Co-sleeping: there is no benefit of breastfeeding worth risking a baby’s death

mother and baby sleep

During the Vietnam War, a military officer remarked about the village of Ben Tre:

“It became necessary to destroy the town to save it.

The quote came to epitomize the brutality and absurdity of the war itself, a war based on killing people in order to “save” them.

I was reminded of that quote by Dr. Melissa Bartick’s irresponsible and hypocritical opinion piece in Maternal Child Nutrition, Babies in boxes and the missing links on safe sleep: Human evolution and cultural revolution. Bartick promotes the deadly practice of co-sleeping in order to support breastfeeding. Apparently she is blind to the absurdity of letting babies die in order to save them.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Dr. Melissa Bartick promotes the deadly practice of co-sleeping.[/pullquote]

When I first saw the evidence about the deadly risks of co-sleeping, I was not persuaded. I had co-slept with my own babies and it was difficult to contemplate that I might have put them at risk. Over the years, however the evidence has become overwhelming and I have come to understand just how deadly co-sleeping can be.

According to the American Academy of Pediatrics:

…[B]ed-sharing is associated with an increased risk of SIDS; a recent meta-analysis of 11 studies investigating the association of bed-sharing and SIDS showed a summary OR of 2.88 (95% CI: 1.99–4.18) with bed-sharing. Furthermore, bed-sharing in an adult bed not designed for infant safety, especially when associated with other risk factors, exposes the infant to additional risks for unintentional injury and death, such as suffocation, asphyxia, entrapment, falls, and strangulation. Infants younger than 4 months194 and those born preterm and/or with low birth weight are at the highest risk, possibly because immature motor skills and muscle strength make it difficult to escape potential threats. In recent years, the concern among public health officials about bed-sharing has increased, because there have been increased reports of SUIDs occurring in high-risk sleep environments, particularly bed-sharing and/or sleeping on a couch or armchair.

It is incontrovertible that bed sharing nearly triples the risk of infant death from SIDS. But apparently for Bartick that pales into insignificance compared to the benefits of promoting breastfeeding. She seems to believe that it makes sense to let babies die in order to save them.

Her “argument” is an inane exposition of the naturalistic fallacy, the fallacy that because something was done in nature, it always and forevermore ought to be continued.

Recommendations enforcing separate sleep are based on 20th century Euro‐American social norms for solitary infant sleep and scheduled feedings via bottles of cow’s milk‐based formula, in contrast to breastsleeping, an evolutionary adaptation facilitating the survival of mammalian infants for millennia. Interventions that aim to prevent bedsharing, such as the cardboard baby box, fail to consider the implications of evolutionary biology or of ethnocentrism in sleep guidance…

As I explained yesterday, only someone who doesn’t understand evolution would offer such a foolish justification for risking babies’ deaths.

Bartick appears to believe that evolution produces perfection and therefore, any deviation from the past is a deviation from perfection. But evolution does not produce perfection; it is based on survival of the fittest. By definition, in the state of nature, some will live, many will die. Why would we want to copy that?

From an evolutionary perspective, the most successful animals are those who can adapt to new environments, not those who are slavishly devoted to recapitulating the behavior of their ancestors. It doesn’t matter what happened in the past, only how well the animal can cope with present conditions.

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, with soft bedding, some of us having smoked tobacco, or ingested alcohol or pharmaceuticals.

The parents who will be most successful evolutionarily are those who let their offspring sleep in a separate bed, on a firm surface, with no bedding or soft toys.

But Bartick isn’t interested in what’s good for babies, she’s interested in what is good for breastfeeding.

She writes

Recognizing breastsleeping as the evolutionary and cross‐cultural norm entails re‐evaluating our research and policy priorities, such as providing greater structural support for families, supporting breastfeeding and safe co‐sleeping, investigating ways to safely minimize separation for formula‐fed infants, and mitigating the potential harms of mother–infant separation when breastsleeping is disrupted…

Pro-tip for Dr. Bartick: a dead baby can’t breastfeed.

Promoting co-sleeping is the equivalent of destroying babies in order to save them.

It’s also extraordinarily hypocritical.

Bartick and other professional lactivists have implied that women who choose formula feeding because breastfeeding causes pain, frustration and exhaustion are “selfish” women more concerned for their own convenience than for their baby’s wellbeing.

In promoting bed sharing, Bartick notes:

Research shows that bedsharing breastfeeding mothers nurse their infants 5.75 times during the night (often without realizing it), compared to 2.5 times a night for moms and babies who do not share a bed.

There is nothing inherent in sleeping separately that prevents a mother from breastfeeding exclusively. Bed sharing just makes breastfeeding more convenient. But according to lactivist logic, if convenience is not an acceptable reason for using formula instead of breastfeeding, it couldn’t possibly be an acceptable reason for refusing to get out of bed to nurse an infant as often as he or she wants.

Lactation professionals have no trouble telling women to set an alarm and pump multiple times during the night in order to boost supply, why don’t they tell breastfeeding mothers to set an alarm and get up and breastfeed 5.75 times a night to maintain breastfeeding while avoiding infant death? Can it be that breastfeeding mothers are simply too lazy and selfish?

Bartick writes:

Moving forward, our frame of reference in determining risk and public policy to manage risk must be normative human physiology …

Wrong! Our frame of reference in determining risk ought to be scientific evidence, not what our ancestors did in the past.

Anything else amounts to letting babies die in order to save them.