Amy Spangler- “Someone’s Been Sleeping in my Bed!”- My Notes

This in no way is the overview of her presentation- this is only my notes from the session at CAPPA 2014 that impacted me. Amy Spangler was the speaker. Here is her website with an article on safe sleeping.

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Amy said that often stats are misleading. For instance there was a study of Sudden Unexpected Infant Deaths that showed 4000 deaths- but only half were really SIDS since 1/2 of the deaths actually had an explanation. The SIDS stats took a dive when the Back to Sleep Campaign was encouraged in 1992 and then again a small hike in 2002 when breastfeeding increased- it was not the breastfeeding that caused it- but they thought perhaps more cosleeping happened due to that and unsafe bed sharing occurred. And in 2007 the campaign for Back to Sleep slipped and the increase occurred that year. The key here is to follow safe bed sharing if you plan to co sleep while breastfeeding. Amy said if you are not breastfeeding she feels the rule should be never to bed share with an infant since there was safety in the fact that the baby was breastfed.

The AAP SIDS recommendations included these suggestions:

  • back to sleep
  • baby sleep nearby but on a separate surface
  • if a baby liked the pacifier- use it at night- (although there was little study on this) but don’t stress over it if the baby does not-
  • do not offer the pacifier until breastfeeding is well established
  • breastfeed
  • never bed share if anyone smokes
  • never share a recliner or sofa
  • never allow a toddler in the same bed as the baby
  • immunize on schedule
  • no bedsharing
  • no crib bumpers along with no blankets or toys

Who actually bed shares? 11% of all folks bedshare. 38% of afro americans, and 20% of hispanic families do. All of these numbers have increased- so if you are going to do it- do it safely!

The question was is the whole idea of overlying a myth or reality? Dr Spock was the instigator of not doing it and Dr McKenna is the one who shouts the benefits of doing it.

Are there benefits to bedsharing? Yes there seems to be more breastfeeding going on and more sleep being had. In fact the studies showed that the moms who sent their newborns to the nursery did not get more sleep at all!

Are there risks to bedsharing? Yes if you do not follow some very basic rules:

  • no water beds
  • no couches
  • no toddlers in the bed
  • no soft surfaces
  • no toys or pillows
  • no blankets
  • no wedges or contraptions that the baby can be trapped between the corners of
  • no drug or alcohol use by bed sharers

Amy shared that the first 28 days is considered the neonate period and should remain with the mom. But moms are not getting the support they need in those first 28 days. She stressed how important it is to not separate the mom during that first month!

She shared what the birth professional’s responsibilities are in teaching this. She suggests never waking a sleeping baby- but play close attention to making sure the baby is getting in 8 to 12 good feeds per day.  She reminded us that the baby’s head growth in the first year is 3 inches. The child will not have another 3 inch growth until they reach the age of 16! So feeding the baby often is a great way to help that baby in that growth!

She reminded us that Dr James McKenna posed two questions- Wiley Abstract

  1. how many babies die because they are placed in an adult bed?
  2. how many babies die because they sleep alone in a crib?

The article was cited in a nursing journal article that stated:

“Cosleeping was found to be positively associated with breastfeeding duration (McKenna, Ball, & Gettler, 2007; Taylor, Donovan, & Leavitt,2008). Mothers who co sleep with their infants were shown to breastfeed their infants twice as often as those who did not cosleep (McKenna et al., 2007). Closeness of the maternal-child dyad should be protected and nurses play a critical role in preventing unnecessary separation. Nurses can support skin-to-skin contact for both preterm and term infants. Mothers who are separated from their child due to illness, employment, or other situations need help in maintaining lactation while separated from their child and the support of those caring for their infants in their absence.”

Amy reminded us that one size does not fit all and we needed to trust that the family could make the best decision for them.

My thoughts: I wonder how much of the recommendations that are made are generalized statements like throwing the baby out with the bath water because the powers of be do not trust that parents will follow safe bed sharing. For someone to be on even a Benadryl for allergies that can cause them to sleep too deeply is drug enough to suggest that their baby not be in their bed. For someone to have a toddler who crawls in bed next to mama over the top of the baby is dangerous. Have the toddler practice sleeping next to dad in the last months of a pregnancy to help them understand this. There are a ton of safe bed sharing recommendations- I in fact have shared an article on this.

So, I am a big fan of having the baby sleep where it gets the most sleep for the most people. But I do feel you can have a baby share your bed safely. So be smart! Just like baby wearing and car seat safety- let’s get  on board with following safe sleeping. And I do trust you will make the best decisions for your family.