep breastfeed an average of twice
as long as non-co-sleeping mothers (McKenna). In addition to the
benefits of breastfeeding, the act of sucking increases oxygen flow,
which is beneficial for both growth and immune functions. Co-sleeping
infants also get more attention and protective care. Mothers who
co-sleep exhibited five times the number of "protective"
behaviors (such as adjusting the infant’s blanket, stroking
or cuddling) as solitary-sleeping mothers (McKenna & Mosko,
1997). These mothers also showed an increased sensitivity to the
presence of the baby in the bed (McKenna).
Long-term Benefits
Higher self-esteem.
Boys who coslept with their parents between birth and five years
of age had significantly higher self-esteem and experienced less
guilt and anxiety. For women, co-sleeping during childhood was associated
with less discomfort about physical contact and affection as adults
(Lewis & Janda, 1988). Co-sleeping appears to promote confidence,
self-esteem, and intimacy, possibly by reflecting an attitude of
parental acceptance (Crawford, 1994).
More positive behavior.
In a study of parents on military bases, co-sleeping children received
higher evaluations from their teachers than did solitary sleeping
children (Forbes et al., 1992). A recent study in England showed
that among the children who "never" slept in their parents
bed, there was a trend to be harder to control, less happy, exhibit
a greater number of tantrums, and these children were actually more
fearful than children who always slept in their parents’ bed,
all night (Heron, 1994).
Increased life satisfaction.
A large, cross-cultural study conducted on five different ethnic
groups in large U.S. cities found that, across all groups, co-sleepers
exhibited a general feeling of satisfaction with life (Mosenkis,
1998).
What Parents Suspect
Co-sleeping promotes sensitivity.
Many parents who co-sleep feel that they become more attuned to
their baby and child. They feel that their sensitivity to the needs
and patterns of their baby translate into daytime sensitivity as
well.
It reduces bedtime struggles.
Parents of co-sleepers know that children who sleep in their parents'’
room have no reason to be afraid of bedtime. As they grow older
and move into their own rooms, they have positive, secure images
of sleeptime. They have no reason to equate bedtime with being alone.
It fosters an environment of acceptance.
Underlying the choice to co-sleep is a willingness to accept a
child's need for the parent both day and night. A parent essentially
communicates that while the child is small and needful, the parent
will be there to help the child and address their needs. Co-sleeping
parents tend to believe that this willingness to respond to the
child's needs carries over into the daytime, and this powerfully
contributes to the overall relationship with the child.
Co-sleeping is just as safe or safer than a crib.
Existing studies do not prove that co-sleeping is inherently hazardous.
The elements of the sleeping environment are what dictate the level
of danger to the infant. When non-smoking parents who do not abuse
alcohol or drugs sleep on a firm mattress devoid of fluffy bedding,
co-sleeping is a safe environment. In addition, it is likely that
there are many children whose lives have been saved by sleeping
next to their parents. There is anecdotal evidence, for instance,
of mothers who have noticed their child not breathing and were able
to stimulate them to breathe.
Problems with Existing Sleep Research
Cultural bias.
The research done thus far on co-sleeping has been, just like any
other kind of research, deeply informed by the culture of the researchers
and their subjects. Co-sleeping research conducted in the U.S. (where
co-sleeping is widely regarded as odd, if not dangerous) is heavily
influenced by the relatively high value Americans place on independence,
technology, consumerism, and parents’ needs for time and privacy.
Work done in other cultures, on the other hand, is more likely to
look at the benefits of co-sleeping and emphasize the needs of infants
as integral to family andsocietal functioning.
Too focused on short-term, specific outcomes.
Clinical research is not well-suited to measuring long-term, complex,
or qualitative outcomes. The benefits of co-sleeping are, as many
co-sleeping parents know from experience, not just short-term and
certainly not easily quantified. Such potential benefits go beyond
SIDS prevention, increased sleep for mother and baby, and increased
breastfeeding in the first few months of life; for instance, they
may include positive long-term effects on the parent-child relationship,
children's self-esteem, and more. Part of what makes studying these
long-term, qualitative benefits difficult is that their link to
co-sleeping may be hard to separate from their link to other parenting
practices common in co-sleeping families. Co-sleeping is simply
one part of a complex ecology of parenting choices.
To truly study co-sleeping, researchers will need to begin asking
different questions, such as what are the long-term outcomes for
children who co-slept as children? Are parents who choose co-sleeping
more likely to choose other parenting behaviors that also affect
the outcomes being studied?
Common Co-Sleeping Myths
Children Can Suffocate.
The recent Consumer Product Safety Commission (CPSC) finding that
adult beds are inherently hazardous is both misleading and inaccurate.
Parents should know that this recent campaign is sponsored and financed
by the Juvenile Product Manufacturing Association (i.e. crib manufacturers),
an organization that has everything to gain from parents choosing
to buy cribs. Parents should also know that perhaps millions of
parents sleep safely with their infants every year. A recent study
persuasively documented that babies who sleep on their backs with
a non-smoking, non-drinking, parent who did not abuse drugs show
no greater risk than solitary sleepers.
Dr. McKenna, professor of anthropology and director of the Mother-Infant
Sleep Lab at Notre Dame, gives the following safety suggestions:
"Infants should sleep on firm surfaces, clean surfaces, in
the absence of smoke, under light (but comfortable) blanketing,
and their heads should never be covered. The bed should not have
any stuffed animals or pillows around the infant and never should
an infant be placed to sleep on top of a pillow. Sheepskins or other
fluffy material and especially beanbag mattresses should never be
used. Water beds can be dangerous, too, and the mattresses should
always tightly intersect the bedframe. Infants should never sleep
on couches or sofas -- with or without adults -- where they can
slip down (face first) into the crevice or get wedged against the
back of a couch."
If they sleep in your bed, they'll never leave.
This has never been studied or documented, and anecdotal evidence
from co-sleeping parents does not bear this out. Many co-sleeping
parents report that their children become willing to leave, with
little or no persuasion, on their own around age two or three, as
they mature physically, emotionally and cognitively. These families
also report that there are many ways to help children find their
own sleeping space.
Co-sleeping families tend not to see things in terms of habits
that need to be broken, but as patterns that can be established,
but that continually evolve and change. For co-sleeping families,
laying the foundation for security and closeness takes precedence
over early independence.
Selected References
Blair, P.S., Fleming, P.J., Smith, I.J., Platt, M.W., Young, J.,
Nadin, P. & Berry, P.J., (1999). Babies sleeping with parents:
case-control study of factors influencing the risk of the sudden
infant death syndrome, British Medical Journal, 319(4): 1457–62.
Crawford, M., (1994). Parenting practices in the Basque country:
Implications of infant and childhood sleeping location for personality
development. Ethos, 22(1):42–82.
Farooqi, S. (1994). Ethnic differences in infant care practices
and in the incidence of sudden infant death syndrome. Early Human
Development, 38(3): 215–20.
Forbes, J. F., Weiss, D.S., Folen, R.A. (1992). The co-sleeping
habits of military children.
Military Medicine, 157(4):196–200.
Hauck, F. R., et al. (1998). Bedsharing promotes breastfeeding
and AAP Task Force on Infant Positioning and SIDS. Pediatrics, 102(3)
Part 1: 662–4.
Hayes, M.J., Roberts, S.M., & Stowe, R. (1996). Early childhood
co-sleeping: Parent-child and parent-infant nighttime interactions.
Infant Mental Health Journal, 17(4): 348–357.
Heron, P. (1994). Nonreactive Co-sleeping and Child Behavior: Getting
a Good Night’s Sleep All Night Every Night. Masters Thesis,
University of Bristol, Bristol, UK
Lewis, R.J., Janda, L.H. (1988). The relationship between adult
sexual adjustment and childhood experience regarding exposure to
nudity, sleeping in the parental bed, and parental attitudes toward
sexuality. Arch Sex Beh,17:349–363.
McKenna, J.J. (1990). Evolution and Sudden Infant Death Syndrome:
I. Infant responsivity to parental
contact. Human Nature, 1(2): 145–177. (See all his references
at www.nd.edu/~alfac/mckenna)
Mitchell, E. A., et al. (1997). Risk factors for sudden infant
death syndrome following the prevention
campaign in New Zealand: a prospective study. Pediatrics, 100(5):
835–40.
Mosenkis, J. (1998). The Effects of Childhood Cosleeping On Later
Life Development. Masters
Thesis. University of Chicago. Dept. of Human Dev.).
Mosko, S., Richard, C. & McKenna, J. (1997). Maternal sleep
and arousals during bedsharing
with infants. Sleep 20(2): 142–150.
Nelson, E. A. and Chan, P. H. (1996). Child care practices and
cot death in Hong Kong. New Zealand Med. 109(1020): 144–6.
Oppenheim, D. (1998). Perspectives on infant mental health from
Israel: The case of changes in collective sleeping on the kibbutz.
Infant Mental Health Journal, 19(1): 76–86.
Richard, C., Mosko, S., & J.J. McKenna (1996). Sleeping position,
orientation and proximity in bedsharing infants and mothers. Sleep,
19(9): 685–90.
Richard, C. A., et al. (1998). Apnea and periodic breathing in
bed-sharing and solitary sleeping infants. Journal of Applied Physiology,
84(4): 1374–80.
Skragg, R. K., et al. (1996). Infant room-sharing and prone sleep
position in sudden infant death syndrome. New Zealand Cot Death
Study Group. Lancet, 347(8993): 7–12.
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