Dear Friends:
 
One of the challenges that we have to surmount in our work is the dreadful 
bedsharing contoversy. 
 
On one hand we have researchers, such as Helen Ball, telling us that many 
people take their newborns to bed, no matter how the baby is fed. We know from 
folks like James McKenna that babies breastfeed more if they are with their 
mothers and that safe bed-sharing is possible.
 
We all know that the hormones of breastfeeding make mothers and babies 
sleepy. We also know, again from the lovely work of Helen Ball, that campaigns to 
prevent bed sharing work against breastfeeding.
 
Personally, I wouldn't know how to breastfeed if I couldn't have slept with 
my babies. I always remember our first night home with our newborn; the next 
morning, her father woke up and said with amazement "I got a full night's sleep. 
People told me that I wouldn't once the baby was here." Our daugher slept 
with us, nursed all night, and we all slept.
 
Now that I am working for a Health Department, I am learning how complex this 
topic is from a public health perspective.
From January 2006 to March 2007, 49 cases of sudden unexplained infant death 
occured. The most common risk factors in these deaths were: sleep surface 
(76%), Environmental tobacco (70%), co-sleeping (defined as "in bed with someone") 
ws 66% and maternal tobacco smoke was 56%.
 
50% of deaths had environmental tobacco smoke, unsafe sleep surface, and 
co-sleeping all present. Cribs were available in the home in 56% of deaths. Never 
breastfed was a factor in about 45% of the cases.
 
Public health wants to give simple messages that apply to everyone, that can 
be understood by everyone, and that promote health.
 
An example is about car seats. Car seats save lives. This is true. So the 
message to the public is to use car seats all the time. 
 
But bed sharing is more complex. We can't say that bed sharing is safe for 
all because there are so many variables. Bed sharing babies die as a consequence 
of unsafe sleep surfaces, of being overlain by parents under the influence, 
by tobacco use in the home, by being entrapped, by being put on their stomachs 
to sleep, by being overheated, by sharing a bed with siblings or adults not 
their parents. They also more likely to die of SIDS if they are formula fed.
 
The message: "You can safely sleep with your baby if you breastfeed, if you 
don't smoke, if you aren't under the influence, if your mattress is firm 
without too many covers or pillows or stuffed animals, if it is only the parents, 
and your mattress and bed frame are well-fitting and away from the walls of your 
bedroom...." is so complex that it doesn't lend itself to a public health 
campaign. At least it hasn't so far.
 
Public health campaigns want simple easy messages such as always use infant 
car seats, or immunize your baby, or use condoms if you are not in a monagamous 
relationship. We live in a sound byte world of mass education.
 
I don't know what to do to promote safe bed-sharing in an easy way. Does 
anyone have any ideas? 
 
warmly,
 
Nikki Lee RN, MS, Mother of 2, IBCLC, CCE, CIMI

www.breastfeedingalwaysbest.com



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