This post is the fifth in a series about my experiences of motherhood and what I wish I’d known before I had a baby. You can see the original post here.
Looking back, I don’t think I gave the question of where my baby would sleep much thought before she was born. Like most modern Britons, I assumed that all babies slept in cots, maybe starting off in a moses basket for the first few months (I had seen some very cute photos of friends’ babies in moses baskets). I’d read some guidance about having them in your room for the first six months, but didn’t read up much more than that. I assumed it would all sort itself out when she arrived. I’d heard that some people did something called co-sleeping (which I thought sounded like a terribly trendy hip new term, and that in itself put me off), and I promptly decided I would never do that. I was terrified it wasn’t safe (after all, you hear about bed-sharing baby deaths every so often in the news), a paediatric nurse friend had told me she had seen accidents involving bed-sharing, and shortly after my daughter was born, a health visitor told me in no uncertain terms that I must not bed-share with my baby, as it was unsafe. But even if I’d been convinced it was safe, I’d ruled it out anyway: I recalled babysitting a three year old while I was at university, and back then I was shocked that, in order to get him to sleep, I had been told I had to lie down next to him in his parents’ bed (and given that one of his parents was my German tutor, that felt somewhat awkward…) until he dropped off. His parents would move him when they got back. It reminded me of my own dear mother’s tales of having to lie down with my brother to get him to sleep until he was four. I decided then and there I was never going to let my children make demands of me like that. I reckoned that if you nip it in the bud early enough and are consistent enough, you can avoid that kind of thing.
I gave it my best shot, and looking back, I am amazed I held out for so long, because my daughter’s demands were truly crippling. I had assumed newborn babies fed every few hours or so. I learnt later that this belief stems from the fact that most babies are formula fed, and their pattern of feeding is quite different from breastfed babies. There are, of course, some breastfed newborns who only nurse for a few minutes every few hours, but mine wasn’t one of those. Most aren’t. Mine screamed mercilessly unless she was on the breast. All the time. I couldn’t take her screaming. It tore my soul in two just to hear it. Nothing else would soothe her, so I put her on the breast. For hours. I have previously noted that her record was twelve hours’ straight nursing, with the odd nappy change here or there. She never repeated that, but she would regularly nurse for six hours or so in the evening in the first few months. And then again after another couple of hours, and again an hour later, oh, and then it was morning already.
Once we’d got the hang of nursing comfortably and without pain, I mostly just sat on the bed and looked up articles on my smartphone in the other hand while she nursed on and on. She would nurse to sleep after an hour or so, and then I’d put her upright onto me. She had really bad reflux, you see, and so I was hoping that holding her upright would mean she wouldn’t cry out in pain when I put her down. So I would sit there for twenty minutes, then attempt a moses basket transfer. I would carefully – so carefully – slide out of bed, gently lay her down on the mattress and – waaaaa! She woke up, thrashing her limbs around, screaming her little lungs out such that the only thing I could do was put her back on the breast just to stop the noise. And so it would begin again. Forty five minutes’ more nursing, holding upright for twenty minutes after she’d nursed to sleep, gently – gently – lowering her down into her moses basket … ha! She stayed asleep! Creep over to bed, get in, switch the light out, start dozing – WAAAAAAA! Five minutes later and she had woken up again. Back on the breast again. The whole cycle would happen five or six times. When I saw midnight I would cry without fail, every night, praying that the next time she would actually stay asleep. Just when the thoughts got truly dark, when I genuinely thought I could no longer cope, I would miraculously wake an hour or two later, and it’s amazing when you’re that sleep deprived how even an hour or two can make you feel totally refreshed.
You might be asking, where was your dear husband in all of this? Why wasn’t he sharing the load? Well, I can’t speak for most people’s other halves, but mine just couldn’t cope with the nights. He went a pale shade of yellow when he had to get up to do anything in the night. It took him five minutes to come round (and I could not take five minutes of screaming), he knocked into everything and fell over frequently, and was generally unable to do much. We realised that we had been given different gifts. Somehow, biology had enabled me to cope better than him at night. We arranged it so that I mostly covered the night duties and he did lots more supporting me during the day (my daughter mostly wanted to nurse all day, too). Of course, sometimes he had no choice, and after hours and hours of nursing he had to take her because I could cope no longer as I was so sleep-deprived. He used to take her downstairs, switch on some David Attenborough series to help him stay awake, and rock her to sleep if he could. If he couldn’t, he’d bring her back up, but on many occasions he could, and she liked sleeping upright on him, as it helped her reflux and well, he is her dad, and it’s nice to have snuggles. She must have felt warm and safe.
On one such occasion I remember ordering my husband to look up on his wonderphone what people did to get more sleep when their baby wanted to nurse non-stop all day and night. And after a brief search of various baby forums he came back with ‘they co-sleep’. I refused. I was still never doing that. I was so tired, how could it be safe?
Of course, the months rolled on and my daughter’s nursing and sleeping patterns changed. She gradually phased out the six hour long cluster feeding sessions, and by about three months old, she would usually be asleep by about 10pm and slept till maybe 3am, then woke again a couple of hours later, and then for good around 9am. Wonderful! Five hour stretches felt like a dream, except… a lot of the time I couldn’t sleep. I wrote about my insomnia and sleep deprivation in this post, and it was at its worst around this time. Even though my daughter was mostly ‘only’ waking twice a night at this stage, the getting up to nurse her and put her back down was getting increasingly draining as the months went by, even though she went down more easily than in the early weeks. It hadn’t helped that she had outgrown her moses basket by about 12 weeks old, and so we had moved her to her cot, but that didn’t fit in our bedroom in its configuration at that time so she was in a separate room from us (contravening those guidelines I mentioned above). The traipsing to the spare room twice or three times a night, sitting upright in a chair for twenty minutes getting chilly while my husband slept on, unaware, then lack of ability to fall back to sleep on my part after my daughter had happily gone back in her cot caused a lot of resentment to build up. I questioned everything about having children. How did people cope? Why did no one ever tell you it was this hard? How is it that millions of women down the generations have gone and done this multiple times with absolutely zero recognition at all for how desperately awful the sleep deprivation is?
Now I know the answers to those questions. They bed-shared and breastfed their babies through infancy and toddlerhood. It took several more months for me even to consider that for us, though. I battled on through illnesses, infections and even an emergency hospital stay because of a tooth abscess, resolute in my decision that bed-sharing wasn’t for us and sceptical that it could really make a difference to my sleep deprivation anyway. Oh, and we had tried all of the other things. Tilting the moses basket mattress to help with reflux, warming the mattress with a hot water bottle, offering a dummy (ha! Like my daughter would take one of those!), swaddling, more layers, fewer layers, holding upright for less time, holding upright for more time, trying to burp her, not burping her, infacol (she wouldn’t take it). The thing that worked every time was nursing. What didn’t work was everything else. Looking back it seems so ludicrous that we had tried so many different artificial things that mimic the comfort and closeness of the nursing relationship when the one thing that provided all of the above was … well, me.
Then a few things happened that caused me to question my previous stance. The first was that I went back to university and realized I couldn’t do a PhD full time without organized childcare as I was suffering from a lot of stress and anxiety, and in any case any academic enterprise off so little sleep was completely impossible. So I switched to part time, which allowed me a lot more time and head space to get involved with various parenting groups in Oxford that I had previously not had any involvement in. I had also started using my sling a lot more at the expense of the pram, and found getting about on the bus so much easier than previously. I had wanted to get to a Baby Cafe, because I was part of its local Facebook group and it had provided me with a lot of reassurance, support and knowledge about breastfeeding and sleep. I knew that the advice given on that group made me think that these were the people I wanted to listen to among the throng of voices telling me how to parent. What I knew I was not prepared to do was any kind of extinction type ‘sleep training’ (I outlined my reasons for this in my last post, but this is a good summary of why the association between Cry It Out/Controlled Crying sleep training and the rise in cortisol levels matters).
I recall my first trip to a Baby Cafe, and I told the facilitator all about how my seven month old woke frequently and I was drained and tired of it. ‘You’ve worked out how to nurse lying down, I take it?’ She asked me in an offhand kind of way. ‘Um, no, I’m coping without doing that,’ I mumbled. In truth, I knew how to nurse lying down, because as soon as my daughter was born the midwives showed me how to do it. Indeed, when I went back to the MLU where my daughter was born for breastfeeding help in the first week of her life, the first thing they did was put me on a spare bed with my daughter and let us have a sleep together. I reflected on this as I got to know more breastfeeding and bed-sharing mothers. If even the midwives had done it, it couldn’t be that bad, right?
The last nail in the coffin, as it were, was when I was chatting to a mum of a baby who was about six months older than my daughter. She looked fresh-faced and well-rested, and I assumed she had One of Those Babies who sleep well. When I asked her about his night time pattern she said ‘oh he wakes several times, but it’s ok. We co-sleep,’ expecting me to understand that co-sleeping somehow made his night wakings ok. That was it. I had to give it a shot. Too many people, from other mum friends to Rosie at our local organic shop had confessed how bed-sharing had saved them from the depths of insanity. I bought this 2014 book by Diane Wiessinger et al., recommended at Baby Cafe, and researched intensively online. I was amazed at what I found, and so cross with myself for not having busted the myth earlier. The truth is that bed-sharing is unsafe for certain groups of people and in certain circumstances. But it is perfectly possible to bed-share safely. Here are just a handful of the the complexities in the bed-sharing/cot death literature. There is much more to be said, but it goes beyond the scope of this blog post to do so. The following points just give you a flavour. I encourage you to do some of your own research if you want to know more, or if you are unconvinced.
- The SIDS/bed-sharing literature is confused with regards to terminology
Broadly, the problem here is that in the literature co-sleeping is sometimes taken to mean bed-sharing, sometimes sharing the same room, sometimes sharing any (including unsafe) sleep surfaces. All the instances get lumped together, and the results look like there are higher risks of Sudden Infant Death Syndrome when co-sleeping (Wiessinger et al. 2014:360). A further problem is the confusion between SIDS deaths and Sudden Unexpected Infant Deaths (SUIDs) which include suffocation, poisonings and infanticide. Studies often refer to SIDS but are actually talking about SUIDs, such as in the following 2012 study that I quote below. Despite the fact that SIDS has nothing to do with suffocation or strangulation, the authors write that
“Bed-sharing has been suggested in the literature to increase the infant risk for SIDS due to the risks of overlaying or entrapment, wedging, falling or strangulation.” (Krause et al., 2012 quoted in Wiessinger et al. 2014:360).
- Data collection is inconsistent
What this means is that researchers don’t include known risk-factors in their data collection, such as whether a baby is formula fed or not (artificial feeding carries much higher risks of SIDS, see here), which position the baby was in, whether there were other children in the bed, whether the mother had smoked in pregnancy, that kind of thing. An apparently often-cited article (Tappin, Ecob & Brooke, 2009) explained that they didn’t collect data on alcohol consumption because it was difficult to obtain accurate information with regards to this, despite the fact that it is a known risk-factor both for SIDS and suffocation. Their conclusions are therefore surely questionable.
- There is much indiscriminate generalization
This basically boils down to policy makers creating a simple message targeting certain at-risk groups and then applying it blanketly to all groups, regardless of risk factor. This is what that Health Visitor was doing when she told me I should never bed-share. It’s a bit like saying you should never drive because people have car accidents. When you look at the details, it emerges that the risks of having a car accident are minuscule when you follow certain safe procedures, like wearing a seat-belt, not driving in adverse weather conditions, driving more slowly, not having any alcohol in your system, that kind of thing. So it is with bed-sharing. It is entirely safe for most people. Unfortunately, it seems that so many are convinced that it is not safe that they end up bed-sharing when they have not prepared for it, by falling asleep on possibly unsafe sleep surfaces such as sofas or sitting up in bed nursing where there are lots of pillows. I have been that person that has dozed off mid-feed in such a situation. It isn’t safe. It is so important to prepare the bed-sharing space before you reach rock bottom in terms of sleep deprivation.
There are many more problems, such as much of the research funding coming from profit making companies (such as tobacco companies), missing variables, researcher bias, lack of prospective studies (i.e. you can’t really ethically set up an experiment to test this kind of thing), the list goes on. I am no stranger to academia, and I was genuinely amazed just how blurred the picture is and how no one could feasibly argue that bed-sharing was unsafe for all mothers everywhere.
Armed with this knowledge, I was determined to give it a go. There are many different approaches to bed-sharing, and no ‘right’ answer, it’s just what works for you. Some have a side-car cot, some put the baby between mum and dad, some get rid of the bed altogether and put mattresses on the floor, some take one side off a cot and put it directly next to the bed… Some people’s partners stay in the bed, some go to another room, sometimes mum sleeps with the baby in a single bed, anything goes! What we did was move our king size bed against the wall, plug the gaps with rolled up towels, move the duvet and get blankets out. She would go next to the wall, then me, then my husband. Some mothers just take their babies to bed with them when they go to sleep, but I knew that I ideally wanted my daughter to start the night in her cot, so that I could have a bit of time away from her, which is essential for my sanity. (By and large, she does this willingly, except when she’s ill.) I was prepared for being kicked in the face (she was 8 months old by this point and very mobile), sleeping really lightly and knew that I had to give it a few weeks to possibly see any difference in my sleep deprivation. I was prepared for another upheaval. Only … it didn’t happen like that. Three nights into bed-sharing and I was cursing myself for not doing this sooner. My daughter didn’t wake any more or less, but nursing her lying down meant that I stayed dozy and our sleep cycles synced so I was rarely woken from a deep sleep. Having her right next to me cured my insomnia, more or less, and clearly I needed her near me to be able to sleep myself. I couldn’t recall how many times she woke up. I stopped looking at the clock. I suddenly started to feel refreshed in the morning. And my husband slept better! I got to her so soon after she woke that he never noticed her waking up, and because she was in the bed he seemed to instinctively have better sleeping habits, and woke me up less with his tossing and turning!
Some people ask me whether I am worried about rolling onto her, or about my husband doing likewise. This seems to be a reason why some mothers choose not to co-sleep. I was a bit nervous at first, but the Wiessinger et al. book told me that it is almost impossible to roll onto a baby if they are in a nursing position, because your knees are bent up by the baby’s feet, preventing you from being able to roll over. I had also read that breastfeeding mothers sleep less deeply and are aware of what their baby’s movements are (which is presumably why formula feeding mothers are advised not to bed-share in the early months). I also got less concerned about this after one night of co-sleeping, and on realising that I never habitually fell out of bed, as I subconsciously knew the edge of the bed was there. Why would I be any different with a baby? My husband was more nervous than me, but as she got bigger, and as he got more confident, he ceased to be concerned. She now mostly sleeps between us.
If you’re wondering about whether you might like to try bed-sharing, then there are plenty of places online to look for advice on how to do it safely. Here is La Leche League’s Safe Sleep Seven, which is a good place to start. Essentially, the ‘safe criteria’ are: you lay your baby on his back to sleep, you are a breastfeeding mother, the baby is on a safe sleep surface, you have had no alcohol, you are not a smoker and didn’t smoke in pregnancy, your baby wasn’t premature, and you don’t swaddle your child. If you need more convincing or want to read up further, then see the following links. Of course, some of you won’t fulfil all those criteria. Some of the following links have good suggestions if you don’t, and see this article if you are a formula feeding mother.
- Dr James McKenna at the University of Notre Dame has been studying infant sleep for decades, and is a well-known advocate of bed-sharing when practised safely. His website is here.
- Kellymom.com is my go-to evidence-based site for anything related to breastfeeding. It has a section on bed-sharing here.
- La Leche League have a lot of useful pages on this topic. Here is one about bed-sharing and the risk of SIDS, and here is one about how policy makers and the media have the wrong understanding about ‘normal’ infant sleep.
- Dr Helen Ball’s research project on infant sleep at the University of Durham has some useful information for parents about where babies should sleep here.
- Dr William Sears, founder of Attachment Parenting, has some useful pages on co-sleeping here.
Ok, ok, you say, I’ve convinced you that it’s safe when you take the necessary precautions, but what about the practical side of it? I don’t want a child in my bed! Or at least, while I quite like having a child in my bed some of the time, I don’t want them to stay there forever! Won’t they ‘get used’ to it and never leave? What about being intimate with my husband/partner? These are valid questions, and I’m not trying to cajole anyone into bed-sharing who doesn’t want to. After all, I didn’t want to. I understand why people don’t.
It is worth dwelling on the fact that most of the rest of the world, outside of the West, bed-shares with their babies and are much more socially accepting of it than we are, and it seems to be peculiar to our culture to view it negatively (alongside viewing it as unsafe), despite the fact that most Western mothers report bed-sharing at some point during their child’s life (and this rises to 80% of American breastfeeding mothers), according to some of the links I referenced above. I have been challenged on this personally, and come to see that bed-sharing is actually the biological norm, even though it’s not our cultural norm. If you think about it, we seem to be the only mammal that expects our young to sleep separately from us. And it would have been near impossible not to co-sleep before the invention of centrally heated houses – sleeping in close proximity was a way of keeping warm, to say nothing of protecting one’s young when they are at their most vulnerable. It seems we are biologically wired to expect to co-sleep, so we can hardly blame our children for wanting to sleep near us. James McKenna, one of the academics listed above, goes even further and believes babies should not sleep alone, and he writes about this here. Not only this, but keeping my eyes and ears open around parents of older children has made me realize that night time fears come back on and off as children get bigger. If I have the expectation that she can come into my bed whenever she likes, then I get less bothered by thoughts of how long she might want to do it for. I also know that, yes, four or five year olds can crave a parent’s closeness at night time. Let’s be honest, who doesn’t remember being a bit scared of the dark as a kid? I want my children to feel safe, and if that means curling up with me when they’re older, than I’m fine with that. I’m pretty sure my daughter wouldn’t want to be caught dead in my bed when she’s 14. They all outgrow it in the end. There is also no evidence to suggest that co-sleeping makes children less independent now or later, nor any evidence (see same link) to suggest parents can’t be intimate. Were this the case, one wonders how the world was peopled in the first place… And while we’re at it, let’s bust another myth too – it’s not ‘bad’ to nurse a baby/child to sleep. It isn’t a rod for your own back, or a bad habit, and it doesn’t mean that a baby will not be able to get to sleep any other way. My baby falls asleep happily for other people (and indeed for me) in the car, in the sling, or in the pushchair, and always has done. I have never not nursed her to sleep when she’s wanted to. It strikes me as odd that some mothers think it makes more sense to spend half an hour bobbing a child up and down when you might as well just nurse them to sleep in ten minutes. If you don’t believe me, see here.
This piece isn’t designed to make everyone feel like bed-sharing is mandatory. It’s about finding what works for your family. If your baby or toddler is happy sleeping on their own and everyone is getting enough sleep – great! I also know that some little ones wake less when they’re on their own, and some parents report sleeping much better without a small person in the bed next to them. Nothing wrong with that. The point of this piece is rather to bust the two myths that co-sleeping is dangerous and that it is somehow ‘bad’. If you’re chronically sleep-deprived, don’t be like me and not do it because you swallowed what some not so well-informed family members/friends/health professionals said without thinking. Do your own homework and make your own informed decision.
I’ll never know if the eight months of abject sleep deprivation would have been mollified by bed-sharing. Perhaps because of her reflux I’d have had to hold her upright anyway. But I suspect that as she nursed for hours, I would have dozed off safely. I’m not pretending co-sleeping is the answer to everything and that I am never tired any more (and that is clearly not the case, as my last blog post revealed). But I have felt ten thousand times more well-rested since we made the change. Whenever the sleep deprivation gets really bad, I remind myself of this. I now only very rarely have thoughts about throwing my baby out of the window, or poking out my husband’s eyes with a nappy nipper. It even sometimes enables me to think ‘oh, the disrupted nights aren’t so bad, really,’ and then I wonder about perhaps having another baby …
Krause, A., Craig, J., Watson, U., et al. 2012. Bed-sharing influences, attitudes, and practices: implications for promoting safe infant sleep. Journal of Child Health Care 16, No. 3: 274-283.
Tappin, D., Ecob, R., Brooke, H. 2009. Bedsharing, roomsharing, and sudden infant death syndrome in Scotland: a case-control study. Journal of Pediatrics 147, no. 1.: 32.
Wiessinger, D., West, D., Smith, L. J., Pitman, T. 2014. Sweet Sleep: Nighttime and Naptime Strategies for the Breastfeeding Family. London: Pinter & Martin.