Friday, October 19, 2007

Three in a bed

You may want to read this article below, which I wrote for the Independent two years ago, before you read my post on co-sleeping. It contains facts and figures as well as describing our experience first time round.

There’s one subject of conversation that unites all new parents: sleep. Who’s been driving round and round the block at 5am to lull the baby with engine noise; who is cowering by the baby monitor as the baby cries it out in the name of “controlled crying”.

With our baby, Jemima, we were relatively lucky. Once asleep, she appeared to have a miraculous talent for staying that way. But it was getting her to sleep that was the problem. My husband and I would take turns rocking her to sleep each night, thinking the hours of peace that followed was a reward well worth the effort. At four months, however, our lost evenings began to get us down, so we followed the advice of countless friends and baby books and taught her to fall asleep on her own – otherwise known as crying herself to sleep, though we never left her alone.

It worked, but I hated every minute of it. And just when we thought we had cracked it and she was going to sleep happily on her own, she began to wake twice a night and was unable to get back to sleep for hours. Exhausted after yet another night of playing musical rooms, and failing dismally with the usual tips of controlled crying or kiss and retreat, we decided to try co-sleeping – as the simple art of sleeping alongside your child is known.

The biologically and culturally evolved practice of co-sleeping dates back to pre-historic life, and remains common in most traditional cultures. It is only in the last 200 years, and mainly in the West, that it has become regarded as normal for a baby to sleep alone. A recent survey carried out by the University of Durham’s Parent-Infant Sleep Lab found that, even today, 46 per cent of British parents co-sleep at some stage of their children’s lives. Yet as I begin to research it, I soon learn that in industrialised societies such as ours it is the cause of much controversy. There are certainly benefits – longer and easier breastfeeding, closer bonds between mother and baby, even if bottle feeding, and secure and independent children.

But what about the pitfalls? Earlier this year, a five-week-old baby died from suffocation after sharing a bed with her mother. Last month [sept] the coroner on the case urged the Government to issue clear warnings against co-sleeping.

The Department of Health and The Foundation for the Study of Infant Deaths (FSID) advise against bed-sharing on the grounds that it can increase the risk of cot deaths and smothering. However, organisations such as UNICEF, Attachment Parenting International, The National Childbirth Trust and the Royal College of Midwives support parents who choose to co-sleep, arguing the benefits of responsible co-sleeping far outweigh the risks. In 2004 UNICEF UK’s Baby Friendly Initiative called upon the UK Government‘s Department of Health to rewrite its leaflet, ‘Reduce the Risk of Cot Death’, recognising “that bed sharing does not increase the risk of cot death in the absence of known risk factors (smoking, alcohol consumption, use of drugs which increase sleepiness, extreme tiredness).”

According to CESDI (Confidential Enquiry into Stillbirths and Deaths in Infancy) 25 per cent of cot deaths occur in adult beds. Nearly all of these involve adults who smoke or were drinking alcohol. The remaining 75 per cent occur in cots, sofas, and other places where the baby was put down to sleep.

What all professionals do agree on is that babies should sleep close to their parents during their first six months at least, when they are most vulnerable to SIDS. This has been proven by a 70 per cent drop in cot deaths in the UK, since this advice was first given in 1991. Tragically, it has also been proven by the development of SIDS, often the first cases of a previously unknown concept, in societies that have replaced their traditional culture of co-sleeping, with the western ideal of cots and nurseries. This is even the case with migrant societies living in the heart of white British communities. A study of Pakistani families in Yorkshire showed that lone sleeping white babies were three times more likely to suffer a cot death than the Pakistani babies, who traditionally share their parents’ bed.

While there continues to be no medical explanation for SIDS, US sleep expert James McKenna and others in his field say we cannot ignore the evidence that where babies sleep close to their mothers as nature intended, they rarely dies of SIDS. McKenna’s ongoing research at his sleep-laboratory shows that bed-sharing babies are more able to self-regulate their temperature, so are unlikely to overheat. They sleep less deeply than solitary sleeping babies, making them less prone to arousal deficiencies that may lead to cot deaths.

Mckenna’s research also looks at the risks of smothering while bed-sharing. He argues that both mother and child are designed to respond to each other’s presence, even when sleeping. “During my many years of studying infant/parent co-sleeping/bed-sharing I am unaware of even one instance in which under safe social and physical conditions, a mother ever suffocated her infant.” A spokesperson from FSID told me that the same is true of the UK. “It is so rare. And when it does happen it is often due to other dangerous factors rather than the act of co-sleeping alone”.

Faced with a tragedy such as the recent one, one can see why the Government and FSID have a blanket policy against co-sleeping. But then it would follow that we also advise against driving with children, rather than using a car seat and driving safely. There is something about co-sleeping that does not seem to fit comfortably in our culture.

Even I, nearly a convert, have another pressing concern. If we invite her into our bed, will she ever leave? This was not helped when, at my local Tots and Tinies, my guiltily confessed plans to co-sleep were greeted by a barrage of “tut, tut” and shaking heads: “You want to knock that on the head right away! You’re making a rod for your own back!” Most contemporary parenting manuals talk of teaching your child to become independent by helping them sleep alone. Dr Christopher Green is so adamant to keep the children out of his bed that he admits, in Taming Toddlers, to having put rope across his own child’s bedroom door. Unconvinced that this is an ideal recipe for healthy independence, yet worried that Jemima will still be in our bed at 16, I turn to the co-sleeping guru, Deborah Jackson, author of “Three in a Bed”, every co-sleepers bible, for advice. Jackson, who continues to research and write extensively on the subject, told me how her three co-sleeping children did not cry in the night, nor rely on transitional objects such as blankets or dummies. They all went on to sleep in their own rooms and their ability to sleep anywhere without waking meant they were asking for sleepovers at the age of three.

“The more security you give a baby, the more secure the child,” Jackson says. She argues the attachment theory: if the child is allowed to decide when they are ready to leave babyhood behind, they will grow to be happy, independent children. Her research shows that they will usually be asking for their own room by the time they are two, or respond well to a gentle weaning process if the parents are able to display trust in their child’s ability to cope with this.

Children who have slept with their parents are also less likely to experience regressive behaviour such as coming into the parents’ bed when they are older. But Jackson recommends you do not turn them away if they do: “Bedtime is when the anxieties of the day resurface. Say your child is having trouble at school or suffering from the arrival of a new baby, inviting them back into bed for a few nights could help. The invitation is often enough to reassure some children, who might prefer to say in their own bed.” It can also help siblings who are not getting on well to spend a few nights together cuddling up close when their defences are down.

If it is all this is true I am beginning to wonder why there is so much negative press on the subject. At my three local bookstores I cannot find any books advocating co-sleeping, or any other kind of attachment parenting manuals. Even Deborah Jackson’s books need to be ordered – there is apparently no call for them in this part of Hampshire. An internet search however brings up a wealth of research proclaiming the benefits of co-sleeping. P.Heron from the University of Bristol’s cross-sectional study of middle class English children, showed that those who did not co-sleep are “harder to control, less happy and exhibit a greater number of tantrums”. Mosenki’s US study of five ethnic groups from Chicago and New York, found that: “co-sleepers exhibited a feeling of satisfaction with life”.

I have read enough to accept that Jemima should benefit from co-sleeping and will eventually return to her own bed. But what about me? What I really need to know right now is will I get any more sleep? Jackson confides: “Though I would never have believed it before, we all had a fantastic night’s sleep! There were no nightmares or night waking. And babies who do wake in a bed with their parents can send themselves easily back to sleep without disturbing anyone”. She reminds me that we are all born with the ability to sleep easily and well, yet by the time we are able to speak our dreams often turn into nightmares. She argues that our obsession with routines and sleep training only results in an increasing percentage of children and adults with sleep problems in the Industrialised world. In countries where co-sleeping is the norm, babies and children sleep well and doctors say sleep disorders among adults are a rare complaint.

When I put Jackson’s theory to Dr Helen Rodwell, from the British Psychological Society, she says it makes sense. “I certainly use sleep as a barometer of one’s emotional well-being. All psychological problems manifest themselves in sleep disorders. Nightmares are a classic symptom of post-traumatic stress disorder”. For children that trauma can be waking alone in a dark room.

With Jackson’s words tantalisingly ringing in my ears, I decide to consult my friend Nicky, who has slept with her baby since birth. “We only planned to have Izobella in bed with us for a few weeks. But a year has passed now and I have not once had to get up at night. If she wakes for a feed I hardly stir and she sleeps so restfully we can’t imagine having her anywhere else but in bed with us. We sometimes consider getting her to sleep alone, like all our friends’ babies, but soon abandon that thought as we love co-sleeping so much.”

I am amazed that despite having what sounds like a perfect, sleeping baby, Nicky would consider changing anything, but I also recognise how hard it can be to go against cultural norms and maintain one’s faith in one’s instincts. Among my wide circle of friends with children, Nicky would be considered quite mad by most, who would echo the words of Sam, mother of two: “I could not think of anything worse than sleeping with the kids. When they come into bed we march them straight back again. Bedtime is our time together as a couple.”

Which brings us to the question on everybody’s minds. What about our sex-life? This is where nearly all advocates of co-sleeping agree on two points. If parents are running about all night trying to get their baby to sleep they won’t have much energy for sex anyway. And if one partner is not comfortable with the idea of sharing the bed with the baby and it is going to cause marital problems, don’t do it. Both Mckenna and Jackson believe that bed-sharing should unite the support network a child needs to depend upon, not tear it apart. Recognising that we live in a culture where marriage and the couple are often valued more than the family unit, co-sleeping is bound to be a cause for concern. I certainly received more warnings about not letting Jemima rule my life or interfere with our marriage than I did realistic advice on accepting and coping with the changes that a new baby will inevitably bring to a relationship. Reviving the practice in the West would require a huge cultural shift. As Jackson puts it, parents need to be ready and mature enough to allow and embrace these changes. “Only then are they likely to experience the wonderful closeness and deepening bond that sleeping with one’s children can bring to a relationship. “

While I understand the concerns that many modern parents have about personal space, independence and preserving their marital relationship, Jackson puts forward a convincing argument. And we have the rest of the house for romance, which helps. How did we get on? The first night that Jemima came into our bed we did not get a wink of sleep – she thought Christmas had come early. But a month on I can report that we are no longer exhausted and James appreciates the extra time he has with his daughter. It is not, however, as peaceful as Nicky and Deborah Jackson describe. Jemima is certainly happier – we know this because she sits up and laughs in the middle of the night, before rolling on top of us for a cuddle. Not everyone’s idea of a perfect night, but it make us happy. She has not quite learnt the adult bedtime etiquette that babies apparently acquire if they co-sleep from birth. Maybe we will have the chance to perfect the art with baby number two. If we can squeeze in one more…

Further info

UNICEF and FSID advice for parents who sleep with their babes
• the mattress should be firm, flat and clean
• avoid overheating – 16-18°C is the best room temperature
• sleep facing the baby

You should not share a bed with a baby if you (or any other person in the bed):
• are a smoker (no matter where or when you smoke)
• have drunk alcohol
• have taken any drug or medication
• are unusually tired
• never sleep with your baby on a sofa or waterbed, bean bag or a sagging mattress.

Useful links for more information about UNICEF’s baby-friendly guidelines for parents and professionals for more information about cot death and baby safety Attachment Parenting International is a non-profit organization that helps found local support groups, and publishes educational and research materials for parents and professionals. to find out more about James McKenna’s research on sleep and SIDS in the US the University of Durham’s Parent-Infant Sleep Lab is the home for a team of researchers examining various aspects of infant sleep and night-time parenting.

Further reading
Deborah Jackson Three in a Bed the benefits of sleeping with your baby Bloomsbury
Jean Liedloff The Continuum Concept Penguin


Dawn said...

Will they ever leave your bed? Our oldest slept with us until my advanced pregnant state made it hard to sleep in our (double) bed. The second one stayed until Baby Three came - Baby One invited Baby Two to come share her bed. So sweet! Baby Three nearly did us in, stayed in our bed until age 5 (Dad's choice....""they're only little a short time"), was an exchange student for a year in Poland at Age 15 (after trips to Italy and France) off to college and Africa and now returning to Poland this winter. All three are remarkably self-sufficient adults and we never had the night terrors or fights. When times are bad in their lives I"ll sometimes find them reading in my bed when they come to visit! Try it. And open your heart to sharing your life with your kids. It will change your life. Maybe it will change the world.

Georgie said...

Hi Dawn,

Thanks for visiting and leaving such a wonderful comment! I entirely agree and am hoping that one day Jemima will invite Bella to share her bed!

Can I ask how you came across my blog? Interested as most of my readers have young children while yours are travelling the world already!

Thanks again and keep visiting!


ellie said...

Yes there have been sad instances where babies have been suffocated by parents but I've only heard of it when drink/drugs are involved - neither of which are things you should do around children anyway. Personally my baby wouldn't sleep in his own bed for the first few months - so it was as you say, bawling baby in cot or sleeping baby in bed. A no brainer as far as I was concerned.

Samantha said...

You have restored my faith in mothers.