First: all of our experiences form us, and our experiences of early
motherhood stay with us for life.  
I honestly believe that every person does the best they can with what they
have.  For us as clinicians this means doing the best we can do, using the
very best information currently available.  It means, too, that some of what
we did as new mothers years or decades ago, we would not do again in light
of current knowledge or in light of our experiences since.

When practicing in a field where we advise others, we have a very strict
obligation to distinguish between what we did with our own children, and
what is safe care given the information available to us today. 

It has been shown that sleeping with a baby in an armchair or on a sofa is
much less safe than sleeping with a baby on a firm, flat bed with room for
both to move about - and probably less safe than letting the baby sleep in a
bed designed to allow a baby normal sleep movements without becoming
entrapped and suffocated.  (I know this is not SIDS, but it is a lethal
outcome and, more importantly, an avoidable one.)  If you did sleep this way
with your child, I'm very happy that it worked for you, but we really can't
advise today's mothers to do it now, and I hope the subscribers on this list
realize that, just as we can no longer advise today's mothers and fathers to
place their babies prone for sleep.  Neither can we pretend that it is OK
for smokers to keep their newborns in their beds, even though the vast
majority do survive.  

Please, let's not commit the cardinal sin in practice that exasperates us to
pieces when other health workers do it, namely the sin of placing one's very
limited and very subjective personal experience above systematically
gathered evidence, when advising others.  If you want to make choices on
that basis for your own life, I won't quibble.  But we all know how we feel
about colleagues in various professions who denigrate breastfeeding and even
sabotage it for others with the argument that 'I didn't breastfeed my kids
and they turned out fine'.  Don't let's do the same thing ourselves.  There
is plenty to criticize in the AAP statement without having to argue on that
level.  I don't mean it is a lower level, because I greatly value personal
experience, but it has its limits in informing practice.

One of the arguments I encourage all of you to use, is the one that there is
no international consensus on bedsharing and SIDS, and quote the English
summary of our report published by the Norwegian Knowledge Centre for the
Health Services (which I have been mistakenly calling the center for
evidence-based practice, because that's how I think it should have been
translated, but never mind).  It is a thick report, like a book, and is a
systematic review of the literature on bedsharing, pacifier use,
breastfeeding and SIDS.  It isn't an article in some other publication, it
is its own publication. 
Here is the URL for the report, English summary from page 34.
 http://www.kunnskapssenteret.no/filer/rapport5-05_krybbedod.pdf
At www.kunnskapssenteret.no you can click on 'English' and read more about
what the center is, its mission, and how it works.  It is an official entity
in the health services and as such carries more weight than a professional
association or an individual.

Rachel Myr
Kristiansand, Norway

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