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Safe Sleep for Breastfed Babies: Is co-sleeping with my newborn okay?

Updated: Apr 10, 2023


Mother and baby cosleeping bedspring safe sleep tips for breastfed babies


Is it okay for breastfeeding mothers to co-sleep with their newborn? Is bed-sharing with a newborn safe? What does "safe sleep" mean? These are all common questions I hear from new parents. The short answer is yes, it is probably safe for you to bed share with your breastfeeding newborn. But there's more to the story, so keep reading!


 

I remember in nursing school one of the first things we were taught during the mother/baby and peds rotation was the golden rule of infant sleep: babies sleep on their back, with a pacifier, in a crib or bassinet, with no blankets or pillows. Every. Time. Otherwise they WILL die.


When I gave birth to my first son, the hospital made me watch a video drilling the same lesson into my head. Your baby will die from SIDS if you co-sleep and you're an irresponsible parent if you fall asleep with your baby ever.


Talk. About. Pressure.

You know what no one ever taught me about? How lactation hormones and sleep work together for both mom and baby. How breastfeeding is actually designed to reduce SIDS and how co-sleeping can be done safely.


Cue weeks of sleep deprivation and misery and the inevitable happened. I fell asleep with my baby. And guess what... it was in a very unsafe way. Thankfully, as the years have gone by, I learned the truth, and it seems that medical organizations are catching on. Recently the AAP has acknowledged that most parents will, at some point, fall asleep with their child and should be taught how to do so safely instead of being vilified.


Let's start by understanding the difference between co-sleeping and bed-sharing.


Ven diagram compares cosleeping and bedspring and discusses safe sleep

First we need to understand co-sleeping and bed-sharing.


Co-sleeping is a broad term that includes bed-sharing, but also refers to the baby sleeping in a cosleeper, bassinet, moses basket, pack n play, or crib in the same room as the parent. Bed-sharing is exactly what it says - specifically mother and baby sharing a sleep surface. The benefits of co-sleeping in the same room (however not the same bed) have been touted by medical organizations for a while. Most notably, co-sleeping for six months is said to reduce the risk of SIDS because the parents are nearby, the baby can hear them breathing and is less likely to fall into a deeper sleep. Furthermore, co-sleeping supports breastfeeding and overall restfulness of new parents as there is not the necessity of going to a separate room to provide overnight care.

However, co-sleeping is not right for all families. Some prefer their baby in another room while some prefer them in the same bed. All options should be considered and families should do what is best, most practical, and safest for them. Let's discuss bed-sharing specifically.


Most new parents are resistant to bed-sharing for a multitude of reasons. Societal norms and pressures are the most cited reason, in my experience, that parents opt out of bed-sharing. Many are concerned about impacts to sleep, safety for baby, impacts to marital intimacy, etc. I would actually like to address each of these concerns.


"I don't want to bed share because I'll just be tired all the time"


One common concern about bed sharing is that you will get less sleep and you won't sleep well. Nothing is one-size-fits all, however, this concern tends to lean on the side of "myth". Being a new parent is exhausting, no matter where your baby sleeps. However, studies have shown that in general, breastfeeding mothers and babies sleep best together. Biologically and anthropologically speaking, mothers and infants are designed to sleep together. Unfettered access to the breast (also called breast sleeping) is supportive of baby's sense of security, growth, reduced SIDS risks, and mom's milk supply. If baby is able to nurse on demand overnight, there is less crying to wake up the whole household, they're more likely to stay on their growth curve, and mom is more likely to have an adequate milk supply. One study actually showed that mothers who have to get up out of bed to tend to their baby reported a perception of more frequent wakings than actually occurred, whereas mothers who were bed-sharing reported a perception of fewer wakings than actually occurred. While this doesn't mean you won't still be tired, it does mean you are likely to experience at least a slight improvement in sleep quality. Personally speaking, this has been true for my family. But it also brings up a concern of safety... If i'm sleeping better, how do I know I won't hurt my baby accidentally?


I'm glad you asked...


"How can I bedshare safely so that suffocation is not a risk to my baby?"


First off, it is important to understand that a breastfeeding mother specifically will naturally make a C shape with her body around her baby as they nurse in a sidelying position. This is actually a protective position that inhibits the chance of "overlaying" or rolling onto baby. It also prevents the likelihood of the partner being able to roll onto baby. Furthermore, there are other key tips for making sure you are bedsharing safely.


  • Parents are not smokers

  • Parents are not under the influence of drugs or alcohol

  • Infant is breastfed

  • There are no fluffy pillows or blankets around baby

    • Parents can use pillows, but infant should be positioned at breast height away from pillows, only light blankets should be used, and they should not be covering baby

  • Baby is NOT swaddled or in a "dock a tot" or other similar device. These are NOT meant for bedsharing and are unsafe for this purpose.

  • No gaps in bed frame/wall and mattress that the baby could become trapped in

  • No pets or other children in the bed (although there are ways to safely cosleep with a toddler and an infant, we can talk about that another day)

  • Do not "bed share" on a couch or recliner or cushy memory foam style mattress, a firm flat surface without gaps is extremely important to reduce suffocation risks.


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Is a pacifier necessary to prevent SIDS when bed sharing?


The recommendation for pacifiers helping to prevent SIDS go hand in hand with mother-infant separation recommendations. When the infant has unfettered access to the breast, a pacifier is not necessary. However, if it is used appropriately as a tool and works for your family, it's not a bad thing either.


What about marital intimacy and bed-sharing?


How to have sex when bed-sharing is a very valid and legitimate concern that many new parents have. Many are on board with bedsharing but don't want it to interfere with sex and intimacy. One option for maintaining non-sexual intimacy can be having the baby on the outside of the bed and both adults beside each other so that they can still snuggle and be close, without feeling like the baby is literally coming between them. Another option is tapping into your adventurous side. There are plenty of creative places you can have sex while your baby sleeps somewhere safe. The floor... the bathroom... the shower... if you don't have other kids or housemates... another bedroom... the kitchen... the laundry room... the couch... the garage... the back deck... your options are endless, just like before you had kids. Who knows?! Being forced to get creative might even re-ignite a spark you didn't expect it to. I must say... as a mom who has co-slept with all of her kiddos for about 2 years each, I've clearly had no issue figuring this one out... considering all my kids are also 2 years apart! If we could figure it out, and if teenagers can figure out how to sneak around parents, you can figure out how to sneak around your baby. I promise!



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As I shared before, sleep, like anything else in parenting is not one size fits all. But when you begin to understand your baby's biological programming, it can become easier to accept the challenges that come with sleep and new parenthood. While I don't want this conversation focused on "sleep training", it is important to understand that sleep training means many different things, and there is no "right" way for every family, however certain methods of "sleep training" do come with risks to infants as they can increase cortisol levels which negatively impacts brain development, forcing sleep routines your baby has not led you into can negatively impact milk supply and your baby's growth pattern. You also have to be prepared for changes in routines due to growth spurts, teething, illness, etc. Bedsharing and cosleeping are the attachment parenting alternative to sleep training and can absolutely be done in a safe and healthy manner. Even if you do not plan to bed share full time, odds are it will happen at some point, so you need to learn how to do it safely and I hope this conversation has been helpful in answering any of your questions. If you have more questions, please ask them in the comments below!



 

IBCLC and Doula in Wichita Falls teaches parents about sleep training, safe infant sleep, cosleeping, bedsharing and breastsleeping

Jaimie Zaki is a Mother, Air Force Wife, IBCLC (lactation consultant), birth doula, and motherhood photographer.


Services:

Virtual Pregnancy Support

Birth Plan Support

Labor & Birth Support

Online Childbirth Education

Online Breastfeeding Classes

Virtual Lactation Consults

In-person Breastfeeding Support (Wichita Falls, Texas)



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