Doctors, Researchers And Parents At Odds Over ‘Safe’ Sleep

Nov 14, 2017

The Indiana Department of Child Services says asphyxiation was the leading cause of child neglect deaths in fiscal year 2015. And, according to DCS data, nearly a quarter of those incidents were the result of parents failing to provide safe sleeping environments.

But what constitutes a “safe” sleep environment is an issue hotly debated among medical professionals, researchers and parents.

Parents At Center Of Bed-Sharing Debate

From the moment one steps into Anna and Beth Drowste-Glowinski’s home, it’s clear they don’t get much downtime. The moms have three daughters who keep them busy.

“Each of the girls has different needs,” Anna said.

That’s one of the reasons Anna and Beth decided to co-sleep with their kids. While each of their daughters has her own sleep space in the room, they can move into their parents’ bed if they want to at any point in the night.

“We’re not forcing our children to co-sleep with us, but if they want to come get a snuggle or they feel scared or they might just need a little reassurance, or we’re going through a big transition, we’re here if they need us,” Anna said.

Anna says it also allows her to nurse her youngest daughter in the middle of the night without having to go into another room and sacrifice her own sleep. Josie will often spend the rest of the night in bed with her parents. It’s a practice called bed-sharing and one that Anna and Beth researched extensively before trying.

“There’s a lot of research that shows, especially really young children, bed-sharing regulates their temperature, their immune system, their whole body,” Anna said.

“It’s important when they’re babies to have comfort.”

Government Agencies Say Babies Should Sleep Alone, Researchers Dispute That Advice

Several national organizations, including the Centers for Disease ControlNational Institutes of Health and American Academy of Pediatrics say while sleeping in the same room as an infant can be beneficial, sharing a bed with a baby can be deadly.

The Indiana State Department of Health offers the same guidance to parents.

Josie often sleeps with her parents' bed in the middle of the night.
Credit Barbara Brosher / WTIU News

“We have something that we refer to as the ABCs of safe sleep,” said Holly Wood, the safe sleep coordinator for the Indiana State Department of Health. “A child needs to sleep alone, on their back, in a crib. And, what that means is alone: absolutely nothing in their sleep environment, no blankets, no pillows and no other humans.”

The Department of Child Services said in its most recent Child Abuse and Neglect Annual report 17 percent of the cases it investigated in fiscal year 2015 were child deaths due to asphyxia. The agency says that number demonstrates an increased need for safe sleeping practices

But James McKenna, who runs the Mother and Baby Behavioral Sleep Lab at the University of Notre Dame in South Bend, Indiana, said blanket statements condemning bed-sharing are misguided.

“It’s very frustrating that they use this wonderful goal we all have of reducing infant deaths in this way and making … irresponsible statements about the nature of the parents who are exhibiting this behavior,” he said.

McKenna has observed hundreds of mothers and babies as part of his research over the years. He says bed-sharing can be safe and even beneficial to both babies and their mothers if done under the right circumstances. According to McKenna’s research, only babies who are breast-fed should bed share with their mothers because of the special connection it establishes.

“There is a biological integration of how mothers’ bodies are actually responding and can respond to those babies in a safe, non-drug using environment,” McKenna said.

McKenna said when organizations make blanket statements against bed-sharing, they fail to educate parents about the many factors that can make the practice unsafe.

In all of the bed-sharing deaths DCS investigated in fiscal year 2015, the parents admitted to or tested positive for drugs and alcohol.

“There has been this terrible failure to understand bed-sharing is the beginning of a conversation,” McKenna said. “It isn’t the end of a conversation. It isn’t a discreet variable, it is composed of many variables including the nature of the relationship the mother has with the baby.”

UNICEF’s United Kingdom Baby Friend Initiative offers slightly different safe sleep guidance to parents than most U.S. agencies. Rather than saying bed-sharing is unsafe under all circumstances, it outlines how to safely share a bed with a baby. 

But the State Department of Health maintains bed-sharing isn’t safe under any circumstances.

“Just being asleep next to an infant and having your arm across their chest can actually result in a sleep-related death,” Wood said.

That puts parents like Anna and Beth in the middle of the heated debate, trying to decide what’s best for their children.

“We decided that our doctor doesn’t live with us and they’re not a parenting expert,” Anna said. “So we take medical advice from our doctor and we take parenting advice from parents.”

They plan to keep practicing what they consider safe sleep – giving their daughters the option to make their way into their parents’ bed when they need to.

This story originally appeared on WTIU News and Indiana NewsDesk