MONDAY January 05, 2004 Experts debate pros and cons of sleeping with baby By Brooke Adams The Salt Lake Tribune The decision to create a family bed was a matter of necessity at first for Suzanne and Jerry Dallapé. When the Kearns couple had their first son, Rio, now 7, adding a crib to their small home's single bedroom would have made it cramped. Besides, they were strongly committed to breastfeeding and keeping their son close by in his first years. "We could have had a crib if we'd really wanted to, but the small space made for a good excuse to cosleep," Suzanne Dallapé says. "When our first child was 3 days old, my husband looked at him lying in the bed and said 'I can't imagine it any other way.' " Even though the Dallapés had moved to a larger home, they skipped the crib again four years later when Ewan, now 3, was born. And this March, when their third son arrives, he will spend the first two years or so of his life sharing the family bed. "Children, like baby mammals, need to be with their mothers," Suzanne Dallapé says. "To remove a being from the warmth and sounds and smells of its mother -- I don't have a good feeling about this because it seems to go against nature." So what is cosleeping -- or bed sharing, sleep sharing or "the family bed," as the practice is sometimes called? Simply put, it means keeping your baby in bed with you during the night. Some parents use an infant "sidecar" that attaches to the parental bed. Cosleeping is not for everyone -- particularly if parents smoke in their bedroom or are under the influence of drugs, alcohol or medication that makes them groggy (see tips on Page 2). And some parents find they aren't comfortable, physically and psychologically, with baby in bed with them. Obviously, thousands of children who sleep separately from their parents turn out just fine as adults. There is no way to track the number of U.S. families who cosleep, though experts figure most parents do it at least occasionally -- 83 percent of parents, according to In Search of Sleep by Bonny Reichert. In much of the rest of the world, cosleeping is the norm. But the practice is controversial in the United States, and not because entertainer Michael Jackson keeps bringing it up. Be assured: Cosleeping as practiced by Utah families -- and those elsewhere -- is as far removed from what Jackson advocates as his Neverland Ranch is from Nephi. For one thing, the family bed is just that -- shared by members of the same family. And most parents ease a child into his or her own bed by the time they are school age. The controversy stems from concerns about safety and perceived risks of the practice. The debate is shaped, too, by a Western cultural preference for "sleep training" children and putting them in their own bedrooms -- an extension, so to speak, of the value Americans place on independence. The Consumer Safety Protection Commission continues to stir the debate with its ongoing warning that parents should not share their beds with a baby. The commission says that between 1990 and 1999, 156 infants died after a parent, caregiver or sibling rolled on top or against the baby while cosleeping. Critics of the study point out its reports don't distinguish fatalities caused by intoxicated parents or note that far more children die while sleeping alone. The Academy of American Pediatrics stops short of condemning the practice while noting it can be hazardous under certain conditions. That also is the stance taken by the state's Child, Adolescent and School Health Program, the division of the Utah Department of Health that oversees SIDS (sudden infant death syndrome) and infant sleep programs. In 2002, five Utah infants died while sleeping in adult beds, though the state's data does not indicate whether the babies were cosleeping with parents. While some advocates say parents who sleep with their babies may be more attuned to problems such as difficulty breathing, the National SIDS Alliance says bedsharing has not been found to protect against SIDS. The alliance does suggest parents keep baby in a crib or bassinet nearby, which lets them monitor its well-being and facilitates breastfeeding and closeness. Twenty years ago, 94 percent of pediatricians disapproved of cosleeping, writes James McKenna, an anthropology professor and director of the Mother-baby Behavioral Sleep Laboratory at the University of Notre Dame. The practice has gained new advocates, but advice from pediatricians on cosleeping remains mixed. The experts who give it a thumbs down include noted pediatricians T. Berry Brazelton and Richard Ferber, head of the Sleep Lab and the Center for Pediatric Sleep Disorders at Children's Hospital in Boston. Ferber's approach, popularized in his book Solve Your Child's Sleep Problems, is to let babies 6 months or older cry it out once they are put to bed. He says parents should provide only a soothing pat on the back if the outburst is prolonged so babies learn nothing is to be gained by crying. Ferber's view of cosleeping is summarized on the Web site http://www.babycenter.com this way: It "isn't a good idea because people sleep better alone" and "in the long run it's best to help [the child] learn to separate from you without anxiety and to encourage her to see herself as an independent individual by having her sleep in her own bed." In his new parenting book The New Basics, New York City pediatrician Michel Cohen, whom the New York Post calls the "hip, must-have" baby doc, sums up cosleeping by saying "there is no 'right' answer" and no definitive evidence it benefits children in the long run. Baby will be fine wherever he or she sleeps, so it is whatever you prefer, he tells parents. And then there are proponents such as Jay Gordon, a Santa Monica, Calif., pediatrician and co-author of Good Nights, who come firmly down on the side of tucking baby in beside you at night. "It builds the best relationship among the family members and I think it is the safest way to raise a child," Gordon told The Salt Lake Tribune. In 25 years as a pediatrician, not a single child who was cosleeping with a parent has succumbed to SIDS, he says. "Many, many more babies get in trouble in a crib than get in trouble in a family bed, and yet there is criticism mainly of the family bed," Gordon says. "When you separate a mother, father and a baby and you put a baby some distance away, it's not the safest way to sleep." He argues that there are benefits in family closeness, communication and safety, since parents are close enough to monitor baby's well-being. In his writings, McKenna seconds that view, saying there is no evidence that sleeping alone instills certain skills or characteristics in children or is better for them than other arrangements. "What we know to be true scientifically is that for nocturnal infant breast feeding and nurturing throughout the night, both mothers and babies were designed biologically and psychologically to sleep next to one another," McKenna writes. He believes babies who cosleep arouse more frequently, breast feed more often and cry less. Critics of cosleeping say the biggest concern is that a parent may roll over onto baby and not realize it. Suzanne Dallapé says while she is extra cautious in the first few weeks of cosleeping with a baby, she has found no reason to worry about smothering her child. "We really don't have a tendency to be so deeply in sleep that we're not aware of what we are doing at night," she says. "People don't often fall out of bed because they sense the edge. By the same token, parents can sense the baby -- especially mothers, because they have the same sleep/wake patterns [as our] babies." The Dallapés agree with the experts who say sleep sharing builds strong family bonds, particularly for dads. Sharing a bed bonds husband and wife, so why should it be any different for parent and child? asks Jerry Dallapé. "When you wake up to a little hand on your chest and your baby has slept through the night because he is secure in the fact that you are there for him, protecting him, you know you are everything that child wants or needs," he says. "It's the best feeling in the world and one I pity other fathers for not getting to experience." And everyone sleeps easier, he says. "As it was, all we had to do was cuddle up next to baby -- or pop out the 'snack machine' in Suzanne's case -- and all was well again," says Jerry Dallapé. "No lost sleep in our house." Diann Jeppson, of West Valley City, experienced a moment of "liberation" 15 years ago when she carted her first baby's crib to a second-hand store after trying to use it twice. "We started in the traditional way, with a nursery, decorating it and getting it ready for a new baby," she says. But Jeppson discovered her first daughter slept better nestled in her arms. Because of her husband's large size and arthritis, she started out sleeping in a twin bed with the baby in another room. In time, they moved to two queen mattresses shoved together in their room to accommodate cosleeping, which they practiced with their three successive daughters as well. "I decided what babies needed was a sling, diapers and a car seat. I really wanted the baby to experience a lot of closeness with me," Jeppson said. "The children take so much comfort in snuggling with another person at night." While the Dallapés eased their boys into individual beds when they were about 18 to 24 months old, the Jeppsons have let their four children, who range in age from 15 to 6, share the family bed for as long as six years. Gordon says parents can cosleep "as long as it works for you. There is nothing wrong with sharing a bed or cuddling with a 2- or 3-year-old. Some parents have their children in bed until they are 5 or 6. No one is going to know your baby as well as you do or know your baby's needs as well as you do." And what about parents' sexual intimacy? Jerry Dallapé says it comes down to creativity. "Some babies are sound sleepers and can be temporarily moved," he says. "Sometimes you move your adult activities to another location -- the floor, the couch, the bathtub, the deck during a mild rain shower. That creativity can actually bring back some of the spark lost during the harsh realities of parenthood."The family bed: Making it a safe haven for baby and parents * If two adults share the bed, both should be comfortable with having baby in the bed and accept responsibility for the baby. The conversation should include how you would react if, by chance, the baby succumbed to SIDS while in the family bed. * The mattress should be firm and fit tightly against the headboard and, if off the ground, have rails to ensure baby can't roll off. Experts advise against the practice if you have a waterbed, featherbed or deep pillowtop mattress. Do not cosleep on a couch or place baby on a beanbag or pillow to sleep. * Do not sleep with excessive pillows, blankets or stuffed animals on the bed. * Baby should sleep between mother and the bed rail, not between parents. * Obese parents should use a bed extension or sidecar. * Because baby will receive warmth from contact with your body, he or she should be lightly wrapped. Do not cover baby's head with a blanket. * Do not share a bed with baby if you are under the influence of alcohol, drugs or prescription medication that makes you groggy. Also, do not cosleep if you smoke in your bedroom. * Do not let children cosleep with baby. Sources: James McKenna, director, Mother-baby Behavioral Sleep Laboratory, University of Notre Dame; Jay Gordon, pediatrician and co-author of Good Nights; Katie Allison Granju, author of Attachment Parenting; American Academy of Pediatrics.