There’s ongoing controversy in the lactation profession about where infants ought to sleep.
Although considerable data shows that co-sleeping is a major risk factor for sudden infant death, breastfeeding professionals have tried to argue that since co-sleeping purportedly improves breastfeeding rates, and breastfeeding proportedly improves infant health, the benefits of breastfeeding outweigh the risks of co-sleeping. That’s untrue.
[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Breastfeeding, co-sleeping and room sharing lead to poorer quantity and quality of infants’ and mothers’ sleep. [/pullquote]
In an effort to reduce the risk of co-sleeping while maintaining mother-infant proximity, the American Academy of Pediatrics recommends room sharing until age one. There’s very little evidence that room sharing has any benefit, but no matter. It seems to be a good compromise.
What impact does co-sleeping and room sharing have on maternal and infant sleep?
Lactation professionals seem to think that co-sleeping improves the quality and quantity of maternal sleep. Room sharing advocates have not really addressed the issue.
The scientific evidence shows that mothers and babies who co-sleep or room share get LESS sleep and poorer quality (more fragmented) sleep.
For example, Mother-Infant Room-Sharing and Sleep Outcomes in the INSIGHT Study was published in Pediatrics in 2017.
The authors note the importance of sleep to both babies and mothers:
The importance of getting an adequate night’s sleep has been increasingly recognized by professional societies including the American Academy of Pediatrics (AAP) and the American Academy of Sleep Medicine. Inadequate sleep has been associated with poorer cognitive, psychomotor, physical, and socioemotional development, which includes emotion regulation, mood, and behavior in infancy and childhood...[I]nfant sleep has a bidirectional relationship with parent outcomes as demonstrated by associations between infant sleep and parental sleep, maternal sensitivity, relationship quality, parental emotional health, and parenting practices.
They note:
The desire to optimize infant sleep duration and consolidation, however, must be balanced with safe infant sleep, a fact reinforced by the 3500 infants who tragically die of sudden infant death syndrome (SIDS) or other sleep-related deaths annually. According to the Eunice Kennedy Shriver National Institute of Child Health and Human Development’s “Safe to Sleep” campaign, most SIDS deaths occur when infants are 1 to 4 months old, 90% occurring before the age of 6 months. Despite these figures, the recently published AAP Policy Statement, SIDS and Other Sleep-Related Infant Deaths, recommended that infants sleep in their parents’room on a separate surface, ideally for the entire first year but at least for the first 6 months.
The 1-year recommendation has questionable congruence with the epidemiology of SIDS (as risk is far lower after 6 months), and it runs counter to the common clinical advice parents receive. Based on evidence of improved infant sleep, clinicians may encourage parents to establish independent sleep environments (ie, in a separate room from parents) during the middle of the first year to promote healthy and sustainable sleep patterns before the typical onset of separation anxiety later in the first year.
The authors compared room sharing and independent sleeping to determine both sleep quantity and quality.
They found:
At 4 months, reported overnight sleep duration was similar between groups, but compared with room-sharers, early independent sleepers had better sleep consolidation (longest stretch: 46 more minutes, P = .02). At 9 months, early independent sleepers slept 40 more minutes nightly than room-sharers and 26 more minutes than later independent sleepers (P = .008). The longest stretch for early independent sleepers was 100 and 45 minutes more than room-sharers and later independent sleepers, respectively (P = .01). At 30 months, infants sleeping independently by 9 months slept >45 more minutes nightly than those room-sharing at 9 months (P = .004). Room-sharers had 4 times the odds of transitioning to bed-sharing overnight at both 4 and 9 months (P < .01 for both).
They concluded:
Room-sharing at ages 4 and 9 months is associated with less nighttime sleep in both the short and long-term, reduced sleep consolidation, and unsafe sleep practices.
That’s room sharing, but what about co-sleeping?
Sleep patterns of co-sleeping and solitary sleeping infants and mothers: a longitudinal study was published in Sleep Medicine in 2015.
Controversies exist regarding the impact of co-sleeping on infant sleep quality. In this context, the current study examined: (a) the differences in objective and subjective sleep patterns between co-sleeping (mostly room-sharing) and solitary sleeping mother-infant dyads; (b) the predictive links between maternal sleep during pregnancy and postnatal sleeping arrangement; (c) the bi-directional prospective associations between sleeping arrangement and infant/maternal sleep quality at 3 and 6 months postpartum.
They found:
Co-sleeping infants had more reported night-wakings than solitary sleeping infants.
Co-sleeping was not related to objective infant sleep quality.
Co-sleeping mothers had more fragmented sleep than solitary sleeping mothers.
Poorer maternal sleep at pregnancy and at 3 months predicted co-sleeping at 6 months.
Breastfeeding was related to poorer maternal/infant sleep and to co-sleeping.
They concluded:
Mothers of co-sleeping infants report more infant night-wakings, and experience poorer sleep than mothers of solitary sleeping infants. The quality of maternal sleep should be taken into clinical consideration when parents consult about co-sleeping.
Breastfeeding is another factor associated with poor infant and maternal sleep.
According to the 2017 paper Exclusive breastfeeding at three months and infant sleep-wake behaviors at two weeks, three and six months:
…At three months, exclusively breastfed infants had a shorter of the longest sleep period at night than exclusively formula fed infants. At six months, exclusively breastfed infants at three months spent more hours awake at night than partially breastfed infants, awake more at night than exclusively formula fed infants, and had a shorter sleep period at night than partially breastfed and exclusively formula fed infants. This study showed differences in sleep-wake behaviors at two weeks, three and six months, when exclusively breastfed infants are compared with partially breastfed and exclusively formula fed infants at three months, while no effects were found for sleep arrangements, depression or anxiety.
Similarly, Sleep Patterns As A function of Breastfeeding: From Infancy to Childhood, published in 2018, showed:
There was a significant interaction between breastfeeding status at 6 months and age, on the longest consecutive sleep period (p<0.001). At 6 and 12 months, breastfed infants had a shorter longest consecutive sleep period than non-breastfed infants, (6:15 ± 2:49 vs 7:56 ± 2:49, p <0.001; 7:26 ± 3:16 vs 8:51 ± 2:52, p <0.001), with no difference at 24 and 36 months (p>0.05). There was no interaction between breastfeeding and age on total nocturnal sleep duration (p>0.05).
It’s long been known that exclusive breastfeeding leads to more fragmented infant sleep and therefore poorer quality sleep for mothers. Co-sleeping and room sharing, far from ameliorating the problem, actually make it worse.
Every women should decide for herself how she will feed her infant and where her baby will sleep, but new mothers deserve to know that breastfeeding, co-sleeping and room sharing lead to poorer quantity and quality of their sleep.
My first born is arriving Jan 9. Sleep duration/quality is already a big issue in our home due to my husband’s adhd. Our plan is to EBF & roomshare for the first month. Introduce formula before end of first month. Transition baby to sleeping in the nursery before the 4th month. To hell with EBF if it jeopardizes our ability to drive safely via exhaustion.
Indeed the best laid plans of mice and men aft gang aglee, but this is our plan and I’m happy at least one group of moms on the internet doesn’t think I’m a terrible proto mom.
Sounds like a good plan. Best of luck!
Won’t this vary considerably depending on the specific mom and baby?
With Girl 1, I tried separate sleeping. I had a baby who was extremely sensitive, to the point that it would take an hour of pacing the halls at night to get her to settle, only to have her awaken the moment I put her in her crib. Any attempt to let her cry resulted in it escalating until she puked. She was reluctant to accept formula. After trying this for several months and becoming a zombie, I started to co-sleep and breastfeed in bed, and finally got some much needed rest. The Boy was the opposite – he needed lots of sleep and preferred to be in his own crib in his own room.
If you do have a baby who feeds at night, I found that it was easier to roll over in bed than it was to physically get up, go to another room, pick up the baby and sit up while feeding, and then try to put the baby back in the crib. After my c-section, the getting up and lifting were particularly hard and my husband wasn’t always there if he was working an overnight shift, so the hospital had encouraged me to co-sleep. Has any study been done to evaluate the safety of deliberate cosleeping with safety precautions versus no planned cosleeping but possible fatigue or accidental cosleeping?
Yes, and the variability within the sample set is reflected in the p-values on the difference in means. If the variability was smaller or the sample size was larger you’d have smaller p-values and tighter confidence intervals. That’s why the authors gave their p-vals and Amy included them.
OT, but does the mum guilt ever go away? I’m torn tonight between irrational fears than my daughter will be much, much less smart than her cousin because he was EBF and she wasn’t *, and guilt because it seems like every other preschooler round here is living some perfect life of swimming lessons and flawlessly healthy snacks. Part of me wants to hold on to the mum guilt because I feel that it’s what spurs me on to do better (I have a childhood memory of my mother saying “I feel sorry for children who don’t have me as a mother” and, to be honest, I’ve always felt that my function (in her eyes) was to be a witness to her perfect mothering more than to be anything or anyone in my own right) but part of me just wants the guilt to sod off already. Tipsy confessional post is tipsy and confessional. Sorry.
* Which is ridiculous because I genuinely don’t give a damn about IQ or whatever. My academic record is basically flawless but I was a career burn-out at 30 because I have all the resilience of a squished marshmallow. I’ll take resilience and confidence for my kid any day.
Your parental guilt sounds like my health guilt. I’ve struggled for a long time, including during my ongoing pregnancy, with fears that if anything goes wrong with my physical health – my blood pressure comes out high, I develop diabetes, I develop some common cancer – it’s surely my fault: I eat too much salt or refined carbs, I ate too much meat before going pescetarian or drank too much alcohol before getting pregnant, and I’m educated and should know or should have known better.
Recently I’ve made some progress on health guilt, using direct evidence. After a doctor recognized my tendency toward “white coat syndrome” (high blood pressure readings from anxiety) early in my pregnancy and told me I should learn to control my nerves before I hit the third trimester exhaustion, I made a plan of “exposure therapy” to start taking my own blood pressure regularly with the support of a therapist. It helped: by seeing the direct evidence that my blood pressure has been well within the normal range most of the time through most of my pregnancy after addressing the anxiety issue, I am much less fearful that I’m eating too much salt or too many refined carbs and thus digging my own grave. Regular weight checks have helped me be more realistic as well (although I was worried at first about some of my gains until my OB seemed unfazed by it), and the gestational diabetes test coming out negative has also helped.
Given that health guilt and parental guilt both come from the same set of upper-middle-class Western cultural norms, they may have similar solutions. Look for the best and most believable data you can, both from reliable external sources and people you know, including your own kid and how she seems to be doing in terms of health, happiness, and schooling, to debunk the notion that minor details of your kid’s diet and extracurriculars are going to make or break the rest of her life. I feel that for the parental stuff, I already have helpful data: my sisters and I are all about equally smart and grew up fine, though our parents divorced, we only ever did one major extracurricular activity each, watched regular TV, ate regular food, took the school bus, and all of us drank formula (my sisters having been exclusively formula fed). I wound up here, though, to help me resist the nonetheless strong social pressure to take on parental guilt of the sort that you describe.
Good luck. That sounds so difficult.
Thanks. I’m a bit embarrassed I even wrote that now, because it actually doesn’t feel that difficult anymore with the progress I’ve made, and could have been much worse before said progress. Hopefully my kid popping out – due just a couple days before yours – will help give me more resolve to cut all sorts of useless crap from my life, including health guilt.
I’m going to go out on a limb and say no. I never felt guilt about feeding method but I’m definitely feeling guilty over quality time spent with my kids (or lack of). I’m a single mom who works from home and is going to school at the same time, so most of my time is devoted to my computer. I think there will always be something to feel guilty about.
Some of it goes away, some of it does not. There’s always the underlying “my children aren’t perfect and it’s my fault” feelings, but then guilt over trivial things like breastmilk vs formula do. It doesn’t matter how your baby gets fed, she’ll still find a decade old stale Cheeto and inhale it before you can stop her. And truly, intelligence is not something that comes from food. I remember being so worried that I was setting my daughter up for academic failure by feeding her formula, but she’s right where she should be, developmentally. Remember that the lives of other people are often less perfect than they appear to outsiders, especially when we’re talking about social media.
My MIL still feels guilty for catching rubella while expecting DH 43 years ago. It’s not ruling her life, but it is still a hard topic for her.
My mom’s mom guilt has left me with some severe daughter guilt. Knowing that my imperfections made her feel bad about herself was really hard on me growing up and still is today. I believe she tried to hide it, but was not very good at it. So with my kids, I try to not feel guilty in the first place (sometimes more, sometimes less successful). It creates new problems for everyone.
This. I once told my mom that she’d gone past beating herself up and was now beating me up. It struck a chord but boy, she still feels lousy about stuff and I’m 41. Not optimistic that I’ll ever stop feeling like I failed in some ways.
Yes, mom guilt can go away. But it doesn’t usually go away on its own. You have to fight against it and put it in its place. And don’t worry, its absence won’t make you lazy, it will make you more energetic because you won’t constantly be drained from guilt and worry. Talk back to it and make it understand that it is not helpful and not welcome. Finding a therapist to coach you can help.
EBF and “flawlessly healthy snacks” have jack to do with intelligence. I fed my 2 kids the same and one tests very high, and the other lowish-normal. If I had to predict who will be more successful it is the lower scoring one, because of a good personality, attitude and social skills. Neither of my kids had those expensive early swimming lessons, and yet both became strong swimmers eventually and love the water.
So, in summary, I would tell your guilt to “sod off” except that I’m American and we don’t say that. We tell things to “fuck off.” But anyway, tell it to go away!
My mom had 12 kids and raised most of us the same way. Among the siblings we have had everything from mental disabilities to teen pregnancy to Ivy League scientist. My bone deep takeaway is that the consequences of Mom’s choices paled in comparison to the impact of our own choices, and unseen genetic variation.
Mom guilt presumes you have much more say over the outcomes than you actually do. It’s hard to embrace uncertainty but it’s closer to the truth than embracing guilt.
Some of it does indeed go away, if you let it.
Step 1 is realizing that decisions needs to be based on what is best for your family, period. Other people may give advice, but they can also be ignored (unless we are talking about something like child protection workers). Get the highest quality advice possible, then make an educated decision that is right for your family. Understand that the advice will likely change.
Step 2 is realizing that very few individual decisions make that much of an impact, unless they are truly disastrous. Who you are and all of the things that impact your child 24/7 is what makes a difference. We tend to make a fetish out of certain isolated things that honestly don’t matter that much in the long run. Breast vs. formula, high-quality daycare vs. SAHM, etc. – these things don’t make the difference. You don’t see debates about “fed vs. starved” or “caring for baby vs. abandoning all day” or “sleep routine vs. putting some brandy in the bottle”. Chances are that you are using some basic common sense.
If it makes you feel better, Girl 1 refused to go near the water when her YMCA daycare offered weekly swim lessons when she was a tot, but she is now a lifeguard. Girl 2 seems to exist on carbs without a veggie in sight, but she is also brilliant. The Boy took forever to roll over and crawl and walk, but he’s really athletic now. He also needed help because he wasn’t reading at all in grade 1, but now loves English and reads all the time. I felt guilty putting Girl 1 in daycare esp when she cried the first week, but she texted me last week that she’s glad I was a working mum. Lots of stuff works out in the end.
I’m sure I’ll be pounded into the dust for say this, but my two kids both slept in their own cribs from day 1! We had baby monitors, but honestly, what does a baby not breathing sound like? Either me or my husband got up at night and I always got at least 3 solid hours at a time. Funny thing is, when my baby made the slightest peep on the monitor I was instantly awake! This didn’t happen for very long as both of them slept through the night by 6 weeks. I think swaddling them up hospital style and making sure they were warm and full at bedtime made a difference. They were fed on a schedule (I know, it’s HORRIFYING to say that out loud any more). I trusted my mothering instincts more than any book or nurse. As for the “same room” sleeping, that’s a little silly unless one lives in a castle. I had to laugh at the notion that a 6 month-18 month old child will suddenly begin to sleep in their own room! Can’t tell you how many parents go through HELL undoing the “same room” scenario! Days and days of screaming “mommy”! I HAD to sleep to be the best mother I could. Yes, I slept less, but managed to get my 40 winks in with help! Scoff if you will, but it worked for me 🙂
My first kid only lasted two weeks in our room and the rest were in their room from day one. Their constant cat noises and waking up the other parent while taking care of the baby was too much for us and neither of us were getting any sleep. I don’t even use a monitor unless we are downstairs as I can still hear the baby with our door open. This is the first time that I have used a video monitor for the baby’s room and this has given me piece of mind as we dealt with reflux and milk allergy issues with our latest addition.
MelJoRo made an interesting point below:
“As I understand it, the recommendation to room share is exactly this—it has a correlation with less SiDS incidents, and the proposed mechanism is that if everyone is sleeping (more) poorly then baby is more easily roused and thus less likely to have a SIDS event.”
Is there any evidence for this mechanism? If so, wouldn’t it be of interest for the poor sleepless parents if the cot was equipped with a sound and movement system that mimics sleeping parent behavior? That way parents get their sleep and the baby has enough stimulation to wake briefly every now and again.
Anecdotally, I know I sleep a lot less well when a toddler needs to crawl into my bed. Between fears of smothering the kid and pushing various portions of the kid off of my face, it’s not the best sleep. Fortunately, they’ve only needed it a few times, like the first night at our new house. Parental snoring and constricted movement are a problem for the kids, too.
I was so sick after a horrific delivery. After bringing home my five days in the NICU post-dates son there was no choice. Dad did night time feeding. Every night and all night. Having the ability to pull in another adult (or more than one!) to feed and otherwise do new baby care means that a formula fed baby has many adults at it’s little loving beck and call. And my son and his father got to know each other very well in those night time feedings. I like to think it is a bond that started then and only grew stronger.
I was also able to have my husband do all the night time feedings and it was really nice. All adults got the sleep they required and the babies were cared for by fully-present adults with no worry about smothering them due to exhaustion.
It’s really sad that this can’t be the reality for more families. I’m a big believer in paid parent leave for all parents.
“new mothers deserve to know that breastfeeding, co-sleeping and room sharing lead to poorer quantity and quality of their sleep.”
How can you tell, based on the cited articles, that co-sleeping and room-sharing *lead to* poorer sleep rather than just being associated with it? It seems like a classic case of correlation vs causation. I coslept with my first *because* he woke up every 5-15 minutes, all night long, when placed on his back on a separate sleep surface. He remained a comparatively bad sleeper when we coslept, but sleeping poorly was a cause, not a result, of cosleeping. (And quite frankly, at some point during the first 18 months of his life, cause and result may have flipped – but there’s no way of telling when and if that happened.) I didn’t move him to his own room early *because* getting up 5-10 times at night and walking down the hall would have been murder. (He did have his own room, with his own crib, where he started the night (waking even move frequently until we brought him into bed), so it’s not like I didn’t give him a chance.) I continue to room share with my second *because* he continues to wake up frequently at night. He might sleep better if he were out of our room, but since he’ll share a room with his brother, he needs to be sleeping well first or there’ll be hell to pay.
I’ve learned a lot from lurking on this blog, but you can’t read yesterday’s post and then today’s and not see the bias in what is deemed causation vs merely correlation.
I agree with this sentiment whole heartedly. I think it is hard to know what comes first, the chicken or the egg. I roomshared for peace of mind in the beginning, then quickly realized that after about 4 months baby knew I was close by and would rather co sleep and night nurse, which I was not ok with, so we moved to his own room. If sleep training and sleeping independently had not worked I may have been in your position.
That said, the AAP recommendations for SIDS prevention are almost all correlation based, with the strongest recommendations generally being there is a correlation, and a possible biological mechanism for causation. As I understand it, th but recommendation to room share is exactly this—it has a correlation with less SiDS incindents, and the proposed mechanism is that if everyone is sleeping (more) poorly then baby is more easily roused and thus less likely to have a SIDS event. I think the whole thing needs to be part of the discussion, because sleeping arrangements are a very personal thing. Mothers deserve to prioritize what works for them and their family, without being afraid that one thing is supposed to work for everyone.
Yes – this assumed mechanism of “lighter/more interrupted sleep leads to less SIDS” thing needs to be said more clearly. Right now there’s this pretense that safe sleep recommendations are independent of good sleep quality or even supporting it, when actually it’s the opposite.
It is about as true as the “donuts don’t give us energy, but broccoli does” BS that my toddler is told in the weekly sports class at daycare.
Sure, for some kids their own room works and they’re the ones making the own-room stats look good. But the others often end up on the room-sharing and co-sleeping groups because their parents consider mediocre sleep still better than awful sleep. Including those cosleeping parents who know about safe sleep but are desperate for any sleep at all.
I agree. With both of my children, I moved them to their own room as soon as they were sleeping well in my room. That means my first moved out of the bassinet into a crib in her own room at about 8 weeks old, and my second moved out of the bassinet into a pack-n-play in my room at 4 months, and then finally into a crib in her own room at 10 months old. I don’t think I did anything different for the two, my first has just always been a better sleeper than her sister.
I totally agree as well. I had never intended to co-sleep but was fine with room sharing when I heard about the benefits regarding SIDS prior to my oldest kid`s birth. He was such a terrible sleeper. Two weeks ago, he finally moved out of my bed at 4.5 YEARS. He definitely taught me that life with children does not always go as planned.
My thoughts too. I was determined to never let baby #2 in my bed. Ha! The first time she slept through the night she was 4. She’s 10 now and still wakes up every night and gets into bed with me (if she doesnt start there. Which we do sometimes because it’s the only way she sleeps through the night. Did i mention she’s 10? 10 Years?)
Yes – I was just thinking this. Older baby slept horribly, ended up in our room because going back and forth got too be too much; younger one was a dream sleeper and stayed happily in his own room. Association is not causation.
Yeah, this is a really good point.
Yes. I had a bassinet for baby, but he would not sleep in it. The longest my baby ever slept on his on was like two hours until he was well into toddler years. Of course there were a lot of things I wish I had done differently, like give him formula so he might go to bed full and satisfied, but my child was SUPER rigid. REFUSED to drink out of a bottle. I tried every bottle in creation, I even tried a haberman feeder. He effectively forced me to breastfeed after I was ready to give up on it, and take domperidone for low milk supply, by flat out refusing to take a bottle. I used to think it was an oral issue, but now I think it was his extreme, spectrumy rigidity that became more evident as he got older. He was also very rigid with sleep. In our house it was co sleeping or no sleeping. This kid would not sleep without me. WOULD NOT. Just stubborn af this baby was. Still kind of rigid, but improving with ABA therapy. In short, I think the poor sleeping may very well be the cause of the co-sleeping, not vice versa.
Funny. My anecdotal evidence is absolutely opposite. Mine absolutely would not sleep when we put him in the bed with us. He fussed and cried and wouldn’t settle. He slept very well in his bassinet and later crib. Of course, that was once he was down – the only way to get him to sleep at first was to hold him and then set him gingerly down while holding your breath. But once he was down, he slept solid if he was alone and woke up immediately if you put him in our bed. Three days old, he defeated his parents will for the first (but not the last) time.
When he was a bit older, he slept best of all in the baby swing. It seemed so easy, pop him in the swing and he was out. I’d feel so horrendously guilty for using it; I called it “the cheater” because it seemed like I wasn’t “doing my job” by using it.
I don’t think you’re necessarily saying the opposite, I think the anecdotes are illustrating what most people know, which is that babies have differing sleep needs and preferences. And you don’t get to choose which kind you get!
My last kid was a bit like that. I had been prepared to co-sleep, but he just got distracted and we quickly learned that he honestly wanted to just sleep by himself. He was the exact opposite of his older sister.
Currently cosleeping with my 8 month old *because* she was waking every hour. It didn’t make her wake less, but rolling over to pat/feed is a lot more conducive to sleep than getting up to lift her out of her crib every hour, not to mention trying to get her back in it still asleep. I was very against cosleeping with my first but he never woke every hour. I want to put her back in the crib but the thought of getting up and lifting a 20 pound baby every 2 hours…
That was my experience – it was the baby that determined the sleep arrangements, and what we ended up doing with each wasn’t what we had planned to do.
My BFHI said on their pamphlet that mothers and babies slept better when they were together. I was like, did the person that write this actually have children?
One reason – of MANY – that I loathe BFHI.
This idea that sleep is improved with an ever-waking newborn present is absurd.
Yes, I detest BFHI too. I specifically looked for hospitals that would take the baby at night and fortunately there were no issues. But it is so important for me to get enough sleep (I become a deeply unpleasant person without enough sleep) that when I heard about the BFHI from this blog, I was truly aghast. BFHI should be renamed the CTWI – Cruelty To Women Initiative.
Uff…although I happen to have met a number of people in person who promote breastfeeding and/or co-sleeping, I don’t think the hospitals are so pushy about it in my location. Which is a good thing, because I too have been finding, especially during my pregnancy, that my moods tend to be much more unstable if I sleep poorly. That means not being able to be flexible about feeding and sleeping options could put me at risk for PPD, which would mess with all the other things I’d want to do for and with my child once she’s born.
Apparently, there is only one hospital locally that *isn’t* BFHI. I delivered at a BFHI three times because my incredible, amazing, 9,000+-delivery-experienced OB delivered there. (And do note that he, fan though he was of natural birth and breastfeeding, fought the whole BFHI thing tooth and nail precisely because of the mom sleep factor.) He has since retired, which about breaks my heart, but the one bright side to that is that I can and will find an OB associated with the non-BFHI hospital for any future kids who might occur. Believe you me, I’ll be letting the BFHI hospital know EXACTLY why I’m not going back.
The hospital where MrC’s daughter delivered is BFHI and did the whole “we don’t have a nursery because mom isn’t going to have help at home so she needs to get used to it” bullshit, but apparently they do have a well baby nursery if mom is deemed sick enough to need it. C-sections apparently qualify, at least the first night. It’s a step in the right direction, I suppose, but imagine being the exhausted mom who doesn’t have a good enough medical indication and being denied sleep, knowing the nursery actually exists.
My BFHI for #3 did not offer a nursery for c-section patients. When I asked what would happen if my husband couldn’t be there I had to keep asking until the charge nurse finally said they would take the baby if they had to. I wrote a whole page length thing on my survey and the director of OB for the hospital called me. I told her point blank that my perception as a customer was this was a cost savings measure and that it was unsafe. She was “stunned” that I would think that.
HA!!! Stunned, eh?
The hospitals I visited for my 2nd delivery all said there was no well baby nursery, but when I told the story of my 1st being a “traumatic” birth and a baby that refused to sleep, the nurses would pull me aside and tell me that there were exceptions to the rule and they would of course take the baby for me so I could sleep. I didn’t quite trust this so I chose the hospital that had the well baby nursery right through the door to L&D for the whole world to see.
Here’s what the BFHI hospitals miss entirely: actually, a LOT of moms have *some* sort of help when they go home, and if a mom has a spouse/significant other/mom/sister/friend/whatever who’s willing to even take the kid just for mom to get a couple of hours of sleep, that’s STILL more help than she gets in a BFHI hospital! I pointed this out…vehemently…to any and anyone in customer service/PR/”patient satisfaction” I could get ahold of this last time.
There’s also the fact that even if mom has absolutely no one who can help when she goes home, she’s at least then 4 days out from major surgery vs a few hours.
BFHI is big on co-sleeping. My local hospital had this program where for your 2 and 6 week post-delivery checkups, they sent a public health nurse to your home. The nurse spent a lot of both visits trying to talk up co-sleeping as a solution to getting better sleep and to improve breastfeeding outcomes.
My baby slept in a mesh-sided bassinet by my bed, less than two feet away from me, but that wasn’t good enough, or “natural” or promoting the mother-infant bond, according to the nurse.
She also never bothered to answer my questions about bleeding after labor or about my own recovery. It was a simple “well, your incision doesn’t look infected” and then all breastfeeding and cosleeping promotion, all the time.
Presenting this data (which lines up with my own experience, incidentally) won’t make a lick of difference to the Boobies Uber Alles crew. They’ll just start talking about “physiologically normal” sleep.
That is actually what makes me crazy about lactivists, for all the talk of studies and evidenced based practices they will never ever accept a point of data that doesn’t confirm their bias.