Many years ago, as a new PA working in pediatrics, I attended a grand rounds presentation on the benefits of sleeping with your baby. The presentation, given by a colleague I highly respected, talked about how wonderful this practice is to nourish the bond between mother and child, and how much it supports breastfeeding. She showed videos of mothers aware of where their baby was even in their sleep and pointed out how moms would shift in their sleep to keep their babies safe and comfortable.
The presentation and the videos both had a profound effect on me, and as I became a mother myself, I slept with my newborn daughter through her first year and beyond. As Tessa grew, she was replaced in our bed by each of her three younger brothers in turn, until the bed that my husband and I had purchased as a wedding gift to each other had truly become a family bed for well over a decade.
During this time, the American Academy of Pediatrics (AAP) tweaked details but remained consistent in their recommendation that people not sleep with their infants because it increases the risks of sudden infant death syndrome (SIDS) and accidental suffocation. Today, the recommendation is to have infants sleep in the same room, but not in the same bed, as their parents. And I have prided myself through my years of practice on always following AAP guidelines with my patients. I have also given tons of practical tips based on my own experiences over the years. But when it came to safe sleep, it was definitely a case of “do as I say, not as I do.”
And I was lucky. All of my babies have grown into happy, healthy children. I was careful, of course. I didn't abuse drugs or go to sleep with them after drinking alcohol. I do not smoke. I am not morbidly obese. All of these factors increase the risk of SIDS with cosleeping, and because I was careful in these things, I thought we were doing what was best for our family.
But here's the thing. Yes, my children grew and thrived. And yes, I loved and will always cherish that time cuddling with them. But if you are aware enough of your children to move for them in your sleep, as those long ago videos showed, you're not sleeping deeply yourself. And after years of waking in response to their every move, my body started waking up all night long, every night, whether or not I had a baby in my bed. I spent more than 15 years constantly exhausted and sleep deprived, missing much of the fun of both a wonderful family and a career I love. I developed postpartum depression.
Children do grow, of course. My youngest son is now 8 years old, and has been mostly out of our bed for several years. But my body didn't know that and is only now beginning to revert to a healthful sleeping pattern. Over a recent vacation, my Fitbit informed me I slept more than 8.5 hours per night on average. Believe me when I tell you it was absolutely glorious, and unlike anything that had happened in the 16 previous years.
I wish I could go back in time and tell a 30-year-old me not to do it. I would remind her that as lovely as it is to sleep with your babies, it absolutely carries risks for them. And even if the risk of SIDS with cosleeping is still a low possibility, the bottom line is it does increase that risk. Beyond that, however, the reality is you won't sleep as well. And that hurts your mental and physical health, and it makes you a less effective parent and partner.
This is the advice I have finally learned to give new parents. Cosleeping is not safe for their babies, of course. They know that, even if they don't really believe SIDS will happen to their child. But every new parent is living sleep deprivation. I remind them that their health and well-being are important, too; new parents forget that. I encourage them to understand the guidelines, and work toward safe solutions that work best for their family. I focus especially on “back to sleep” and a safe sleep environment, such as a firm surface without soft objects, but we also talk about sleep location and balancing out how parents and babies alike can get the best, safest sleep.
As clinicians, if we look at the parent as our patient as much as the child is, we can go a long way toward nurturing safe, healthy bonds and families. A good night's sleep for everyone is an important first step.