Despite the official warning from the nation's pediatricians and the raised eyebrows from one set of grandparents, the Hanson family in...
Despite the official warning from the nation’s pediatricians and the raised eyebrows from one set of grandparents, the Hanson family in West Seattle — daddy, mommy and baby — sleep together in the same bed every night.
That way, when 6-month-old Jackson wakes up hungry, all mom Jeanie has to do is lift her shirt to nurse.
“It’s sort of saved my sanity and allowed me to get more sleep,” she said. “I don’t have to get up and walk down the hall.”
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A year has passed since the American Academy of Pediatrics (AAP) officially recommended “that infants not bed share during sleep” to reduce the risk of accidental death.
They may be nursed and comforted in bed but should go back to their own crib or bassinet — in the parents’ bedroom — when the parent is ready to go back to sleep, the AAP says.
While the policy statement surely raised awareness, it hasn’t dampened the debate about bed-sharing in the local medical community or among parents, for whom infant sleep is a huge issue.
Bed-sharing with an infant is a personal decision for parents. The American Academy of Pediatrics recommends against the practice, saying it increases the risk of accidental death. But for those who choose to ignore the recommendation, there are ways to make it safer:
Sleep position: Put the baby on his back to sleep.
Clothing: Dress the baby less warmly than if she were sleeping alone; adult body heat must be taken into account.
Mattress: Be sure the mattress is firm. Waterbeds, sofas, armchairs and pillowed mattresses are unsuitable for sleeping with a baby.
Bedding: Don’t place pillows, quilts, comforters or sheepskins under a sleeping infant. Don’t have extra pillows in the bed, and be cautious of adult covers.
Physical dangers: Make sure there are no spaces where the baby’s head can get wedged, such as between the mattress and the wall, headboard or footboard.
Dangerous behaviors: Don’t smoke around the baby. If you abuse drugs or alcohol or are overly tired, don’t sleep with a baby.
Age: Don’t let the baby sleep with other children.
Source: Swedish Medical Center, American Academy of Pediatrics
“It’s very controversial within the pediatric community, even at the highest levels, ” said Dr. Nancy Danoff, a pediatrician at a local public-health clinic. “… I truly think the jury is still out.”
Danoff personally believes the practice is fine, if done according to recommended safety guidelines. However, she adds, Public Health-Seattle & King County hasn’t taken an official position on the issue.
Most of Danoff’s patients are immigrants from countries where bed-sharing is a cultural norm, and at least 85 percent continue to observe that tradition in this country. Rather than advising them against the practice, she tells them how to do it safely.
At Swedish Medical Center, newborn-care instructors give parents information on the risks and benefits of bed-sharing as well as safety tips. But they also stress that it’s up to the parents to do what’s best for their families.
Harborview Medical Center’s chief of pediatrics, Dr. Brian Johnston, feels he cannot “sign off” on bed sharing — “But I respect the right of families to make that choice.”
The best observational data to date shows bed-sharing may pose a small increase in infant deaths, especially among those younger than 3 months, he said, but it’s not as clear-cut as many other things, such as the importance of having a car seat or smoke detector.
Group Health published its own no-bed-sharing policy as early as 2001. Now nurses bring it up like a mantra.
“I know our patients have heard this message many times,” said Dr. Jane Dimer, head of the Maternity and Child Clinical Services team.
But what those parents are doing in the privacy of home, she doesn’t know.
What’s happening is all over the map. A 2003 study showed bed-sharing was on the rise, and at least one birth-and-family educator surmises that parent sentiment is evenly split for and against bed-sharing.
Many parents share a bed with their baby for months.
“I know hundreds and hundreds of women who are bed-sharing,” said Betsy Hoffmeister, an accredited leader with the La Leche League in Seattle.
The League doesn’t formally endorse the practice, except to note that it enhances breast-feeding in a safe sleep environment. Also, mothers who return to work often use bed-sharing to establish a closeness with the baby that’s not possible during the day, said Hoffmeister.
“It was a nice opportunity for us as a family to bond,” said Sarah Ogier, who went back to work as manager of King County’s Groundwater Protection Program when her daughter was 4 months old.
“I also felt as a woman it was a nice way to have my partner share in the responsibilities. He knew she was fussing as much as I did.”
Some parents decide to use what’s called a co-sleeper, a special kind of mattress or small crib that attaches to the parents’ bed within easy reach for breastfeeding. The AAP mentions co-sleepers as an option but also says safety standards for such devices have not yet been established by the Consumer Product Safety Commission.
Jamie Mesman-Davis and her husband, Craig Davis, decided a co-sleeper was the safest choice for their son Drew. He couldn’t roll over into their space and vice versa.
“When he would wake up … I’d feed him, with me sitting up straight,” said Mesman-Davis, a 9th-grade teacher in Snohomish. “It was just a fear of falling asleep and rolling on him or having our blankets cover him.”
Other parents start baby out almost right away in a separate room — which also is against the AAP’s guidelines.
Catherine Fenner really wanted to sleep in the same bed with each of her sons, but unexpectedly it didn’t work out. It wasn’t a safety issue; she found the Academy of Pediatrics statement opposing bed-sharing “ridiculous.”
Rather, “I wasn’t comfortable … my babies seemed so fidgety … my husband wasn’t comfortable. None of us were sleeping very well.”
“It’s very confusing”
Several parents agree the decision can be difficult to sort out.
“It’s very confusing,” said Lynda Sullivan, who gave birth for the first time last year.
“It depends on who you ask.”
Most of the information Sullivan reads advises against bed-sharing. Instructors in her parenting class also said not to do it. But everybody in her breast-feeding class encourages the practice. And lots of friends have opted to bed-share with their infants.
“You don’t really know which way to go,” said Sullivan, a portfolio accountant with a pension-fund adviser in Seattle.
Ultimately, she and her husband decided bed-sharing wasn’t worth the risk: “We were told stories that it wasn’t a good idea and hence we never have.”
At first, their daughter slept in a bassinet right next to Sullivan, but she kept waking up every 2 ½ hours to breastfeed. Only after they moved the baby into a separate room did she start sleeping through most of the night.
“All I know is I’m getting more sleep, now that she’s in her crib in the other room,” said Sullivan. “That makes me a happy parent. … I’m not going to question it too much.”
“A fringe idea”
No matter what they decide, bed-sharing can sometimes be such a sensitive, emotionally charged topic that parents only bring it up with very close friends.
One parent remembers feeling uncomfortable as the only mother in her support group who shared a bed with her infant. Did the other parents see her as negligent, she wondered. Then she realized this was just the first step of being a parent — a job that would often require relying on her own judgment in the face of conflicting opinions.
“I still feel like it’s a fringe idea,” said Jeanie Hanson, who like many moms has not told her pediatrician exactly where her baby sleeps.
What would be the point? she asks.
Hanson believes doctors are “all sort of against it” and knows she isn’t about to change her mind.
Instead, she makes sure the bed environment is safe with a flat sheet and Jackson dressed warmly enough that he doesn’t need a cover. Jeanie also doesn’t use a blanket above her waist nor does she drink or smoke.
As to when Jackson might move into his own bed, let alone his own room — mom and dad have no definite plans.
“This feels so right to me,” said Jeanie, enjoying the moment. “He really feels like he belongs cradled in my arms.”
Marsha King: 206-464-2232 or email@example.com