Bed sharing has always been dangerous. The first reported bed sharing death occurred nearly 3,000 years ago.
Two women came to King Solomon and stood before him. One woman said: “My Lord, this woman and I dwell in the same house, and I gave birth to a child while with her in the house. On the third day after I gave birth, she also gave birth. We live together; there is no outsider with us in the house; only the two of us were there. The son of this woman died during the night because she lay upon him. She arose during the night and took my son from my side while I was asleep, and lay him in her bosom, and her dead son she laid in my bosom. when I got up in the morning to nurse my son, behold, he was dead! But when I observed him (later on) in the morning, I realized that he was not my son to whom I had given birth!”
You may recognize this as the background to a story of King Solomon’s wisdom in suggesting that the two women split the baby.
[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Those who promote bed sharing “have never heard the guttural scream from a mother who was just told her baby was dead.”[/pullquote]
Bed sharing was a deadly problem in 950 BC and it’s a deadly problem in 2018. That’s why pediatricians and public health officials are in agreement that bed sharing with young infant should be avoided. Lactivists, however, who believe that bed sharing is critical to promoting breastfeeding, have been working very hard to conceal or minimize its risks.
They often cite Notre Dame anthropologist James McKenna who wrote the 2015 paper There is no such thing as infant sleep, there is no such thing as breastfeeding, there is only breastsleeping.
McKenna coined the term “breastsleeping” in an effort to:
help both resolve the bedsharing debate and to distinguish the significant differences (and associated advantages) of the breastfeeding–bedsharing dyad when compared with the nonbreastfeeding–bedsharing situations, when the combination of breastfeeding–bedsharing is practiced in the absence of all known hazardous factors. Breastfeeding is so physiologically and behaviourally entwined and func- tionally interdependent with forms of cosleeping that we propose the use of the term breastsleeping to acknowledge the following: (i) the critical role that immediate and sustained maternal contact plays in helping to establish optimal breastfeeding; (ii) the fact that normal, human (species wide) infant sleep can only be derived from studies of breastsleeping dyads … and (iii) that breastsleeping by mother–infant pairs comprises such vastly different behavioural and physiological characteristics compared with nonbreastfeeding mothers and infants …
That’s a fancy and long winded (and unverifiable) way of implying that promoting breastfeeding is more important than whether babies lie or die.
Is it?
I belong to a private Facebook group of medical professionals who were discussing this issue. The stories that nurses told were chilling. If you think bed sharing death is something that only happens to other people, people who smoke and drink and use drugs, think again.
Consider:
Whenever I think about cosleeping it reminds me of a former patient of one of my coworkers. My friend and coworker had cared for a baby in NICU for 4 months. The first night the parents had the baby home, they decided to sleep with the baby in their bed. The baby ended up suffocating and dying that night, first night home after 4 months in NICU.
Or this:
This issue really hits home with me. For the last 2 years I have been living in xxxx, where they are proud of the fact that every maternity hospital is designated Baby Friendly. I know I have personally cared for 3 infants who died from SIDS after discharge due to co-sleeping. I have also helped futilely code a 2 month old brought into the ER in cardiac arrest. Mom admitted to co-sleeping and was EBF.
The baby was not considered high risk.
This infant would have been considered “low risk,” .., thus it would have been an acceptable risk to co-sleep. They obviously have never heard the guttural scream from a mother who was just told her baby was dead. There are not words to comfort her when she keeps asking how she is going to tell her husband who is deployed overseas.
The nurse goes on to say:
Mind you I am currently a nurse in a small 15 bed level II NICU. Formerly, I worked in a xxxx 90 bed high acuity level III NICU, which unofficially practiced Fed is Best. We would occasionally hear of some of our former graduates dying of SIDS, but nothing like the frequency I hear about in my current NICU. If one of the stated benefits of exclusive breastfeeding and a promoted benefit of Baby Friendly hospital designation is reduced SIDS rates, then why does there seem to be a real issue in a state where the only option is to deliver at a baby-friendly facility?
A third nurse writes:
I too have been involved with multiple SIDs cases. One was IN our BFHI hospital, suffocation while BF during the night–fresh section mom.
That’s not the only harm from breastfeeding promotion. As the second nurse comments:
Believe me, it has been an eye opening experience going from a feeding friendly hospital to a baby-friendly hospital. The amount of preventable infant harm I have seen is sickening. From severe dehydration to SIDS, there are so many things wrong with baby friendly practices.
The idea that co-sleeping must be closest too perfection because it’s natural is a perversion of evolutionary theory. Evolution does not lead to perfection. Many natural practices have high failure/death rates. Only the fittest survive and fitness changes as the environment changes.
Even if it were the case that women and babies co-slept in the past, they did so on bare ground in the cold. Humans haven’t slept on the bare ground in the cold since fire was mastered. The way we sleep has changed over time and now we sleep in ways that are harmful to babies: on soft surfaces and with soft bedding.
Moreover, there is nothing inherent in sleeping separately that prevents a mother from breastfeeding exclusively. Bed sharing just makes breastfeeding more convenient and therefore supposedly more likely. The underlying assumption is that breastfeeding is so critically important to infant health and that risking an infant’s death is a reasonable choice in order to promote breastfeeding. Except breastfeeding is not critically important and dead babies can’t breastfeed.
An individual mother may consider the small risk of death from bed sharing an acceptable choice. But she can’t make an informed choice if lactivists lie about the risks. Bed sharing is deadly in low risk situations as well as high risk situations. Mothers deserve to know.
I think it’s important for medical professionals to take a harm reduction approach to co-sleeping rather than total abstinence.
I never intended to co-sleep with my kids, but after falling asleep nursing my son I ultimately decided it was safer to plan to co-sleep by making the sleep surface as safe as possible than to do it unintentionally.
King Solomon Tangent: If you’re wondering why one of the putative mothers was willing to chop the baby in half, its because the father died and left his children by these 2 concubines his money. The 2 concubines had nursed both babies as their own and the other people of the household weren’t sure which woman was the mother of which baby since they traded them back and forth. Solomon’s judgment was divide the baby and divide the fortune. The lady who opted to give up the baby & the fortune may not actually have been the bio parent but she certainly was the one that loved the kid most…..and Solomon decided that made her the “real” mother.
There’s another piece to this that parents need to be aware of to make an informed decision. The most current model of infants suffocating while asleep is made of three related parts.
The part we are discussing now is the safety of the sleep environment – and that’s the easiest part to identify for a given family.
Another part is how good a given baby’s brain is at waking a baby whose blood CO2 levels are rising so that the baby moves their face into a better breathing position. We know of some risk factors like prematurity – but there is a subset of term babies whose brains don’t wake them very well and are at higher risk of suffocation.
The last part is transient issues that change the baby’s airway or ability to exchange gases. These would be things like illnesses or even increased saliva production from teething.
Hopefully, researchers can find some biomarkers to identify babies in the second group some day – but we don’t have those yet. Similarly, a baby’s overall risk changes over time as the kid has various illnesses over time.
We don’t have a great way to screen healthy term babies for the second and third criteria for suffocation risk which leads to emphasizing the one criterion we can control. Nothing wrong with that – as long as parents are made aware that a small number of term, healthy babies are extremely poor candidates for bed-sharing and we are horrible at pre-identifying that group.
A few years ago, i was in training to be a la leche league leader. I called the primary writer of the womanly art of breastfeeding with my concerns about the way the book promoted co sleeping, cited a few studies to consider, and advocated for softening the stance (the womanly art is emphatically pro co sleeping). Well, she did not appreciate my opinion, told me she was a world renowned expert in co sleeping, speaks for the WHO on the topic, and was by no means going to soften the stance.
Oh well, i tried to bring sense and reason to that organization, but they didn’t want it . I didn’t become a leader.
Meanwhile I was literally hallucinating and falling asleep at my BFH, but damn it, keep breastfeeding!
I toured the BFH I am about to give birth at (all the hospitals in my area are BF or I would not be choosing this one) and asked the nurses what their policy was if I became too sleepy or groggy to safely care for the baby. They looked at me like I had two heads. I finally spoke with the charge nurse and she said “if you call for help, we will help”. I am not feeling optimistic about my stay there.
In my experience, they don’t want to tell you point blank during the tour that they will take your baby if you ask. I got the same response when touring hospitals but when I explained the horror of my first birth and need for sleep, I was pulled aside after the tours and told that the nurses would work with me to care for the baby during the night. I ultimately chose a hospital that still had a well baby nursery – partly due to that and partly due the NICU care and availability of anesthesiologists and crash C-sections.
Thanks! this makes me feel better.
I would highly recommend privately confirming that they will help you. I was hallucinating from lack of sleep, drugged up like crazy and they straight up refused to take my baby. They propped him between me (a very “fluffy” and well endowed woman) and the bed rail with a pillow. He’s going on 8 and I’m still enraged at the risks they took with us.
I wasn’t allowed to go to the bathroom by myself, but a BFH would insist I care for two infants on my own. It’s nonsensical. (Mine when to the NICU, so I didn’t have to find out whether anyone would help me in that state.)
Falling asleep while breastfeeding was my biggest fear during the first weeks with my baby. I guess I have to thank Donald Trump for tweeting so much nonsense that it kept me awake, reading my Twitter timeline in disbelief.
Ha! At least his nonsense is good for something : )
I always felt a little guilty about cosleeping with my first for half the night. It was dangerous; I was just so freaking tired that I was falling asleep even upright every night.