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 Crib or Family Bed - which is safer for infants?
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marfknox
SFN Die Hard

USA
3739 Posts

Posted - 04/23/2007 :  19:15:18  Show Profile  Visit marfknox's Homepage  Send marfknox an AOL message Send marfknox a Private Message  Reply with Quote
A friend of mine is having a baby and she's been warned by her health insurance co. against sleeping with the baby. I was a little shocked by this since most of my peers with babies sleep with their babies at least part of the time and I thought the whole fear of smothering the baby was bullshit. After all, human mothers have been sleeping beside their babies for most of our existence and most in the world today still do this. We evolved under such conditions - wouldn't we have evolved a natural precaution against accidentally smother our babies?

Since at least the 70's there has been a big movement to be in direct physical contact with babies more and more, and go against the previous Western, modern notions which favor letting children cry when they have no obvious and immediate needs, and keeping them in cribs, pens, and strollers.

I went to this article on Wikipedia: http://en.wikipedia.org/wiki/Co-sleeping And I found some of the arguments against co-sleeping rather stupid, such as this (what I put in bold):
quote:
Opponents argue that co-sleeping is both stressful and dangerous for the baby,[4] and argue that modern-day bedding is not safe for co-sleeping. They point to evidence that co-sleeping may increase the risk of SIDS,[4] and argue that the parent may smother the child or promote an unhealthy dependence of the child on the parent. On the other side, they note that this practice may interfere with the parents' own relationship in terms of reducing both communication and sexual intercourse at bedtime.
First, it should be noted that advocates of co-sleeping argue that the risk of SIDS is greater in a crib. (Who is right on that point?) How can sleeping next to the parents be more stressful for a baby than sleeping alone? Given our evolutionary history, I would think that babies are programed to be fearful of being left alone in the dark - that's when they would have been most vulnerable to predators. And how can a baby have an unhealthy dependence on its mother? Studies such as those cited in biologist Sarah Hrdy's book Mother Nature say that children with the most attentive mothers become more independent while children with more aloof mothers become overly attached and timid. As for reducing "communication" or "sexual intercourse", how does the baby's presence inhibit the former (I would think it would provide another avenue for a couple to bond), and I would think a baby screaming in a crib would be just as disruptive of sex as a baby sharing the bed. What couples only have sex at bedtime anyway? It seems that could be easily worked around. Sleeping with a baby is not the same as having a baby glued to you.

The only legit criticisms of co-sleeping seem to be the whole modern bedding thing (heavy bedding and falling can be a hazard) and not sleeping with the baby if you are on drugs or alcohol. Gee... duh.

I'm gonna have to agree I think with this article: http://www.askdrsears.com/html/10/t102200.asp

quote:
Until a legitimate survey is done to determine how many babies sleep with their parents, and this is factored into the rate of SIDS in a bed versus a crib, it is unwarranted to state that sleeping in a crib is safer than a bed.

If the incidence of SIDS is dramatically higher in crib versus a parent's bed, and because the cases of accidental smothering and entrapment are only 1.5% of the total SIDS cases, then sleeping with a baby in your bed would be far safer than putting baby in a crib.

The answer is not to tell parents they shouldn't sleep with their baby, but rather to educate them on how to sleep with their infants safely.

"Too much certainty and clarity could lead to cruel intolerance" -Karen Armstrong

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beskeptigal
SFN Die Hard

USA
3834 Posts

Posted - 04/23/2007 :  19:57:18   [Permalink]  Show Profile Send beskeptigal a Private Message  Reply with Quote
Ask Dr. Sears?

Try these sources:

American Academy of Pediatrics has a position statement on infant sleeping positions.
quote:
1.Infants should be placed for sleep in a nonprone position. a supine position (wholly on the back) confers the lowest risk and is preferred. However, a side position also carries a significantly lower risk than a prone position. If the side position is used, caregivers should be advised to bring the dependent arm forward, to lessen the likelihood of the baby rolling into a prone position.

2.Soft surfaces and gas-trapping objects should be avoided in an infant's sleeping environment. Of particular importance, soft surfaces such as pillows or quilts should not be placed under a sleeping infant.

3.The current recommendation is for healthy infants only. The pediatrician should consider the relative risks and benefits. Gastroesophageal reflux and certain upper airway anomalies that predispose to airway obstruction and perhaps some other illnesses may be indications for a prone sleeping position.

4.The current recommendation is for infants during sleep. A certain amount of "tummy time," while the infant is awake and observed, is recommended for developmental reasons and to help prevent flat spots on the occiput.

No mention of whose bed except for the bedding issues.


A more recent study notes, Higher SIDS Risk Found in Infants Placed in Unaccustomed Sleeping Position.
quote:
Infants accustomed to sleeping on their backs who are then placed to sleep on their stomachs or sides are at an increased risk for SIDS-greater than the increased SIDS risk of infants always placed on their stomachs or sides. The study, conducted by Kaiser Permanente in Northern and Southern California and supported by the National Institute of Child Health and Human Development (NICHD) and the National Institute on Deafness and Other Communications Disorders (NIDCD), appears in the current issue of the American Journal of Epidemiology.

The study also shows that infants sleeping on their sides are at an increased risk of SIDS. The researchers think that a large part of the risk may be due to the instability of the side sleeping position and the tendency for infants sleeping in this position to turn onto their stomachs.

The study, which was conducted in 11 counties in Northern and Southern California, is the first to examine the relationship between infant sleeping position and SIDS in a racially diverse U.S. population. The incidence of SIDS has declined over 50 percent since 1992, when the American Academy of Pediatrics recommended that infants be placed on their backs to sleep. Before the current study, evidence of the link between stomach sleeping and SIDS risk was based largely on overseas studies, where populations and cultural practices are different from those in the United States.




Then there is this data, Bedsharing and maternal smoking in a population-based survey of new mothers.
quote:
Some studies have found that bedsharing is associated with SIDS, but, to date, there is only strong evidence for a risk among infants of smoking mothers and some evidence of a risk among young infants of nonsmoking mothers. Despite the lack of convincing scientific evidence, bedsharing with nonsmoking mothers remains controversial....

CONCLUSIONS: Although a number of case series have raised concerns about the safety of mother-infant bedsharing, even among nonsmoking mothers, this has not yet been confirmed by careful, controlled studies. There have been 9 large-scale case-control studies of the relationship between bedsharing and SIDS. Three case-control studies did not stratify by maternal smoking status, but found no increased risk for SIDS. Six case control studies reported results stratified by maternal smoking status: 1 study, while asserting an association, provided an unexplained range of univariable odds ratios without CIs; 3 found no increased risk for older infants of nonsmoking mothers; and 2 found a risk only for infants <8-11 weeks of age. Despite the preponderance of evidence that bedsharing by nonsmoking mothers does not increase the risk for SIDS among older infants, the recent specter of bedsharing as a cause of SIDS, based on uncontrolled case series and medical examiners' anecdotal experience, has led some medical examiners to label a death "suffocation" or "overlay asphyxiation" simply because the infant was bedsharing at the time of death. This "diagnostic drift" may greatly complicate future studies of the relationship between bedsharing and SIDS. Epidemiologic evidence shows that there is little or no increased risk for SIDS among infants of nonsmoking mothers but increased risk among infants of smoking mothers and younger infants of nonsmoking mothers. It seems prudent to discourage bedsharing among all infants <3 months old. Young infants brought to bed to be breastfed should be returned to a crib when finished.




Which is where these conclusions come from, Clinical inquiries: What are safe sleeping arrangements for infants?
quote:
Non-supine sleep position and parental tobacco use are known risk factors for sudden infant death syndrome (SIDS). Recent studies show that co-sleeping (bed sharing) slightly increases the overall risk of SIDS (strength of recommendation [SOR]: B) and is greatest for infants less than 11 weeks old (SOR: B). The relationship between bed sharing and SIDS is strongest for infants whose parents use tobacco (SOR: B). Infants who sleep in a room separate from their caregivers or on a couch or an armchair are at increased risk for SIDS (SOR: B). Using bedding accessories such as duvets or pillows may increase an infant's risk of SIDS (SOR: B).

If you go with the science you want your baby in your bedroom but not in your bed (because we don't know if it's a risk yet but it might be) on his/her back when sleeping for the first three months.

My feelings in the matter are that sleep is hard enough to get in those first 3 months. If you fall asleep while baby's feeding once or twice don't sweat it, but putting baby back in the bassinet in between meals might just give mom a bit more rest over all (speaking from experience here). If you are there when baby wakes up and baby dozes off quickly in that bassinet after eating, I don't think you'll have security and/or bonding issues. I imagine in the first 3 months an infant could be asleep with a warm puppy and wouldn't know the difference as long as they were attended to when they cry.


Edited by - beskeptigal on 04/23/2007 20:11:12
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Dr. Mabuse
Septic Fiend

Sweden
9688 Posts

Posted - 04/23/2007 :  20:03:42   [Permalink]  Show Profile  Send Dr. Mabuse an ICQ Message Send Dr. Mabuse a Private Message  Reply with Quote
quote:
Originally posted by marfknox
We evolved under such conditions - wouldn't we have evolved a natural precaution against accidentally smother our babies?

We didn't evolve soft beds until very recently.
If the mattress is soft, you might roll over and press down the baby under you without noticing. If you're sleeping on the hard ground you'd feel you rolled into something bumpy.

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beskeptigal
SFN Die Hard

USA
3834 Posts

Posted - 04/23/2007 :  20:09:55   [Permalink]  Show Profile Send beskeptigal a Private Message  Reply with Quote
Re Dr and Ns Sears, they certainly have the experience, and they did report on the science, sort of.
quote:
The data on the first question is available, but has anyone examined it? In fact, one independent researcher examined the CPSC's data and came to the opposite conclusion than did the CPSC - this data supports the conclusion that sleeping with your baby is actually SAFER than not sleeping with your baby (see Mothering Magazine Sept/Oct 2002). As for the second question, many people may think that very few babies sleep with their parents, but we shouldn't be too quick to assume this. The number of parents that bring their babies into their bed at 4 am is probably quite high.
Probably they refer the reader to Mothering Mag because of their assumptions about their audience. But I like to check on those kind of sources for accuracy just to be sure. There was an Oregon study I passed looking for the stuff in my other post that did find a very large portion of parents sleep with their infants. But as far as the safety, I didn't see much that said there are "benefits" for having the baby in one's bed. It's important not to let clinical silliness or extremes interfere with natural parenting. OTOH, some people go a little too far the other way and take the "natural" part too far as well. There are a lot of dangerous practices parents have done routinely in the past that have been stopped with actual examination of the practice. Animals sleep with their nursing offspring but they don't have beds and blankets usually. So whose to say what's 'natural' given the technology which is the natural state for humans now.




Edited by - beskeptigal on 04/23/2007 20:10:40
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Hawks
SFN Regular

Canada
1383 Posts

Posted - 04/23/2007 :  21:30:25   [Permalink]  Show Profile  Visit Hawks's Homepage Send Hawks a Private Message  Reply with Quote
quote:
What couples only have sex at bedtime anyway?

Most likely the ones that have attention-demanding infants and toddlers in the house.

I think that there are better reasons than safety for not having your baby in bed with you (well, not better maybe, but pretty good). Judging from a sample size of one, I claim that the snorting and constant moving around is reason enough to have the little ones sleeping in a separate room - preferably on the other side of the house.

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Siberia
SFN Addict

Brazil
2322 Posts

Posted - 04/24/2007 :  08:33:25   [Permalink]  Show Profile  Visit Siberia's Homepage  Send Siberia an AOL message  Send Siberia a Yahoo! Message Send Siberia a Private Message  Reply with Quote
quote:
Originally posted by Hawks

quote:
What couples only have sex at bedtime anyway?

Most likely the ones that have attention-demanding infants and toddlers in the house.

I think that there are better reasons than safety for not having your baby in bed with you (well, not better maybe, but pretty good). Judging from a sample size of one, I claim that the snorting and constant moving around is reason enough to have the little ones sleeping in a separate room - preferably on the other side of the house.


From a sample size of 2, my mother slept with both me and my sister in a crib right next to her bed, close enough that she could touch us or immediately tend to us. According to her, we never cried a lot through the night - we usually slept all night long, even when I was ill. Knowing my mother, I'm sure she sometimes slept with us in her bed as well (and with me until I was about seven; she's a single mother and I need physical help to do everything, so she prefered to keep me close to her, as I had to take medication through the night and such), especially after the husband(s) were kicked out (first one because she discovered he'd been lying to her the whole time, second because he couldn't cope with my illness). She never liked soft beds, so...

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Gorgo
SFN Die Hard

USA
5310 Posts

Posted - 04/24/2007 :  09:29:58   [Permalink]  Show Profile Send Gorgo a Private Message  Reply with Quote
I think you bypassed some questions. Never get married. If you get married, never have children. If you don't get married, never have children. If you get married, never get divorced. If you get divorced, never marry again. If you marry again, never have children. If you don't get married again, never have children.

As you can see, your questions is therefore now and fer all time answered and if you follow all these rules, you shall never suffer from the mistakes that married people make, and that parents make.

Glad I could help.

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Original_Intent
SFN Regular

USA
609 Posts

Posted - 04/24/2007 :  12:49:15   [Permalink]  Show Profile Send Original_Intent a Private Message  Reply with Quote
Parenting advice: What worked/works for us.

I have a toddler turning 2 in May, and a 1 week old. As my toddler is a perfectly healthy rambuncious bundle of energy who (for the most part) is able to communicate her needs and desires and is perfectly at home entertaining herself or us.........

1) Dr Spock's Baby and Child Care, updated by Dr. Needleman.

2) What to Expect (the Toddler Years) by Eisenberg, Murkoff, and Hathaway.

3) "Exclusive Attachment Syndrome"..... Hub bub bologna.....

4) Speak softly. Use real words in short sentences.

5) Discipline is something you need to come to an agreement on with your spouse. There is some truth to "spare the rod, spoil the child" I am convinced of this. But each child is difirent. With Maria, as we are not very loud, we scared he when we got loud. No problems with the dangerous stuff (light sockets, electrical outlets, swinging from the chandilier (not yet anyway)). A real loud NO! took care of it. We try to use no only in that context, and use don't for stuff we just don't want her to do. Don'ts have to be repeated.... thats a toddler, the NO! has never had to be repeated.

6) Sleeping with.... Not a great idea if there is any chance of dropping the infant, or rolling over the infant. I have napped with her in my arms, on the couch with us both supported. I would never dar go to bed with her. I almost killed one of my cats that way........

If you choose to have your baby in the same room with you... god luck with that. Do not expect a lot of sleep. YOur hormones are going to prepare you for this (unfortunately not your husband) and will continue to keep you sleeping light for some time. Babies make a lot of noise. grunt/groan/hiccup/small complaint/yawnd/gurgle.... You will find you both sleep better if the baby is out of the room and you have a baby monitor. I am not sure if the new ones have battery backup for the transmitter, I am sure someone has to make one. We have ours hooked to a UPS that belonged to the computers.

7) Currently, as of now, and not neccessarily tomorrow....... The infant should be in a crib with breathable mattress on their back or righ-side. Pillows/bumpers not reccomended.

I am very blessed with two wonderful little girls, and a wonderful wife. I am doubly blessed as my body was failing, and forcing me into severe economical downfalls, my wifes income was going up. Although not at the same level we were, it is not worth it to us for me to seek a serious carear path economicaly. My wife works 24 hours on the weekend, gets' paid for 36 + benefits. I work 4 long days during the week. We only have one good day together, but my children are safe at home with their mother or I, not in a day care.

I just wish that we were economically able to home-school.......

Just remember to take all advice, both written and spoken, with a grain of salt and a starting point to figure out what works best for your baby, for you and your husband.

Maybe more later.... baby in need

Peace
Joe




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HalfMooner
Dingaling

Philippines
15831 Posts

Posted - 04/24/2007 :  15:33:53   [Permalink]  Show Profile Send HalfMooner a Private Message  Reply with Quote
I think one consideration that should be mentioned is drinking. If the parent(s) even occasionally drink heavily before retiring, the baby should not be in the same bed. A numb parent could crush or suffocate a baby without realizing it.

My daughter did not sleep with her mother and I, but in a nearby crib. It seems to me, however, that "co-sleeping" is reasonable in most cases, and may promote child-parent bonding. My tiny Chihuahua slept in my bed for many years without incident. I was somehow aware of her presence even when asleep. However, once I put a heat pad under her own little bed, she has chosen not to sleep with me since. It wasn't bonding or affection she was seeking, merely heat.


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marfknox
SFN Die Hard

USA
3739 Posts

Posted - 04/24/2007 :  15:47:52   [Permalink]  Show Profile  Visit marfknox's Homepage  Send marfknox an AOL message Send marfknox a Private Message  Reply with Quote
HM wrote:
quote:
I think one consideration that should be mentioned is drinking.


It was, in my first post.
quote:
The only legit criticisms (from the wikipedia article) of co-sleeping seem to be the whole modern bedding thing (heavy bedding and falling can be a hazard) and not sleeping with the baby if you are on drugs or alcohol.
I still find this criticism rather obvious. If someone doesn't realize that they shouldn't be sleeping with a baby when they are drunk, they are undoubtedly doing other kinds of reckless parenting.

So it seems the overall verdict is that sleeping with a baby is primarily dangerous in modern times due to soft bedding which can making smothering a slight possibility. Also sleeping with a baby while inebriated is dangerous. To me, these things seem like common sense, but maybe I'm off about that.

I'm more persuaded by the advantages of sleeping with the baby cited in the articles I've read and that my friends have shared with me. Two friends of mine slept with their baby against all advise and in their case it really strengthened their feelings for each other by giving them an opportunity to jointly bond with the baby in a directly physical way on a daily basis. Although originally they started doing it because they got more sleep since they didn't have to get out of bed when the baby woke up. They stopped when their daughter turned 2.


"Too much certainty and clarity could lead to cruel intolerance" -Karen Armstrong

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Edited by - marfknox on 04/24/2007 15:48:11
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Vegeta
Skeptic Friend

United Kingdom
238 Posts

Posted - 04/24/2007 :  16:57:33   [Permalink]  Show Profile Send Vegeta a Private Message  Reply with Quote
Surely its down to personal preference more than anything. Even if there was a minute statistical advantage to sleeping with the baby, I sure as hell wouldn't want to do it and I think most men I know would agree. Especially until it were 2 years old.

I don't know if we evolved this way or not since in tribal times I'm not sure if monogamous couples existed in the same way as today anyway, it may have been the case for the mother to sleep with the baby.

My own paternal instincts would leave me more inclined not to 'encourage independance' but to discourage overdependance on the security of sleeping with the parents. This could be a matter of nurture over nature anyway, as this was the way things happened in my family.

What are you looking at? Haven't you ever seen a pink shirt before?

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Dave W.
Info Junkie

USA
26022 Posts

Posted - 04/24/2007 :  17:41:58   [Permalink]  Show Profile  Visit Dave W.'s Homepage Send Dave W. a Private Message  Reply with Quote
quote:
Originally posted by marfknox

To me, these things seem like common sense, but maybe I'm off about that.
In a world where people must be told that their coffee is hot, and to avoid mixing bathtubs and hair dryers, common sense often seems to take a backseat to authoritarian pronouncements. With that in mind, the more times we see "don't sleep with your baby on a pillowtop bed," the less likely it is that some poor maternity coach will be sued out of business by someone whose entire lawsuit consists of "she never told me not to." Regardless of how obvious something seems to you, marf, it isn't to someone else (and that's true of any proposition you might care to name). And because we're talking about the lives of infants here, I think it's critical that we not downplay the importance of things like the advice to not sleep with your kid when you're plastered. The Law of Large Numbers suggests that someone out there is doing so, right now.

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HalfMooner
Dingaling

Philippines
15831 Posts

Posted - 04/25/2007 :  03:11:41   [Permalink]  Show Profile Send HalfMooner a Private Message  Reply with Quote
I just wanted to add that I'd missed your mention of drinking in my first reading, Marf, or I would not have added the idea.


Biology is just physics that has begun to smell bad.” —HalfMooner
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