Aside from feeding, there may be no other newborn parenting subject that garners as much ire as where your baby sleeps. Everyone has an opinion, and everyone is happy to tell you what you “should” be doing. Moreover, the experts can make it seem as though the simplest of things – where your baby sleeps – can be the difference between life or death for your infant. With seemingly so much at stake, the pressure to do things “right” can be almost debilitating, and, in some ways, can make things more dangerous.
As your doula, my job is not to tell you how you “should” parent. My job is to listen to your concerns and provide you with current, evidence-based information to empower you to make decisions that work best for your family. Because – I’ll let you in on a parenting secret – there is no one “right” way to parent.
First, let’s make sure we have some basic definitions under our belt.
While often used interchangeably, co-sleeping, roomsharing, bedsharing are not the same things.
Co-sleeping – the practice of sleeping in close proximity to one’s child.
Bedsharing – the practice of sleeping in the same bed as one’s child.
Roomsharing – the practice of sleeping on separate surfaces in the same room as one’s child.
Roomsharing and bedsharing are specific types of sleeping arrangements that fall under the co-sleeping umbrella.
Safe Sleep Basics
- Placing Baby on their back to sleep
- Using a firm mattress or sleep surface
- Removing any soft and cumbersome materials – blankets, pillows, toys, and bumper pads
- Sharing a room, but not a bed for the first 6 months to a year of the infant’s life
- Providing a smoke-free environment
- Avoiding drugs and alcohol that can inhibit your ability to respond to your baby
Other practices that have been linked to lower SIDS rates:
- Skin-to-skin contact directly after birth
- Keeping the sleep environment cool (between 60°F-68°F)
- Using a pacifier
- Attending all well-child visits
With all the guidelines in mind, the safest way for an infant to sleep is on their back on a firm surface in a shared room with their caretaker.
All of these practices sound pretty straightforward, right? While simple when taken at face value, these guidelines can be a little harder to follow in real life. In a 2015 study, The Pregnancy Risk Assessment Monitoring System (PRAMS) found that nearly 61% of parent participants reported bedsharing.
As a doula, I often see parents who are sleep-deprived from round-the-clock feedings or babies that just won’t sleep without some form of physical contact. Desperate yet well-intentioned, parents set up a co-sleeping arrangement that feels safe to them but actually puts Baby at more risk. What’s more, many parents are hesitant to admit to bedsharing, feeling a sense of failure or shame from the experts around them and, in keeping quiet, miss out on information that could keep their infant safe.
A parent’s need for sleep is valid, and, with more than half of parents reporting bedsharing, talking about it openly equips parents with a knowledge base to bedshare in relatively low-risk scenarios. Here, please note the use of the term low-risk. Any form of bedsharing is not without some risk.
La Leche League International developed the “Safe Sleep Seven” to enable those parents desperate for a good night’s sleep to do so as safely as possible. In essence, the Safe Sleep Seven protocol uses the expert guidelines to say that if you’re following the guidelines in your own bed, the risk of SIDS should be just as low.
Safe Sleep Seven
- Sober and unimpaired
- A breastfeeding mother and your baby is:
- Full-term and healthy (bedsharing should never be practiced with preterm infants or infants with pre-exisitng health conditions).
- On its back
- Lightly dressed
- On a safe surface
In my experience, the number one risky bedsharing behavior involves safe sleeping surfaces. So what makes a safe surface?
A safe surface is:
- Free of soft and cumbersome materials
- No heavy blankets, soft pillows, toys, or PETS!
- Clear of cords and gaps
- If your bed is pushed against a wall, even the smallest gap between mattress and wall can pose an entrapment risk for Baby.
- Firm and flat
- Rethink that pillowtop mattress
- Mindful of height
A safe surface is not:
- A couch
- A recliner or upholstered chair
- A sleep pod or in-bed sleeper like a DockATot, Baby Delight, or Boppy pillow
- A carseat or baby swing
Certainly, a baby sleeping in a bed with unimpaired parents following the Safe Sleep Seven is safer than a baby tucked in its desperately drowsy mother’s arms on a soft, squishy couch or recliner.
While I can’t tell you how your baby should sleep, I do know that planning ahead, educating yourself, and preparing a safe sleep environment not only in your infant’s bed but in your own bed as well can come in handy on those hard nights. Whatever sleep arrangement works best for your family, practicing safe sleep guidelines will minimize your infant’s risk of sleep-related deaths… and help you stand in the power that your parental decisions are well-informed.
Additional information on safe sleep: