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I never intended to practice co-sleeping or infant bed sharing with my first baby. I had the tiny cot prepared for him next to my bed. It was a “firm, flat surface” as recommended. My (ex)partner was skeptical. He comes from a country where people don’t use cribs and the newest baby is always in bed with the parents until they get big enough to go to the room with the other kids or the next baby comes. But that first night I brought him home, just a few hours old, he choked in his sleep. It’s not out of the realm of normal for a baby to choke a little or cough in their sleep, but as a brand new terrified mama and a partner that thought he should be in the bed anyway, I brought him into our bed. 

And I slept. Having him next to me also made me feel whole. His little body was so recently part of me and I felt safer having him touching me. The next few weeks, I tried to get him back in his own “firm, flat surface”, but he protested. He woke up multiple times a night, as babies do. He screamed if I put him in his bed alone. I’d finally get him to sleep and try to lay him down, but he would immediately wake, screaming.

I was scared to have him in my bed and actually co-sleeping but I was also exhausted. I loved having him next to me and also was afraid of hurting him. I didn’t talk to anyone about it. I was afraid that no one would understand that I was trying to do the right thing and failing. That it was the only way I could get some sleep. 

My Co-Sleeping Experience Is Not Unique

Postpartum Essentials - a line art drawing of a baby being cradled with a parent's hand on their head with a very light pink background with peach water color circles and gold glitter accents

I know that my co-sleeping experience is not unique. I now know that many parents start out with the best of intentions in not bedsharing, but end up with a challenging baby, are desperate for sleep, or prefer sleeping with their baby close.

For this reason, I think we need to take a harm reduction approach to bedsharing. It is inevitable that babies will end up in their parents’ bed at some point in their baby phase.

Telling parents that under no circumstances should you sleep with your baby means that parents hide that information from their medical providers, do not obtain information on “safer” bedsharing, or sleep with their infant in a less than ideal environment. 

A harm-reduction approach means that we can make co-sleeping or infant bed sharing as safe as possible, knowing that the ideal is a “firm, flat surface” and also providing parents with help and guidance on what to do if that doesn’t work out for them. 

Here’s a list of recommendations that can help make infant bed sharing safer*

  1. Remove blankets from the bed
  2. The sleeping space is a firm mattress (not a couch or chair)
  3. Remove pillows or limit to small personal pillows
  4. Family uses a bed railing and the baby sleeps between the birthing parent and the bed rail. The bed rail is firmly attached without a gap.
  5. Parents do not use drugs, alcohol, or prescriptions that cause sleepiness or make them hard to wake. This is required.
  6. Birthing parents are chestfeeding.
  7. Tie long hair back
  8. Pajamas are somewhat snug and do not contain loose strings (like the strings in a hoodie).
  9. Baby should be on their back.
  10. Room should be cool and/or have a fan or A/C.
  11. Baby sleeps in their own bed for part of the night. Perhaps they go to bed fine but once they wake up they are inconsolable unless they are in the parents’ bed. Having them in their own bed for some of the time is better than none of the time.
  12. Keep pets off the bed.

Giving guidelines like these means that parents can find a way to make bed-sharing safer. It means that we can say that this isn’t the ideal situation, but if you need to do it, here’s how you can do it the safest way possible. It also means that they aren’t going to fall asleep with a newborn in a chair because they were trying so hard to stay awake, trying so hard to fight the sleep exhaustion.

Can Co-Sleeping Lead to Infant Death?

But what about the infant deaths, you may be thinking. This is, of course, a vital question and consideration.

The data in the US is extremely difficult to untangle. First, they lump sudden infant death syndrome (SIDS), accidental suffocation, and deaths from unknown causes all into one bucket. Second, researchers have recently linked SIDS to genetics.

Meaning that if a baby died during bedsharing and it was determined to be SIDS, it is not necessarily the infant bed sharing that was related to SIDS, but that the baby was genetically predisposed to it.

Third, many of the co-sleeping deaths are from parents that were on a couch or a chair, and dozed off. Or involved a parent that was using drugs. Both of those situations lack good information on the details of the infant bed sharing environment at the time of death.

Many parents will bring their baby into their bed out of desperation. Taking a harm reduction approach means that we can help them make it as safe as possible and still understand that it may not be the safest option.

I had a second baby and he was happy to be sleeping on his own, next to my bed in his own “firm, flat surface”. I realized that I didn’t do anything wrong with my first child. Some babies just adapt to a “safe sleep” surface easier.

I realized that if I hadn’t brought him into my bed, I would have fallen further and further into sleep exhaustion. Postpartum depression affects so many parents. Sleep exhaustion greatly exacerbates this. Guidance needs to also consider the dyad, not only the infant. Giving parents guidelines can help their mental health and give a baby what they are asking for- closeness to the home they knew for 9 months. 

Postpartum Essentials - a line art drawing of a mother and father cradling each other and a newborn on the father's shoulder with a beige background with green water color circle and gold glitter accents

*Where did these recommendations come from? 

This list is a compilation of recommendations from other countries that do encourage bedsharing, current research, common sense, my own experience, and experience working with clients.

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