Cosleeping vs bed sharing for 4 month old

[katrina2017]

@xuanang01 The good news is once baby has head control, it's much less risky, so you're through the most dangerous window for bedsharing already!

As you note, sleep training is not appropriate for a 4 month old (they should be at least 6 months for this)

Unfortunately there are no RCTs on cosleeping and SIDS which is the gold standard for evidence: https://pubmed.ncbi.nlm.nih.gov/33831222/

All the other data there is is unfortunately just ecological data (correlation). What this means is we can't know for sure whether safer bed sharing is okay, or if it's just that bed sharing has the potential to go wrong more (for instance, if a parent is drunk).

Other parents have mentioned this but we did the floor bed thing - getting them to fall asleep with you, but then leaving. Not sure if this will work for you in a hotel though.

 

[wendio]

@katrina2017 On the contrary evidence I've found says that sleep training is appropriate from 4 months

https://health.clevelandclinic.org/when-and-how-to-sleep-train-your-baby/

I've known paediatricians to give the go ahead earlier in some cases, but 6 months is definitely not the standard age.

 

[stephanie2425]

@xuanang01 I truly don’t want to get into a debate about the socio moral scientific virtues of sleep training BUT.. if you participate in the western industrial work society, sleep training is something created so you can go to work. PERSONALLY I am a chill global citizen of the world cosleep rock the baby to bed all day all night stay-at-home mama but if I were flying helicopters, I’d at least consider sleep training as an option. FYI I’m a twin mom who slept trained my son because he loved it and cuddles my daughter whenever she wants because she loves it. Also, if you’re moving around and in transition, I assume you don’t have a warm consistent place with a nice comfy rocking chair.. which was the #1 purchase in calming both my babies through their first year. Maybe things will settle down when you do.

 

[youthpastor500]

@xuanang01 I think you need to think about all the risks you're managing. Not just SIDS. But like you said, also the physical and emotional risks of mama being so exhausted too. Especially with the type of job you have.

But you have options. Between 4 and 7 months, my baby spent a lot of time in a sidecar crib. So, one wall removed and pushed up against and secured to my side of the bed. I could cuddle him to fall asleep and then (try) to roll away. Roll back to feed or cuddle as needed.

I wouldn't have been emotionally or physically OK if I hadn't bed shared in the first 6 months........ And honestly I wouldn't have been OK if I hadn't done some sleep training after that, even though I never wanted to do it.

Weigh your situation holistically. Experiment and adapt to change. Then don't feel guilty about it.

 

[emmatcheau]

@xuanang01 I can’t believe that anyone feels so comfortable recommending co-sleeping to a stranger online. It’s SO easy for it to go horrifically wrong. Why risk it?Comparing it to the danger of driving a car is a totally false analogy on so many levels. OP, you might need your partner to take over the nights so that you can get sleep. There are other solutions. The survivor bias on Reddit with co sleeping is stifling.

 

[diana14]

@emmatcheau What about the countless other cultures that cosleep as the norm? I understand that there are several aspects of the classic western bedroom set up that are hazardous to an infant but if controlling for these risks then cosleeping as a concept is not hazardous. It is how it is done that makes it risky or not, and not giving information on how to be safe is by far a larger danger than cosleeping itself.

 

[james_1991]

@xuanang01 Is a sidecar bassinet or separate mattress for baby (you could use the crib mattress) an option? That way you can be within hands reach while reducing the suffocation risk.

I bedshare for babys last sleep cycle/first nap (like 6am-9am ish). I personally couldn’t do overnight as I’m a flip flopper sleeper who loves a fluffy doona. But for a few hours I can doze off and get one sleep cycle for me (mostly) which is better than getting in and out of bed and doing the resettle routine.

 

[danielmarcoulis]

@james_1991 Yep, we found a bedside sleeper for bigger babies to use after she outgrew the bassinet and it's been helpful, plus no stress about rolling over etc. We also have a floor bed if a night gets really bad, but it's very very thin and safe for her, meaning it's incredibly uncomfortable and nearly impossible to sleep on for us

 

[alangeh]

@xuanang01 Personally I think breastfeeding in conjunction with closely recreating AAP guidelines in your own bed are the most important things to consider if you are thinking of bedsharing. People shit on the safe sleep 7 but really that’s what those guidelines do - it’s AAP without the crib and with the addition of the mother + extra guidelines on sobriety etc.

No one really talks about it but formula feeding is likely a controllable risk factor for SIDS. While yes there’s a risk of accidental suffocation, the SIDS risk is still higher than the suffocation risk. The formula thing is often overlooked, because for many parents breastfeeding isn’t an option.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2812877/

Case-control studies suggest that formula feeding is associated with a 1.6-(95% CI, 1.2–2.3)1 to 2.1-fold (95% CI, 1.7–2.7)35 increased odds of SIDS compared with breastfeeding. These associations persisted after adjustment for sleeping position, maternal smoking, and socioeconomic status. In reviewing the evidence, the American Academy of Pediatrics Task Force on Sudden Infant Death Syndrome concluded that factors associated with breastfeeding, but not breastfeeding per se, were associated with a lower incidence of SIDS.

We bedshared from day 1 and to this day enjoy snuggling with my 21m old in the family bed. I never experienced the mom exhaustion you hear about, but my career is undoubtedly more low stress than yours! I WFH as a product designer and my husband WFH as a mechanical eng, I took 6 months maternity leave as well. There were definitely difficult weeks where my son would wake up to 9x a night, but it always coincided with him feeling unwell or a growth spurt and after each phase passed he slept better than before.

My husband and I have a very different risk tolerance than a lot of parents on Reddit. For many, the risk of suffocating your child in bed could be 0.00001% and they would never do it, because to them it’s simply not worth it. Then tack on the anecdotal stories from ER nurses/doctors, first responders, and people who know people who lost their baby in bed, and the voices become louder than the millions and millions of families worldwide who bedshare safely each night. You have to decide what’s right for your family.

 

[joew1983]

@alangeh I totally agree that everyone needs to make their own decision based on their own understanding of the risks involved,. However, for clarity, that guideline from ACOG you cite is out of date. It references the AAP's stance in 2006, but they have come out with multiple new evidence bases, incorporating new data and scientific consensus for their recommendations since (the latest is from 2022). From my review of the data, it's actually not safer to continue to breastfeed if that means you need to bedshare. Paraphrasing below from the last time I dove into this research:

As far as I can find from my review of the data, the answer to “if you breastfeed, does that cancel out the risk of bedsharing?” is no.

A few studies clearly highlight that breastfeeding is associated with bedsharing (both longer duration and initial uptake). Breastfeeding for at least two months does reduce the risk of SUID by about 50% (there are four metanalyses referenced to support that order of magnitude decrease in risk in the AAP evidence base but here's one).

But bedsharing increases the risk of SIDS (compared to alone, back, crib sleep) by 288-500%. Even the highest estimates of a decrease in risk of SIDS from an ABC baseline due to breastfeeding peg it at ~60%.

Statistically, bedsharing but continuing to breastfeed is not a safer choice, formula feeding and ABC sleep would be substantially safer, at least according to the evidence we have.

 

[alangeh]

@joew1983 Ah I hadn't seen this new data, thank you for sharing! I'm definitely not suggesting that breastfeeding while bedsharing is safer than formula feeding and following ABC sleep, just that its important to consider if you're thinking of bedsharing. I agree if you breastfeed it does not cancel out the risk of bedsharing.

The point im making above is that breastfeeding + bedsharing is relatively safer than formula feeding + bedsharing.

ETA: after reviewing the data, I’m really glad they finally defined bedsharing: “Parent(s) and infant sleeping together on any surface (bed, couch, chair). Medical examiners prefer the term “surface sharing.” I think it’s super important to note that all surface sharing deaths are not from just bedsharing families, and also include exhausted parents who fall asleep with baby on a couch or chair. I hope they continue to refine these terms for us moving forward.

 

[sawry1]

@alangeh There’s also a 3-11x (mind you surface-sharing is 3x increased risk when no risk factors are controlled) increase of risk for SIDS when not room-sharing before 6 months, but this is NEVER cited as a cause/risk for SIDS in the online safe sleep discussion.

 

[cap1975]

@alangeh Thank you so much for this comment. The formula note gets brushed over way too often in my opinion. Nobody bats an eye here on Reddit if a mother switches to formula to allow herself more sleep (no more night pumping, dad/family can take night shifts, etc.) but mothers asking about bed-sharing will always attract those who want to scare them away from it. I have been bed-sharing since baby was 2wo at the peak of my exhaustion, when I believed my lack of sleep could be dangerous for my baby. If exhaustion is dangerous for someone, it is harmless to at least weigh the risks and come to a decision from there

 

[fangorn]

@cap1975 This is a wild assertion about the risk of formula. Also breastfeeding may help with SIDS reduction, but formula is NOT a contributor. Also what about breast milk that’s been pumped but bottle fed? This leap to point out parents choosing formula = bad parents who shouldn’t be supported or who are the exact same as parents who bed share or whatever is trying to be done really doesn’t belong in this subreddit. Can we remember the science, please? And also not drag other parents?

 

[cap1975]

@fangorn Woah, this was in no way an attempt to drag formula-feeding parents. https://pubmed.ncbi.nlm.nih.gov/19254976/

Some people NEED to bed-share to get a proper amount of sleep. Just like some people NEED to formula feed for their mental health or many other reasons. I'm only pointing out how unfair it is for bed-sharing to still be so taboo and ridiculed on this platform when formula feeding is (rightly) fully accepted.

 

[fangorn]

@cap1975 I don’t find the need to debate this but I’d encourage you to review the line you start with, “no one bats an eye here on Reddit if a mother (ps dads are often part of the decision too…at least mine was) to allow herself more sleep…”

Why would people bat an eye? Formula doesn’t lead to SIDS? Maybe you’re removing a protective element, but again, that’s breastfeeding in particular that may have a protective element not breast milk vs formula.

Also most of us don’t make the decision in a vacuum. No one I know who has chosen formula did so simply because they were tired.

Again, you do you, but it really hurt my heart to see the knock (even if unintentional) against formula, particularly in a science based subreddit.



ETA: I think part of the problem is equating formula choice (or other parenting choices) with an activity that can be connected to SUID. I agree we all have to weigh risks in parenting, and that this will look different for every family. Just didn’t see the need to pull in formula because, well, it’s just entirely different from this topic.

 

[cap1975]

@fangorn A crib/bassinet in this case is the protective element..

I'm sorry if I didn't word that carefully enough, I promise I was not trying to bash formula at all. Formula kept my son fed while we were still learning how to latch.

If you don't want to debate any further I understand! Love and peace to you as well

 

[fangorn]

@cap1975 Appreciate the engagement/context/openness. Cheers!

 

[sawry1]

@fangorn It’s not different. The only difference is that the choice to formula feed is widely accepted and protected (it is the cultural norm in the US) and bed-sharing is widely taboo and shunned (which frankly increases the risk around bed-sharing and sleep deprivation anyways).

Both choices have a link to SUID cases. The debate about “protective factors vs risk factors” is just semantics.

 

[iluvjesu]

@xuanang01 I don’t have any scientific studies to share. Quite frankly I never felt the need for it. I grew up in Mongolia. Over there mothers overwhelmingly breast feed and sleep with their babies. When I had my baby in the US, I expected that and it worked out. My baby now at four months still wakes up and I feed him to sleep. My sleep is interrupted and low quality from sleeping with the baby. But it definitely is better than getting up to a crib or another room. Bed sharing is the only way to survive the nighttime with infants.