World-renowned sleep researcher James McKenna, Ph.D., is among those challenging the recent conclusion by the American Academy of Pediatrics’ (AAP) task force on sudden infant death syndrome (SIDS) that sharing a bed with your infant is more dangerous than putting her in a crib.
World-renowned sleep researcher James McKenna, Ph.D., is among those challenging the recent conclusion by the American Academy of Pediatrics’ (AAP) task force on sudden infant death syndrome (SIDS) that sharing a bed with your infant is more dangerous than putting her in a crib. (However, the AAP does recommend placing babies to sleep close to their parents but on a different surface, such as in a bedside co-sleeper.) McKenna, director of the mother/ baby behavioral sleep laboratory at the University of Notre Dame in Indiana and a consultant to the AAP task force, has been leading federally funded sleep and SIDS research for 25 years. In 1986, he became the first scientist to identify the link between side-by-side mother/infant sleeping and a decrease in SIDS. He recently shared his thoughts on the AAP’s advice with Fit Pregnancy.
To be safe, shouldn’t parents just go along with the AAP’s new guidelines? It’s normal human behavior to have your baby sleeping next to you, and in societies around the world in which bed-sharing is the highest, you’ll find the lowest SIDS rates. The question should be: What are the conditions that transform an otherwise safe arrangement into something dangerous?
What do you object to most about the AAP’s recommendation? The assumption that American parents are not particularly educable as to how to bed-share safely. The AAP thinks that a single, simple, uniform message is required to save those families that cannot be educated. My contention is rather than come out against bed-sharing, which happens and will continue to happen, we should illuminate what we know about the specific risk factors. I also fear that the new recommendations will impair women’s efforts to breastfeed, as it and bed-sharing go hand in hand and are almost inseparable for many mothers.
But what about accidental suffocation by a parent, or “overlay”? Is this sometimes blamed on SIDS? It’s very difficult to distinguish between SIDS, suffocation (or asphyxiation) and infanticide. The confusion has people arguing that SIDS is both overrepresented and underrepresented. I’m concerned that now whenever a baby dies in bed, people will assume it was because of bed-sharing. There are risks associated with everything. What’s imperative is the degree to which the parent goes to sleep at night and puts the baby first and foremost in his or her head.
Should obesity be added to the list of risk factors, along with heavy drinking and drug use?
I think there is a slightly added risk of overlay for extremely obese women. But an obese mother could well be aware of her situation and perhaps keep herself a little bit farther from her infant, acknowledging the capacity of the baby to roll toward her due to the compression of the bed by her body. The same applies to an obese father. And no one should sleep on a couch with an infant.
What is your advice for parents who want to bed-share but are concerned? Parents should read the scientific papers cited in the AAP’s statement [http://pediatrics.aappublications.org/cgi/content/full/peds.2005-1499v1] and educate themselves about bed-sharing at www.nd.edu/%7Ejmckenn1/lab/faq. html. They should also remember this is their decision to make. — Kim Acosta