Dr. Bob: I have heard that sleeping with your infant is dangerous. My daughter-in-law sleeps with her 3-month-old baby, and I am very concerned. She says that it makes breastfeeding in the middle of the night so much easier, but I have read that there is a real danger associated with co-sleeping. What can I gently tell her to stop sleeping with my grandchild?
Answer: You are right about the danger. There is a real possibility of accidental suffocation, and I have seen cases in my pediatric career of such tragedies. When I have counseled families of infants in the office, some have insisted that they would never fall asleep with a baby in their arms and accidentally suffocate the baby. Such thinking is unfortunate. Let me tell you a story.
Back in 2010, Dr. Sam Hanke, a pediatric cardiologist, laid down on the couch with his 3-week-old baby, to give his wife a break. She needed some rest. Charlie fell asleep on his chest. Dr. Hanke inadvertently fell asleep also. Dr. Hanke woke up some time later, but Charlie did not. Charlie accidently was suffocated. This gut-wrenching tragedy has led the Hankes to lead a movement, Charlie’s Kids, to advocate safe sleep to prevent infant death. (https://charlieskids.org/our-story/ ) Safe sleep might be tough but the prevention of the death of a healthy child is so worth it.
Their movement is supported by sound scientific evidence. Their message is not one of fear. They do not wish to scare everyone into compliance, but rather to encourage safe sleep practices that make sense to save lives. We use car seats to protect children in cars, and we even insist that they go home from the hospital in a car seat. Promoting safe sleep is no different. Car seats will not always prevent infant death in the event of an accident, but they will dramatically decrease the risk. Safe sleep measures will not prevent all infant deaths while sleeping. There are still some unknown causes, but safe sleep measures will dramatically decrease the risk.
What are the safe sleep measures? They are actually very straight forward.
- Place the infant on their back to sleep. The rate of sudden infant death syndrome has plummeted over the years after this recommendation. It really works. Folks are very concerned that infants will choke and die if they get sick. The airway is very protected when on the back, and even more protected than when on the stomach.
- Place the infant in a crib or pack-and-play. The infant should be in their own sleep setting (crib or pack-and-play), not in the bed, easy chair or couch. The surface should be firm, not squishy. And remember that alone is not alone. Your bed can be right next to the crib.
- The infant should be alone. There should not be any blankets, pillows, stuffed animals, or bumper pads. Only the infant’s clothing and the fitted sheet over the mattress and nothing else. Extra items can accidentally lead to suffocation. They might be in the crib for show but should be removed when placing the infant down to sleep.
Some folks will argue that they never did these things, and their infant did fine. My reply to that argument has been that new evidence shows that we can provide an even safer environment for our children and why would we want to ignore that advice.
The Hankes never thought that they would have such a tragic event. Let’s thank them for leading a movement to protect all children and make the world a safer place. Let’s eliminate co-sleeping.
Dr. Saul is Professor of Pediatrics (Emeritus) at Prisma Health and his website is www.mychildrenschildren.com. Contact Dr. Bob at askdrbobsaul@gmail.com with more questions.