Is Co-Sleeping With Infants Dangerous?

Some parents are deeply attached to sleeping next to their infants. New research shows this practice may have some very serious risks. We hear from pediatrician Dr. Sydney Spiesel about co-sleeping and from mothers Alice Grob and Dalila Ali Rajah, who think co-sleeping is a good way to bond with children.

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ALEX COHEN, host:

This is Day to Day from NPR News. I'm Alex Cohen.

MADELEINE BRAND, host:

I'm Madeleine Brand. We are going to leap now into one of the more passionate debates around child rearing: where the baby sleeps. Yes, where. The latest medical research says parents should not sleep with their infants. In a moment, we'll hear from a couple of moms who are passionate about the family bed. First, pediatrician Sydney Spiesel is here to explain the research. He's a regular on our show, and he has a column on this subject up at Slate.com. And Syd, as you well know, this is really a hot topic for parents, and some people are just really committed to co-sleeping. What, according to the study, what is the risk there?

Dr. SYDNEY SPIESEL (Pediatrics, Yale University School of Medicine): Well, the study was simply - it took a 20-year period and looked at death certificates, looking specifically at a particular class of deaths which are the so-called sudden unexpected infant deaths, where babies are found dead for no reason that we can anticipate. That is, there's no antecedent illness. Now, early on, at the beginning of the study, almost all of those kids were classified, all those deaths were classified, as sudden infant death syndrome, which some people call - and I'm quite resentful of this - they call SIDS. And in those cases, no real cause could be found. Then, it was discovered, actually, in New Zealand and Australia that sleeping facedown and sleeping on soft bedding contribute to it. And once people knew about that, the rate fell. But the other thing that happened is that there got to be a program of what's called death scene investigation, of actually trying to reconstruct what happened; how was the baby found. And that added a new category. These were kids who were - where the death was attributed to accidental suffocation and strangulation. And that's - those are the kids that we're particularly looking at and concerned about.

BRAND: OK. So, this study didn't necessarily look at the traditional SIDS deaths, the crib deaths, where kids were sleeping facedown?

Dr. SPIESEL: Right.

BRAND: So, it was looking at this other category that you mentioned, and what did it find?

Dr. SPIESEL: It found that the total number of sudden unexpected deaths has been dropping over time, and there's been a substantial number drop in the kids who were attributed to SIDS, the deaths attributed to SIDS. But at the same time, especially in the last eight years, there's been a climb in the number of kids where the attribution is to suffocation or strangulation. You know, a baby is found in the parent's bed, and a parent is lying over the - it's called overlying - a deeply sleeping parent kind of rolls over and smothers the baby or a baby gets trapped and strangled by an old-fashioned and badly designed crib. We don't allow them anymore, but there's still a lot in use. Now, only 15 percent of kids in this category were found, you know, caught in a crib. The - 80 percent of them were co-sleeping.

BRAND: And so, the conclusions that you draw are what?

Dr. SPIESEL: Well, the conclusion that I draw is that co-sleeping makes me nervous. Putting these numbers together - we don't really have data. I mean, one thing we don't know, for example, is what we see is that in the last eight years, there's been a fourfold increase in the number of babies in the category of babies who were found - they were strangled or suffocated. And as I say, most of them were co-sleeping. Now, has there been a fourfold increase in co-sleeping during this time? We don't have any data that says that's true, although I will say, from my own practice that I think it - I think that - I don't know whether it's fourfold, but I think there actually has been a substantial increase in co-sleeping.

BRAND: All right, Syd. Well, we have two moms on the line now, both of whom co-sleep with their children. Alice Grob lives Los Angeles, and her daughter is three years old. And Dalila Ali Rajah is also in Los Angeles, and her daughter is six years old. Hello, both of you.

Ms. ALICE GROB (Co-Sleeping Proponent, Los Angeles, California): Hello.

Ms. DALILA ALI RAJAH (Co-Sleeping Proponent, Los Angeles, California): Hello.

BRAND: Well, first of all, let me just get your reaction to what you just heard from Dr. Spiesel, and let's start with you, Alice.

Ms. GROB: I think that, you know, it's possible. I think it really has to do with the type of parent. For me, when I was sleeping with my daughter, there was not a moment that I wasn't aware of her next to me, as well as her father. And you know, she slept between us. I never even - like, she would roll up underneath my armpit. And I would say I probably got less sleep than a mom who chose to put their baby in the crib, because I was so aware that she was right there with me. But I think that co-sleeping for me has just been such a blessing. We've really bonded with my daughter, and you know, I never was an advocate of, you know, let them cry it out in the bed.

BRAND: Dalila, what do you think?

Ms. ALI RAJAH: I would say the same thing. I was incredibly, incredibly aware of having my daughter in the bed, especially when she was really - like, those first few weeks, she would be on my chest, at first. I actually do feel like I got more sleep because I didn't have to actually get up and go to another room to nurse. And it just made nursing more simple. It was a great bonding experience for me and my daughter. We're very, very close. She now, most of the time, doesn't sleep in the bed with me anymore, but that is because she announced herself she wanted to sleep on her own. When she hit about four, she was like, Mommy, I want to sleep in my own bed. And I said, OK, sleep in your own bed. So, I think, like, the whole thing a lot of people worry, too, that they'll never want to sleep on their own, and she - when she was ready to be independent, that's what she did.

BRAND: Well, Syd, I imagine you hear a lot of this in your practice, where moms say, look, I really want to bond with my kids, my babies, and I really want to do this, and I think that this benefit far outweighs the chance, the remote chance, that there might be a problem with suffocation.

Dr. SPIESEL: Well, what can I say? I mean, first of all, you know, I love the idea of bonding; I love the idea of closeness. However, I am also aware that some people sleep exceptionally deeply. And I certainly, you know, want to repeat that warning, that notion, that people shouldn't take - if you're taking any medication that might make you sleepy, even an antihistamine, I certainly wouldn't do - wouldn't even consider co-sleeping at that night. You know, I just want people to know - to make a judgment themselves what the risk is. The risk is actually technically sort of low. But you know, you'd hate to be a parent of such a child. It would be an awful experience. So, you know, I just want people to make that rational decision knowing the data.

BRAND: And I'm just wondering - Alice or Dalila, whoever wants to answer this - did you think about that before you decided to co-sleep?

Ms. ALI RAJAH: This is Dalila. I had read some of it. I'm one of those mommies who did a ton of research. I found I resonated more with the things that were attachment-parenting oriented. They just made more sense to me and resonated with me in my gut. And all of them leaned towards co-sleeping as a bonding experience with a child. So, even though I had thought about some of those things, a lot of them seemed to be geared towards people who have the issues of, like, drinking before bed, that sort of thing, really soft bedding, like, things that I was very conscious of and very aware of.

BRAND: I wonder, Syd, you probably get a lot of questions not just on the medical risks and benefits of co-sleeping, but also for behavioral reasons. And we touched on that a little bit. There are parents who worry that once the baby's in the bed, they'll never get the baby out.

Dr. SPIESEL: Well, sooner or later, the baby usually gets out, at least by college.

(Soundbite of laughter)

Dr. SPIESEL: Where do I stand on that? Well, again, you know, there's a sort of different kind of pediatrician than I am who does think that, well, it's important that kids achieve independence and that they have to learn to tough it out. And I'm not that kind of guy. I do think - and again, there are some studies, which I'm not wild about, but there are some studies that suggest that when parents and kids co-sleep, neither one's sleep is fully in a satisfying way, possibly because you are always aware of that.

BRAND: So, Alice, Dalila, does any of this change your mind at all? Or are you still committed co-sleepers?

Ms. RAJAH: This is Dalila. No way.

(Soundbite of laughter)

Ms. GROB: Yeah. This is Alice. No way. I'm committed, and I feel really good about what we've done. And if I had another child, I'd probably do the same thing.

Ms. ALI RAJAH: Me, too. Mine is an adorable little cuddle bug, and I love it. And she's an incredibly loving, strong and independent child, and I think that's part of why.

Dr. SPIESEL: I think a lot of times mothers get, also, a lot of pleasure from this relationship. It has got to be beneficial. And for better or worse, it's a great form of birth control.

(Soundbite of laughter)

BRAND: All right. Well, I want to thank you all very much.

Ms. ALI RAJAH: Thank you.

Ms. GROB: Thank you.

Dr. SPIESEL: Thank you.

BRAND: That's Alice Grob and Dalila Ali Rajah, both two moms who co-sleep, and Dr. Sydney Spiesel. He's a professor at Yale Medical School and our resident expert on all things medical.

(Soundbite of music)

BRAND: Stay with us. NPR's Day to Day continues.

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