Wanted to let you know again about the "good" baby I saw who was gaining
poorly.  Baby was nearly 4 mos, gaining just below the low end of normal,
very happy, and eating infrequently.  After some responses here, I got some
more history from mom and found baby was regularly going 4 hours between
feedings.  And although mom reported responding to baby's cues to eat
quickly, I watched her jiggle, rock, pat, and offer pacifier to this baby
for 20 minutes in my office while baby was giving obvious hunger signs.
Despite being repeatedly reassured that she could nurse the baby (either
while talking to me or I would be happy to wait until she was done if she
was not comfortable) she kept saying "Oh, no, we'll be home soon."  My
partner saw the baby again today.  Mom eventually took the advice of family
and started supplementing with formula.  Baby is still mostly breastfed and
is gaining better.  However, I remain convinced she would have done better
to just nurse more often and on cue!
My question involves co-sleeping.  Do any of you worry about condoning, or
as I frequently do, recommending co-sleeping?  I am thinking of the news
stories I see talking about the dangers, and even the articles in major
peer-reviewed journals.  I frequently take care of families with seriously
disturbed sleep, though, where it's obvious co-sleeping would make everyone
happier.  And of course breastfeeding is so much easier, and night feedings
encouraged better in the family bed.
I admit to worrying more since a young baby in our practice died in bed with
the parents not long ago.  However, this was not at all the type of
situation I am usually recommending the family bed for.  Baby was an
ex-preemie, exclusively formula fed, both parents smokers, baby sleeping on
belly, and both parents and infant sleeping together in a twin bed at a
relative's house.
All of my own babies co-slept, and I've never thought the data on the
"dangers" of co-sleeping was very well gathered.  I have had a lot of
patients ask me about those studies, though.  I am just wondering how the
rest of you feel about making recommendations like co-sleeping, that go
against the current mainstream.
Jennifer Tieman, MD
Family Physician
Mom to 3, and new baby #4 expected 5/31/03

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