I had the pleasure of hearing Helen Ball, an anthroplogist from NE of
England speak about her research into baby sleep and breastfeeding, again
last week.  I don't think I have seen anything about her work here on
lactnet, but I think many of you may be interested.

Helen and her team are doing a long project with different aspects.  They
sampled a large cohort of mother-baby pairs from Stockton/Tees and
interviewed them about their sleeping habits with their babies.  This area
has pretty low bf rates and they spoke to both breastfeeding and formula
feeding mums.  The did interviews at one month and at three months, some
parent kept sleep logs and they also get some parents to volunteer to come
to the sleep lab for three nights of observation -- they use infared camaras
and get whole nights of sleep on film.  the parents do whatever they
normally do (the first night is really to get them used to the situation)
and it is observed.

From the observational data HB has come up with a characteristic sleep
posture of a breastfeeding bed-sharing mother - knees raised (so baby
unlikely to slip benearth the covers), arm bent out to make a shiled to stop
baby creeping up the bed, turned toward the baby -- really making a safe
'nest' for the baby to sleep in.  'I have never seen a breastfeeding mother
turn her back on her baby in bed.'  Whereas bottlefeeding mothers who share
their bed may or may not adopt this posture.

From the observational work, she and colleagues found that bed-sharing is
highly correlated with breastfeeding.  At a conservative estimate she says
that in the early weeks 50 - 75% of breastfed babies share their mothers' /
parents' beds.  Most of these babies are in for some of the time, only 3%
were in all night every night.

Bed sharing declines with increasing infant age.  -- so in HB's view there
are implications about when we / health professionals give information about
bed sharing -- in her view this should happen just after birth.

Bed sharing is most prevalent among youngest babies (no surprises there!) so
this has implications for interpretation of the cot death figures -- it may
look as if youngest
babies are at most risk in their parents' beds, but partly this is an
artifact of this age bias of bed-sharing.

In this study, at 3 months the breastfed babies were still feeding at
similar frequencies to one month, while those who were bottlefed -- either
from birth, or changed to bottlefeeding -- were sleeping longer at night.
HB points out that the norms of infant sleep -- which parents continue to
expect to 'acheive' -- were established in the 50's and 60's, when
breastfeeding rates were at their lowest.

Over the three months studied for the families in this research, there was a
much steeper decline in breastfeeding for those who did not bed-share.
Those who shared their beds with their babies from the beginning were more
likely to continue breastfeeding.  Helen showed some really interesting
figures which showed that this effect was most marked for women in the
lowest social/economic classes.

"Babies evolved to sleep with their breastfeeding mum."

She talked about bed-sharing safety and also implications for SIDS, but
perhps this email is long enough.

Ball, HL, Hooker, E, Kelly, PJ (2000) Parent-infant cosleeping: fathers'
perspectives and roles.  INfant and Child Development 9(2) 67-74

Ball, HL, Hooker, E Kelly, PJ (1999) Where will the baby sleep? Atitudes adn
practices of new and experienced parents regarding cosleeping with their
new-born babies.  American Anthroplogist 101(1) 143-151

Hooker, R, Ball, HL Kelly, PJ Sleeping like a baby: parent-infant cosleeping
in North Tees, England  Medical Anthropologist *in press*

Magda Sachs
Breastfeeding Supporter, BfN, UK

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