Apologies for joining this discussion several days late -- just catching up
on the christmas email back-log!

Heather and Gitte both mentioned our research on bed-sharing (or
co-sleeping) in the UK and I would like to add a couple of points that are
particularly pertinent here. We have recently documented (using in-home
bed-sharing video data)that on aggregate, moms who bed-share but don't
breastfeed sleep with their babies in ways that differ markedly from
breastfeeding moms -- primarily involving the position and orientation of
the mother and the baby in the bed. Whereas breastfeeding moms and babies
tend to sleep in a characteristic position that we have talked about before
here on lact-net (mom curled up around baby, baby facing mom at breast
height, mom's arm above infant's head, knees below infant's feet, see
lact-net archives May 2001) moms in our study who bed-shared regularly, but
had never breastfed their infant, did not assume this position as frequently
(some didn't do it at all), they spent less sleep time oriented facing their
infant, and formula-fed infants were positioned at mother's face-height
rather than chest height in the bed (meaning they were either propped up on
the parents' pillows, or were placed in the gap between the parents'
pillows). These findings that formula-fed bed-sharing infants tend to sleep
on or between pillows, that mothers face their infants' for significantly
smaller proportions of the night, and do not create a confined space with
their bodies for their infants to sleep in, all have implications for the
information that is provided to parents about how to bed-share safely. It
would seem that the physical relationship of breastfeeding pairs along a
'breast-baby axis' means a breastfeeding mother automatically sleeps with
her infant in a safer manner than a formula-feeding mother who doesn't
automatically orient her infant to her breast for sleep. Here in the UK, the
Baby-Friendly UK team have recently produced an excellent leaflet on
bed-sharing for breastfeeding mothers (available at their website at:
www.babyfriendly.org.uk/sharebed.html). After I presented the results of the
above study at the BFI UK conference this November, they are discussing
preparing a similar leaflet specifically aimed at formula-feeding mothers --
i.e. teaching them how to emulate breastfeeding bed-sharing. Regarding
Diane's question on preventing bed-sharing tragedies, another means of
encouraging safe bed-sharing therefore, would be to discuss *how* one
physically sleeps with an infant, in addition to advice on when not to
bed-share. Given the high proportion of infants who bed-share at least
ocassionally in the 1st 4 months, I think this information should be
provided to all parents soon after birth.

I should note that we are focussing in our studies on young infants --
generally under 4 months old, as in the UK the peak age of infant deaths in
parental beds is 2 months (UK CESDI report), and the peak age of bed-sharing
is 1 month (publication in prep). Mothers bed-sharing with older infants who
can roll over, grab, attract attention, and also who may feed less
frequently through the night will not necessarily have the same degree of
orientation and vigilance as mothers of younger babies, but we have only
observed a few babies of 4-6 months, and none older than 6 months.

Papers based on the above research have been (and are being)submitted for
publication. I'll let you know when they eventually  make it to print!

Regards, Helen
_______
Helen Ball, PhD, Parent-Infant Sleep Lab, Dept Anthropology, University of
Durham, UK

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Diane wrote:
This baby was bottlefed.  We have a similar case, with a baby placed to
sleep on a waterbed.  Both babies suffocated, were resuscitated, and are
very brain-damaged.  The back-to-sleep program has helped to reduce the
incidence of SIDS, but I'd like to help prevent cases such as these.
Yes, I've fallen asleep breastfeeding my babies in bed.  But when you see
the results of these tragedies, you really desire to prevent them.
Diane, RNC, MSN, PNP

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