The Recent AAP Statement on SIDS and Bedsharing

I have been saddened by the new American Academy of Pediatrics’ Statement on SIDS (Pediatrics, November 2011).  The AAP include two recommendations which can cancel out the benefit of extended breastfeeding amenorrhea: sleep in the same room but not the same bed (in other words, no bedsharing between mother and infant) and use a pacifier.

In our community new parents may be told in the hospital to “never sleep with your baby.”  Have these folks ever nursed a baby sitting up during the cold, dark night and fallen asleep while doing so?  Have they ever almost dropped their baby while nursing in a comfortable chair during the middle hours of the night?  Some parents fear the crib or their bed due to poor instruction and fall asleep nursing their baby on a couch or elsewhere where their babies can be at much greater risk.

In Cincinnati the Police and Citizens on Patrol are now handing out pamphlets warning parents about the alleged dangers of sleeping with their baby.  Here is my husband’s response followed by Dr. James McKenna’s response.

JOHN: “I am a former member of Citizens on Patrol and would strenuously object to distributing the semi-false-alarm material dealing with co-sleeping.  Fortunately we raised our children before the current effort to spread these semi-false alarms.  Our last four children slept in our family bed.  (With our first, we shared the fears now being promulgated.) Let’s start by remembering that SIDS formerly was called crib death.  The family bed is the safest place for a baby when the parents practice the same safe-sleep practices they will have to adopt for crib sleeping — no toys, a firm mattress, no soft pillows or pets or siblings near baby, etc.  In addition, the mother should be breastfeeding and the parents have to be non-smokers, not obese, and not under the influence of alcohol or other drugs.  It also helps greatly to have a king-size mattress.  It’s also the easiest way to do ecological breastfeeding, the kind that normally postpones the return of fertility for well over a year.  A better informed health department, police force, and COP groups should be promoting breastfeeding and safe-sleep practices including the presence only of the baby’s married parents in the family bed.”

Dr. James McKenna has been informed about the anti-bedsharing campaign in Cincinnati, and has responded eloquently.   What follows are his unique qualifications and then his comments.
QUALIFICATIONS:  Dr. James J. McKenna, has published no less than 50 or so peer reviewed papers on cosleeping—cosleeping in the form of bedsharing,  breastfeeding and SIDS reduction—all in the top medical journals in the world. He was recently selected as a “Fellow” in the world’s most prestigious scientific organization, the American Association for the Advancement of Science (an honor accorded to only about 10% of America’s top scientists ). Dr. McKenna supports and defends a family’s choice to bedshare when adverse factors can be eliminated and if the mother is breastfeeding. He has argued consistently in his publications for the best possible education being provided for bedsharing families rather than simply depriving them of information that itself can be life-saving. He insists that so powerful is the biological connection between sleeping close and in contact while breastfeeding that at some point, even those mothers who didn’t intend to bedshare with their babies find themselves doing so because mothers and infants acquire more sleep, babies are happier and more settled, and moms manage their milk supply more efficiently.

DR. JAMES McKENNA:
“I hope the lactation committee and parents everywhere will rise up to correct the deficiencies of this overly simplistic statement and remind the authorities that it is not their right or capacity on any level to decide where an infant will sleep but the parents’ decision. Indeed, access to each others bodies in the context of the infant eliciting its needs and the mother responding (infant to the mother’s, mother to the infant’s) is an inherent civil, human right [emphasis mine].

Sleeping with a baby is biologically appropriate and will not be subject to cultural, political or medical nullification. Breastfeeding mothers sleeping next to an infant on the same surface or close by is how the system was designed by nature to work, optimally maximizing the chances of infant survival.

Safe infant sleep begins prenatally by the mother never ingesting smoke during her pregnancy as smoke is absorbed by her fetus/infant to damage critical specific brain cells required for lifesaving infant protective responses to breathing pauses and apneas, therein maintaining sufficient oxygen saturation levels.

Safe sleep begins with exclusive breastfeeding for the first six months.  This protects infants from SIDS and other kinds of deaths, likely because infants sleep more lightly and arouse more frequently, while increased protection is simultaneously afforded by receiving mother’s home grown antibodies targeted against microbes or germs found in the very environment in which the infant will live.

Safe infant sleep means never letting an infant sleep in a room by itself without the presence of the committed caregiver reminding us that it is not the inert walls of the room during “roomsharing” that protects the infant but rather who is in the room and what they do while sleeping close.

Separate surface cosleeping (mother and baby within sensory range on different surfaces) saves infants lives, according to four epidemiological studies.  Safe infant sleep means placing infants on their backs for sleep giving them easy access to mother’s breast, the original function of babies sleeping on their backs.

Safe infant sleep involves exclusive breastfeeding and saves more infant lives from SIDS and other causes of death than safe forms of bedsharing kills them.  That is, safe bedsharing is about the absence of adverse independent SIDS risk factors such as bottlefeeding, placing infants prone, having smoked during pregnancy, other children in the bed and bedsharers taking illegal drugs, sedatives, or alcohol.”
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Those couples interested in lactational amenorrhea should read The Seven Standards of Ecological Breastfeeding: The Frequency Factor.  It lists over 20 benefits to bedsharing besides the benefit of extended breastfeeding amenorrhea.

Additional reading recommended is The Womanly Art of Breastfeeding. This La Leche League manual has good information on bedsharing.

I would also encourage you to go to “links” at www.NFPandmore.org.  Scroll down and review the information and brochures on safe bedsharing guidelines, especially when breastfeeding.

For excellent information on bedsharing, go to Dr. McKenna’s website.  He “has powerpoints, articles (downloadable) and videos with interviews about cosleeping and explains how to bedshare as safely as is possible.”  Also read an excellent blog on the scar tactics of Milwaukee’s Safe Sleep Campaign.  Another interesting article shows a country’s Infant Mortality Rate could be related to the number of vaccines required by that country.

Sheila Kippley
The Seven Standards of Ecological Breastfeeding: The Frequency Factor

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