The U.S. Healthy People goal for 2020 is to increase the number of women who exclusively breastfeed their infants in the first three months to from 33% to 46.2%. And UNICEF and other international organizations are also actively promoting the practice.
But there is far from unanimous agreement on bedsharing. La Leche League and many parent groups support it because they believe it encourages nursing, while the American Academy of Pediatrics recommends against it because of an increased risk of suffocation and SIDS.
It certainly seems as if bedsharing makes breastfeeding easier, but until a new study published today in JAMA Pediatrics, there was incomplete evidence that the practice actually helped mothers nurse more or longer. There was always the chicken versus egg dilemma: does nursing promote bedsharing or the other way around?
The new research, based on the Infant Feeding Practices Study II, enrolled pregnant women and sent them questionnaires periodically during their babies’ first year. The study results showed that frequent bedsharing was in fact associated with mothers who breastfed longer. Those who bedshared moderately nursed for less time but still longer than the women who rarely shared beds. So, yes, says study co-author Dr. Fern Hauck, a professor of family medicine at the University of Virginia, “The two things are quite intertwined, but we believe that bedsharing promoted breastfeeding, not the other way around.”
Still, she cautioned, physicians’ groups are not recommending sharing a bed with baby because placing infants in adult beds is associated with three times the risk of suffocation or SIDS, even among parents who do not drink, smoke or take drugs. The risks are even higher for parents who do. More research is needed, she says to find other, safer ways to encourage breastfeeding.
The American Academy of Pediatrics currently recommends that parents place babies in their own, safe place in the parents’ room. It can be near their mothers’ bed for ease of nursing, but when finished feeding, mothers should put babies back in their dedicated crib or bassinet.
On a psychological note, Dr. Fran Walfish, a child and family psychologist in Beverly Hills and author of The Self-Aware Parent, says that although it may seem easier for mothers to let babies fall asleep at their breast, doing so may ultimately make things harder. “A key life coping skill is developed when babies are allowed to learn self-soothing in order to fall asleep,” Walfish says. She recommends gently arousing your baby and meeting her eyes when putting her down. “Say goodnight, kiss her and lay her into her crib,” she suggests. Babies will learn to soothe themselves with a thumb, pacifier, or, later, a love object.
While it is typical for breastfed babies to fall asleep at the breast and sleep more soundly, Hauck says, there’s a dark side to such profound slumber. “We believe,” she explains, “”that SIDS is a disorder of arousal. So if babies are sleeping too soundly and they get into a position like getting the nose down into the mattress, they are at higher risk of SIDS.”
So how do new moms balance the benefits of staying physically close to their newborns while not putting them at risk of SIDS? Room sharing might be a solution, say some experts. “Keeping the mother and infant together for most of the time, including night time,” says neonatologist Dr. David daCosta at Henry Ford Hospital in Detroit, “represents the most biologically appropriate arrangement simply because breastfeeding is not possible or easily managed without it. In my mind, room-sharing with safe-sleep practices would produce similar benefits in motivated parents.”