Breastfeeding and Safer Sleep

I was pleasantly surprised recently to watch an Irish pediatrician being interviewed about newborn sleep and admitting to bed sharing. (For context - if you live in the US or some parts of Europe you may be aware that bedsharing is considered a BAD word). But how did mothers sleeping with our babies (like all mammals) get such bad press?

The biggest contributing factor is the ongoing misunderstanding of SIDS and suffocation.

One of the most debated parenting choices after deciding how you’ll feed your baby is where your baby will sleep. If your baby hasn’t arrived yet you may have already decided that your baby will NEVER be in your bed. Then reality hits with the night feeds, and you may start to question that decision especially if sleep deprivation is impacting your mental health. But if you live in a weird culture such as the US, all of the experts tell you NEVER to sleep with your baby. Other parents will even attempt to shame mothers out of this decision, suggesting they are selfish for putting their baby in such ‘danger’. Would it surprise you to know that countries such as Japan which have some of the lowest SIDS rates in the world co-sleep in a family bed from birth? It’s also quite unusual for Japanese parents to report infant sleep issues - as their expectations of newborn sleep are normalised.

Breastfeeding hormones released during nursing are designed to relax you so it’s not a case of IF you fall asleep nursing your baby - but WHEN. As we discussed on my recent interview following the safer sleep guidelines can in fact be protective of your baby’s health. Exhausted moms at the end of their rope are more likely to stop breastfeeding and move baby to their own room sooner - increasing your baby’s risk of SIDS.

Definitions:

SIDS (Sudden Infant Death Syndrome): SIDS is when a healthy baby under one-year-old dies suddenly and for no apparent reason, usually during sleep. It's like a mysterious and unexplained death.

SUDS (Sudden Unexpected Death in Sleep): SUDS is a broader term that includes any sudden, unexplained death of an infant during sleep, whether or not they were healthy. It's like a category that covers all unexplained sleep-related infant deaths. SIDS is one type of SUDS, but not all SUDS cases are SIDS - make sense?

*Suffocation:

  • Cause: Suffocation occurs when an infant's airway becomes blocked, limiting their ability to breathe. This blockage can be due to objects like pillows, blankets, or stuffed animals in the sleep environment, or it can happen if an infant's face is pressed against a soft surface.

  • Preventable: Suffocation is typically preventable by maintaining a safe sleep environment. Removing potential suffocation hazards and ensuring that the baby sleeps on their back in a clear crib or bassinet with a firm mattress can reduce the risk of suffocation. SIDS/SUDS are unexplained.

  • SIDS is not preventable through specific actions or interventions since its exact cause remains a mystery. However, following safer sleep practices can reduce the risk of SIDS.

Telling a mom never to bring her baby into bed and promoting abstinence-only programs for teen sex have some similarities in that they both approach complex issues with a one-size-fits-all solution, which can be problematic for various reasons:

Lack of Realistic Information:

Abstinence-only programs often provide incomplete or unrealistic information about sexual health and contraception, leaving teenagers ill-equipped to make informed choices. Similarly, telling a mom not to bring her baby into bed without offering alternatives or addressing the underlying reasons can be unhelpful and unrealistic.

Ignoring Individual Circumstances:

Both approaches can fail to consider the unique circumstances and needs of individuals. Teenagers may engage in sexual activity for various reasons, including peer pressure or lack of access to comprehensive sex education. Similarly, co-sleeping may be practiced by some parents for cultural, comfort, or practical reasons.

Shaming and Guilt:

Both approaches can unintentionally introduce shame and guilt. Abstinence-only programs may make sexually active teens feel ashamed, while telling a mom not to co-sleep without understanding her reasons can lead to feelings of inadequacy or guilt (many moms lie to providers when asked about having baby in bed).

Risk Mitigation vs. Abstinence:

A more balanced approach recognizes that while abstinence is a valid choice, it's equally important to provide comprehensive information about contraception and safe sex practices. Similarly, co-sleeping can be done safely with appropriate precautions, and parents should be educated about those precautions rather than being told a blanket "no."

The vast majority of moms who safely co-sleep will tell you what a game changer it is in those early weeks of bleary eyed exhaustion. I couldn’t remember how many times I nursed my little boy in the morning - but the family agrees, everyone was the better for it.

Which Advice Should I Trust?

Every parenting situation is different - learning about global sleep practices rather than just the US can open your eyes to a whole new world (safely).

Resources:

Safe Sleep 7 Guidelines

Professor Helen Ball - International Infant Sleep Expert

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