Why We Need To Focus On Safe Bed-Sharing Instead Of Prohibitions

Why We Need To Focus On Safe Bed-Sharing Instead Of Shaming Nursing Moms

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After my first son was born, I remember being very confused about whether it was safe to sleep in a bed with him. On the one hand, my pediatrician (as well as The Academy of American Pediatrics) said I should not be sharing a bed with my baby, because it increased his risk of suffocation. But I was also a breastfeeding mom, and every book and breastfeeding organization told me that breastfeeding protects against SIDS and that bedsharing makes breastfeeding easier and more successful.

I soon found that it wasn’t a matter of what was best or recommended, but that I often feel asleep breastfeeding out of sheer necessity. I mean, babies breastfeed all the damn time, including a ton during the middle of the night. The only way I could function was to bring my baby into bed with me, nurse him when he wanted (I learned to latch him on in the dark, which was a game-changer), and get on with my life.

Luckily, I was a baby-safety geek, and made sure to learn the guidelines for safe bedsharing (more on that in a sec) and adhered to them very carefully. And yet, I continued to feel like I was doing something taboo. When my pediatrician asked where my baby slept, I told her that he slept in the crib next to my bed — which was only partially a lie. We did have a crib next to our bed, only it was perpetually filled with laundry, not baby.

Since then – and since becoming a lactation consultant who counsels moms about breastfeeding and sleep practices – I have often thought that rather than scaring moms into thinking that bedsharing is never acceptable, we should instead teach them the way to safely share a bed with a baby and how to decrease the risks of harm during bedsharing.

This is not only because I know how helpful (not to mention sweet and cozy) bedsharing can be, but also because no matter what we say or do, moms are definitely going to fall asleep during breastfeeding at some point, and we ought to teach them how to do it safely.

Dr. Ann Kellams, Vice Chair of Clinical Affairs in the Department of Pediatrics at the University of Virginia, recently penned a fantastic article on the Academy of Breastfeeding Medicine’s blog echoing similar sentiments to mine.

“Rather than talk about breastfeeding recommendations as something separate from safe sleep recommendations, I think we need to focus on ‘safe nighttime feeding spaces,’” writes Dr. Kellams. “You likely are going to fall asleep while feeding your baby whether it is planned or unplanned. So, perhaps it is time to think about the feedings when a mother may fall asleep, and make them as safe as possible.”

Yes, yes, and yes.

Think about it for a second: not everyone knows that falling asleep with a baby on a couch or armchair is actually unsafe (your baby could unintentionally get wedged between a cushion). If you are simply told: DO NOT BEDSHARE NO MATTER WHAT, but you are completely exhausted (because all mothers are), you may just give up and let yourself fall asleep on the couch with your baby, rather than moving to your safely set-up bed first.

The same goes for things like being under the influence of alcohol or sedative drugs, smoking cigarettes in the room with your baby, or falling asleep with someone else who is using those substances. These things increase your baby’s risk of harm while bedsharing, but if you are not informed — and instead only told that sharing a bed with your baby is just never okay under any circumstance — you are less likely to take the appropriate precautions to keep your baby safe.

It’s far better to be realistic and understand that the necessities and practicalities of newborns (and the exhaustion of new motherhood) mean that, best intentions aside, moms will fall asleep with their babies so that we can focus on safe bed-sharing instead of no bed-sharing.

OK, so ready to get yourself educated about safe bedsharing?

Dr. Kellams has a really cool way to remember the guidelines. “When thinking about falling asleep while feeding, think of the letter ‘F’,” she says.

So what are the “Fs” of safe sleeping, according to Dr. Kellams?

– First, your baby should be Face-up, on a Flat, Firm mattress

– Your bed should be Free of any excess stuff: pillows, soft bedding, heavy comforters, or anything that could cover your baby’s head

– Safe bedsharing works best if  your baby is Feeding breastmilk only

– Your bed should be Free of anyone besides you (in my case, I would have the baby sleep between myself and a bedrail so my partner could be in bed, but not next to the baby)

– You are “Fully-aware” and not under the influence of any sedating drugs or substances

– The air should be Fresh (no tobacco and not too hot)

– Your baby should be Fully-vaccinated

In addition to these things, says Dr. Kellams, you should never sleep with your baby in an armchair or couch, and babies who are ill or premature should not bedshare without doctor’s approval. For more safe sleep information, I recommend La Leche League’s excellent guidelines.

Here’s the thing: no one is saying that bedsharing is completely risk-free. And you should discuss any concerns you may have about it with a trusted healthcare provider. However, if you follow the safety guidelines carefully, you can mitigate the risks substantially. And the fact is, even if you don’t want to bedshare full-time, you will likely zonk out while breastfeeding at some point or another, so it’s much better to have a plan in place to do is safely and responsibly.

Now go curl up next to your little one and enjoy those cozy nighttime cuddles while they last – it truly goes so fast.