As a sleep doctor, and a parent, I have a problem with cosleeping. Cosleeping in infancy has been found to cause a small but significant increase in SIDS risk. We chose not to co-sleep with our sons. Since infancy, they have always slept better in their own beds, and so did we. [To be clear, when I say “cosleeping in this blog post, I mean bed-sharing and not room sharing]. It’s not just a safety issue, however. I think that kids and parents sleep better when they have their own space, and that learning to sleep well is an important life skill for children that is best learned at an early age.
Like many topics in parenting, cosleeping has become a political issue. I personally do not recommend it to friends or patients, because of the risk of death in infancy, and because it seems to lead to poor sleep for the whole family. (Here are some great illustrations of this). The likely mechanism is via inappropriate sleep associations. I also think it is unhealthy for parents’ lives to revolve around their children 24 hours a day, and that sometimes, children have to “fit within the frame”. That includes having children being able to be apart from their parents for the night. As I have stated previously, there is no evidence that sleep training harms children. Moreover, I am unaware of any long-term studies which show direct benefit of cosleeping for children who are in otherwise loving homes. Parents who disagree with me may site Dr. William Sears’ work, but many of the researchers cited by him claim that their research was misrepresented.
A recent study in Norway supports my experience on this topic. The study found that children who routinely cosleep in infancy tend to be poor sleepers as toddlers. (Thanks to my friend Susan Curley at Joyeux Parenting for bringing this to my attention). This study surveyed over 55,000 mothers, taking into account factors such as breast- vs. bottle-feeding, sleeping practices, child sleep duration, and nocturnal awakenings. There were several important take-homes from this study:
1. Bedsharing at six months of age was associated with shorter sleep and more frequent awakenings at 18 months of age.
2. Poor sleepers at six months had were more likely to have problems at 18 months of age.
3. Breastfeeding at six months seemed to have a mild protective effect against awakenings at 18 months of age.
This is a strong study because it follows a large number of families from birth and sees what happens over time, as opposed to surveying parents who are having difficulty and asking them to remember what they were doing six months previously. (I don’t know about you, but I’m not sure what I was eating for lunch yesterday, let alone how my kids were sleeping a year ago).
There are two pathways to cosleeping which I have observed:
- Intentional cosleeping: where parents have made it part of their agenda to bed share with their child
- Reactive cosleeping: where parents get into the habit of having their child fall asleep in their bed at night, or bring them into bed in the middle of the night when they wake up.
Either way, this seems to result in poor quality sleep. I have found that both in the comments on this blog and in my clinic, habitual cosleeping seems to be associated with lousy sleep. Here’s a sample:
I really hope you can help us. We have a 15-month-old that from birth has been cosleeping. When we coslept, Emma would wake up 3–5 times to nurse since she didn’t know how to self soothe. About two weeks ago I weaned her completely off breastfeeding and after a week of weaning, she began sleeping through the night! Fast forward two weeks later. We are now transitioning her to her crib. It’s been about 5 days since we stopped cosleeping and we are still having problems with her waking up crying hysterically…It takes my husband or myself an hour or more to put her back to sleep. Katrina P
I really feel for this family. They are obviously having a hard time. This mother has been feeding this child three to five times per night for fifteen months. That adds up to a lot of poor sleep for both mother and child. I get grumpy if I get woken up even once at night, be it by a child or a page from the sleep lab.
Even outside of this, there is another significant issue with cosleeping: where does it end? It seems like children seldom give it up on their own. Do you try to transition your child out of bed when they stop nursing? When they start kindergarten? When they enter puberty? When they leave for college? Let me tell you the hard truth: it is much easier to fix a sleep problem at six months than six years of age.
Perhaps I am way off of base here, and there are a huge number of children staying in their parents’ bed, where everyone is getting a terrific night of sleep. I certainly think that “if it ain’t broke, don’t fix it.” I’d love to hear your thoughts on this controversial topic.
But if you are not one of these happy cosleeping families, and have fallen into a cosleeping pattern you can’t break, have hope! Next week: a post on how to stop cosleeping and start sleeping well.