Is it safe for our newborn baby to sleep in our bed?

Parents all over the world share their beds with their babies. Until recent years, some people thought that babies slept better if they were in their own cribs but no one questioned whether "co-sleeping" was a health risk for a baby. Now, because of the concern that the position in which a baby sleeps is a contributing factor to Sudden Infant Death Syndrome(SIDS), some parents and professionals are wondering if co-sleeping is less safe than having a baby sleep in a separate bassinet or crib. 

The controversy over whether babies should sleep with parents for health reasons is related to recommendations from the American Academy of Pediatrics that all babies be put to sleep in their cribs on their backs. Researchers believe that a baby who is sleeping face down or with his face against a soft surface may have more trouble regulating his breathing than a baby who sleeps on his back. So all parents are encouraged to put their babies on their backs for naps or nighttime sleep.

Of course, most babies never have difficulty breathing when they are asleep. That is why SIDS is so rare. Researchers believe that certain intrinsic factors in some babies, combined with environmental factors, put them at higher risk for SIDS. Unfortunately, we don't know what the intrinsic factors are that cause some babies to be vulnerable. We do know that some factors such as maternal smoking before and after the baby's birth, lack of pre-natal care, and premature birth increase the risk of SIDS occurring. When these factors are present, babies are more vulnerable to SIDS if they sleep face down. Because the cause of SIDS is unknown, the advice we give to parents emphasizes prevention of risks that are known to be associated with SIDS even if we don't know if they are the direct cause.

A set of statistics that contributes to the disagreements between those who think it's fine for mothers to sleep with their babies and those think it is not is that in countries where co-sleeping is common, the rate of SIDS is lower than in the United States. Many parents feel that there are excellent reasons to sleep with their baby. It is sometimes stressful for a mother who is accustomed to carrying her baby all the time inside her to suddenly have her baby out of her reach or out of her sight. It can be hard for both parents if every time that the baby needs to be fed a parent must wake up and get out of bed. Many parents feel that the experience of sleeping next to a baby at night is valuable for building a strong relationship with their child. Even if a baby goes to sleep in a bassinet he may fall asleep next to his mother after a middle of the night feeding.

If you want to have your baby in your bed, these precautions will help keep your baby safe:

• Sleep in a bed that is big enough to provide space between parents and to keep the baby's environment from getting too warm.

• Consider using a co-sleeper if your bed is small. Do not push another bed up against yours--a baby can get trapped in the crack. However, if you use one sheet and mattress cover over both beds this method can work (a sheet alone will not cover a crack snugly)

• Use lightweight sheets and bed covers and don't let them cover the baby's head.

• Use a firm mattress and keep soft pillows to a minimum so that nothing can push into a baby's face. Avoid fluffy comforters.

• Second hand smoke is a known risk factor for SIDS. If you smoke, or if anyone in your home smokes, your baby is at risk for more breathing problems. Try to have a smokefree home, but if you can't, have your baby sleep separately from you.

• A parent should never sleep with a baby if he or she has been drinking or using any drugs.

Meg Zweiback, R.N., CPNP, is an infant sleep consultant in Oakland, California