Bed-sharing: What your pediatrician won't tell you

Here's how the typical American story goes: Mom and dad take baby home. When nighttime rolls around, they put baby in his crib and head to their own bed. Baby gets hungry some time later and starts stirring. He starts smacking his lips, moving his head around looking for mommy's breast. He doesn't find it and starts to wail. This pulls mom (and dad) out of sleep, and mom drags herself to go pick baby up and try not to fall asleep as she feeds him. She will repeat this several times a night for months.

What ends up happening is that moms will fall asleep with the baby in her arms on the couch, in the glider, or in her bed. This can be dangerous if the baby slips out of her arms into soft couch cushions. But there is an alternative. Safe bedsharing, or as this article calls it, "smart bedsharing." I'm convinced that if you took out all of the unintentional bedsharing (any instance of falling asleep with baby in an unplanned, unprepared way), the data would show that intentional bedsharing is as safe as "safe sleep" (ie: putting the baby on his back in an obstacle-free separate space).  

I had already made the decision to bedshare with my newborn daughter by the third day she was home. Like most new parents, I was under the impression that the baby has to be in her own space. I tried to put her down, but she wouldn't cooperate. She simply slept best on me. For the first two nights, I slept on the couch the whole night with her on my chest. (Read: very dangerous!)

Then I hired a post-partum doula. She, of course, would not advise me to bedshare. I'm pretty sure it's a liability issue. Nobody will advise you to do it. Yet, every parent I talk to says that they bedshare(d) with their infants, whether or not they intended to. Many sheepishly admit they did it, adding that it's inevitable.

If bedsharing is inevitable, then can we please talk openly about how to do it safely and its benefits? And while we are being real, let's admit to ourselves, collectively, that far more infants die in car crashes from sleep-deprived parents on the road than die in bedsharing accidents? Yet, we aren't really telling parents to stay off the road.

I'll start by saying what I love about bedsharing:

1. It helps establish milk supply. With the baby next to me or sleeping on me, I get plenty of skin-to-skin contact with her. This helped to establish my milk supply in those early days.

2. Significantly improved sleep. I wake up when she starts to get hungry, rather than waiting for her to be all-out crying. This means that everyone gets better sleep -- mom, dad, and baby (and any others within earshot).

3. Baby gets comfort from sleeping next to mom. She also gets cues from mom, such as regular breathing.

4. Varied sleeping positions. After she nurses, I'll position her on my chest or on my stomach so that she can be on an incline after feeding -- helping her get burps out. This allows her and me to get right back to sleep without the discomfort of bubbles in her belly. 

5. Both mom and baby love snuggling. This is a scientific fact.

In contrast, putting baby on her back in her own space results in poor sleep for everyone involved (at least in my family), more gas and discomfort, less skin-to-skin, no breathing benefits, and it's less fun for both mommy and baby. But it is reportedly the safest position to reduce SIDS and suffocation deaths.

Here's the truth: people will end up bedsharing. But if it is not recommended or talked about, then parents will not do it intentionally and thus not safely. I mentioned to our pediatrician that I was bedsharing with our daughter, and told her that I was fully aware that the recommendation was to put baby on her back in her own space, but that I had already looked into the matter and had come to a decision. This would have been a great opportunity for the doctor to educate me on making bedsharing as safe as possible. Instead, she went on and on about the guidelines for safe sleep, trying to talk me out of it.

Back to our doula: After recognizing that safe sleep guidelines all recommend back sleeping, she worked with with me to make the bedsharing environment safe. We inspected the mattresses in my home and determined the best one for baby (on the firmer side -- not the pillowtop one). We made the bed with a tight fit with jersey sheets. We pulled down the blanket to mid-bed. We chose a small pillow for me that would be placed under my head, but with my head at one end with the other end away from baby. We tried out several positions -- baby facing me, facing away, on chest, on stomach.

Guidelines for safe bedsharing:

1. Mattress is firm. Pillowtop or memory foam mattresses should be avoided. Feel a crib mattress for comparison. 
2. Fitted sheet is tightly tucked so that there are no folds. 
3. Minimize blankets. I use the top sheet plus one blanket. 
4. Keep blankets at waist level. You can wear a long-sleeved shirt for warmth up top (though you may want to wear a nursing top). 
5. Place baby on her back. I also place the baby on her side facing me, but you will have to determine your level of comfort.