Hi everyone
I received the following from James McKenna, might help with letter-writing
and discussion.. not as direct quotes but as ideas for your own letters.
Jan Cornfoot
[log in to unmask]

> 1) The <underline>unqualified</underline> claim that to sleep next to,
> within arms reach of an infant, is to put the infant at increased risk,
> is pattently absurd and cannot be supported scientifically, and does
> not accord with the world ethnographic data which shows that only in a
> cosleeping/breast feeding context, are the babies chances of survival
> and well-being enhanced.
>
> 2) The most sereious difficulty is that  the authors fail to
> differentiate between bedsharing per se, and the various kind s of
> circumstances within which it can occur--which ranges from potentially
> beneficial, to benign, to risky. Like crib sleeping, bedsharing should
> be conceptualized in terms of a range of possible outcomes--each one of
> which depends on the motivations of adult cosleepers--thier awreness of
> safety issues--the structures they sleep on--nature of bedding etc
> etc...and what they do with theinfant once in bed. Bedsharing, as
> McKenna has argued, is more than a location--and treating it as if it
> were the same everywhere it is practiced--represents a gross
> simplification of a complex phenomenon,which when done ssafely can be a
rewarding experince for the families.
>
>
> 3) Also , what perhaps is one of the paper most serious weaknesses is
> that the authors fail to make  a distinction between bedsharing and
> infant parent cosleeping and the two need to be distinguished, as
> McKenna argued in 1993. Cosleeping is a generic concept--bedsharing a
> particular "type of cosleeping. While all bedsharing is a form of
> cosleping, not all cosleeping is represented by bedsharing. Cosleeping
> occurs whenever the mother and infant sleep withn proximity to permit
> each to detect the senosry signals or cues of the other--even when they
> are sleeping on different surfaces--like when the crib is next to th e
> bed.  To use the concepts interchangeably (cosleeping and bedsharing)
> is not to acknowledge that different forms of cosleeping require
> different kinds of precautions--and that, certainly, the types of risks
> associated with one kind of cosleeping are not always relevant to other
> types. To lump them together and to dismiss them all or to characterize
> them all as "dangerous and risky" is completely unjustified and lacking
> in preciseness and scinetific accuracy.
>
>
> 4) The New Zealand Cot Death study  found, for example, that babies
> that sleep in the same room as their mothers (but not siblings) are
> four times less likely to die of SIDS, and Peter Fleming's
> epidemiological study (the Cesdi study in Great Britain)  show that
> where babies sleep in the same room with their mother--are taken in and
> out of the bed to breast feed..and, hence, bedshare episodically,  and
> room share when not in bed with the mother, --their chances of dying
> from SIDS are less than babies sleepining in a diferent room, in a
> crib, by themselves! Moreover, while Fleming's study show that
> bedsharing can be dangerous where mothers sleep with their babies on
> sofas--or bedshare in combination with maternal smoking--the CESDI
> study  rpovide  no data showing that SIDS risks are increased where
> mothers do not smoke, but breast feed and bedshare! The British sample
>  did not include enough mothers bedsharing under the most optimal
> conditions--i,.e.  bedsharing on hard mattresses, when breast feeding,
> among nonsmoking mothers. Therefore, no statements can be made about
> the relative advantages or disadvantages of  bedshaaring for this low
> risk group of mothers.
>
>
>
> 5) From their own data the authors could just as easily have argued
> that infants sleeping alone in a crib, under  unsupervised conditions,
> carries as much of a  risk to infants, when done unsafely,  as infants
> sleeping on adult beds, unsupervised, or, with parents, but under
> unsafe bedsharing conditions. That they chose to select only
> bedsharing---as a practice to be to "discouraged"  (and notjust the
> dangerous conditions associated with some bedsharing)  rather than
> unsupervised crib sleeping, reflects cultural bias, rather than
> objective analysis. It also displays  a dismissal of at least 50 years
> of studies in developmenta l psychology and anthropology  which show
> how and why increased contact between babies and parents is highly
> significant to healthy  human development and healthy mother-infant
> attachment and breast feeding.
>
>
> 6) The authors jump from a delineation of dangerous conditions--to a
> characterization of all bedsharing, using dangerous conditions as a
> proxy for the act of a mother and baby lying next to one another.
>
>
> 7) Since cosleeping in th e form of bedsharing challenges existing
> cultural and scientific norms, it is apparently acceptable to use the
> extreme dangerous conditions that can be found under  tragic
> circumstances, as the characterization of all bedsharing--all
> cosleeping, independent of the social and physcial circumstances within
> which it occurs. <bold>But notice that when the dangerous circumstances
> are delineated for crib sleeping, the dangerous conditions become the
> focus for problem -solving  and the elimination ofthe  dangerous
> conditions,  not the practice of crib sleeping itself. In other words,
> where the sleep practice is deemed acceptable and preferred to the
> authors--crib sleeping--problem associated with practice are simply
> problems to be solved or avoided---but where problems can be associated
> with bedsharing--no longer are the problems to be solved--but the
> entire practice, for all people, under all circumstances--under all
> conditions (safe or unsafe) is to be recommended against! This is an
> example of cultural values underlying scientific interprettaion and
> practice.</bold>
>
> 8) The data in the article fail to support the conclusion reached--that
> bedsharing should be dsiscouraged-- . No information is given on how
> many of the total bedsharing deaths are explained by the presence of
> dangerous conditions--asopposed to the  act itself. Dangerous
> conditions could pertain to instances wherein parnets are
> drunk,desensitized by drugs, or perhaps  onepartner didnot know
> thatthebaby was in the bed.  Maybe themother smoked--didnot breast feed
> and thebaby was sleeping rpone on a soft mattress andhad its head
> covered because theparent did not know that this was dangerous (whether
> sleeping in a crib or in theadult bed).  Of those bedsharing deaths it
> is critical to know: how many o f the total deaths deaths  involved
> overlaying by moters who were breast feeding--and/or were   nonsmoking,
> breast feeding, mothers sleeping on firm mattresses with no dangerous
> sleeping conditions present.
> 9) SIDS risks are extremely high among the urban underclass--among
> socially and economically disenfranchised groups--the very group sthat
> bedshare the most and which are targeted groups for infant mortality
> studies--and which constitute a major proportion of SIDS. These
> populations historically have the highest SIDS risks, SIDS deaths, and
> the most bedsharing behavior, and their cultural values that favor
> parents to "admitting" to the practice--while the cultural values of
> more affluent people favors hiding  fact that  bedsharingis practiced.
> This fact potentially skews the types of  outcomes toward the
> negative--and masks or hides outcomes associated with bedsharing when
> done under more optimal conditions. The authors fail toreport where th
> emajority of bedsharing deatsh came from--what the socioeconomic levels
> were--and this is a major factor in such deaths.  My guess is that only
> a very small proportion of bedsharing deaths were found under favorable
> (safe) environmental conditions.
> > 10) Th e authors assume incorrectly that a baby cannot die from SIDS
> independently of the place it sleeps, unless it dies from SIDS in a
> crib. In other words, current data on SIDS suggests  that some babies
> will die from SIDS even where no risk factors exist. The authors assume
> that if a baby dies from SIDS in the parental bed--then something
> intrinsic to the adult bed, or to an interaction with the mother or
> father--is responsible for the death. or increased its liklihood. Such
> a presumption yet again reflects cultural bias against the biological
> "normalcy" of infant-parent cosleeping.
>
> 11) The authors dismiss and ignore at least eight scientific articles,
> all scientifically reviewed by peers and published in the most
> competitive of scientific journals--which hypothesize that, rather than
> being a source of danger, the presence of the mother next to her infant
> during the night, can confer  benefits particularly through  the
> increased breast feeding it stimulates--breast feeding  known to
> decrease both mortality and morbidity worldwide. As discussed and shown
> in peer reviewed research papers,  routine cosleeping has been shown to
> increase both  maternal and infant mutual sensitivity, reduce the
> amount of time very young infants spend in the deepest stages of sleep
> (which may make iteasier  for some babies to awaken to terminate life
> threatening apneas), increase infant sleep time, and reduce infant cry
> time. Recent articles show that bedsharing increases breathing
> variability which may also be clinically beneficial.   Two of these
> scientifically-based papers were published in Pediatrics and they bot h
> suggest  that infant-parent cosleping in the form of bedsharing, at
> least among low risk groups, potentially change th e physiology o f
> theinfants in ways that migh reduce SIDS. not increase it. Moreover,
> these papers suggest that the presence of mother near the
> infant,itself, places th emother in a position to intervene,should the
> baby confront crises--such as strnagling or choking--the very kinds of
> deaths associated with babies sleeping alone and unsupervised, as
> described in the authors same report.
>
>
> 12). Breast feeding is at an all time high in the United States. Other
> researchers have observed that breast feeding promotes bedsharing. This
> means that probably some form of cosleeping, or partical
> cosleeping--which is so compellingly logical and biologically
> appropriate when mothers breast feed throughout the night and early
> morning hours, (and convenient) ) is probably being practiced at
> unprecedented rates. It is unfortunate that rather than revealing how
> to bedshare or exhibit other forms of cosleeping in the safest possible
> way,  the authors promote a view that will prove very problematic for
> thousands, maybe hundreds of thousands of mothers and babies. One
> possible outcome will be that many mothers and fathers will feel so
> unsupported as to hide the fact that they cosleep from their
> physicians--as has been the pattern until recent years where cosleeping
> has come out of the closet. This paper potentially will drive it
> parents back into the closet for fear of censure.
>
>
> 13) No present epidemiological data exist that show that among
> bedsharing ,breast feeding, nonsmoking mothers, sleeping on firm
> surfaces--that there babies are at increased risks for SIDS. In fact th
> emost recent and oneof the largest epidemiological studies conducted in
> Great britain. led ny Peter Fleming show that :
>
> 41.That accidents or deaths can occur under extreme bedsharing
> circumstances--dangerous circumstances, is nor more an argument against
> all bedhsharing than is th efact that babies die alone in cribs when
> sleeping in dangerous cribs is an argument against all crib sleeping.
> By using the  atedmakes it clear that it is much easier especially in
> western cultures to document.
>
>
> 15) Theauthors simply assume--that bedsharing  cannot be experienced
> safely--that all bedsharing is the same, homogenous, with just<bold>
> one</bold> likley outcome rather than a range of likely outcomes which
> are predicted by a particular conditions within which the bedsharing
> occurs.  In the case of the former (bedsharing)the authors  assume that
> dangerous problems associated with this form of cosleeping are
> unsolvable, or <underline>not worth solving --which is a value
> judgment--</underline> and they insinuate that parents should not
> therefore have the choice to bedshare. In this way, the inferences
> drawn from their  data shows social, scientific and cultural bias--and
> they reflect  assumptions that parents with other goals and concerns
> would not necessarily make--parents whose assessments of risks would be
> different from the authors.
>
>
>
>
> <bold> What I take from the article is some risks are worth taking and
> are acceptable (unsupervised crib sleeping)  while others are not i.e.
> bedsharing. But who has the right to decide this? An analogy could be
> made between the risks of car transportation and safe care seats and
> strapping procedures for infants and children. In the case of car
> transportation, the fact that some parentts fail to properly strap
> their children in, and, hence, children die or are seriously injured in
> automobile accidents, does not lead to the conclusion that, therefore,
> all car transportaion for children should be banned; rather it leads to
> better education of parents--better car seats with easier
> fastenings--it leads to the cnclusion that we need to be more
> sensitized to th eiportance of transporting infants and children in
> cars more safely.. to minimize risks.  We accept those risks--after we
> have done everything to assure safety--because, on balance, the trade
> offs or benefits of car travel outweigh the potential risks--as
> determined by particular families. But in this paper, essentially the
> issue is: since some parents might bedshare unsafely--or because it
> remians possible that some infants may well die accidentally in rare
> situations even when precticed safely (much nobody shouldbe permited to
> cosleep in the form of bedsharing Instead--the risks of solitary , crib
> sleeping are acceptable because, afterall, don't all families agree
> that solitary sleep is the preferred higher family value and goal. I
> say: not at all--this characterization is not congruent with many
> families set of values which lead them to evaluate risks
> differently--and to take precautions needed to bedshare safely.
>
>
> No environment is risk free. And in any particular environment, the
> authors are right that specific knowledge is required to maximize the
> chances of infant safety. The question is, of course, who has the right
> to decide what factors will be weighed more heavily than others--and
> who has the right to decide which aspects of such an  analysis are
> those that should weigh the heaviest in postulating or proposing public
> policy--decisions that parents, who have different values and different
> goals--might have to live with.  My argument is: that a fully informed
> populace-on such complex issues--is better than one informed by limited
> or selective data and interpretation. The conclusion that only
> bedsharing should be discouraged, based on the nature of the evidence
> presented, and degree of specificity of the data, is completely biased
> and inappropriate.

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