Family Bed Safety

By Stephanie Nakhleh
Issue 132, September/October 2005

The Consumer Product Safety Commission (CSPC), which issued a study in fall 1999 warning against the dangers of cosleeping, might have you believe that cribs are safe and family beds are not. But the truth is, there is no inherently safe place for babies to sleep.

The CPSC, which reached far beyond its scope when condemning the practice of cosleeping, based its warning on a poorly researched study that was denounced by many experts—including Mary Sheila Gall, vice president of the CPSC. Gall issued a statement after the study was released criticizing its purpose. "The only peril I can detect in this particular episode is overreaching by a federal regulatory agency," she said.1

James J. McKenna, professor of anthropology and director of the University of Notre Dame's Center for Behavioral Studies of Mother-Infant Sleep, has this to say about the CPSC study: "It attempted to medicalize an event that is a rational issue. It is a safety issue, but not only a safety issue. . . . Most babies die in cribs, so do you conclude that cribs are dangerous and babies should sleep with parents? No, you concentrate on solving the problem, but with cosleeping you attempt to eliminate the practice. That is not science, that is a cultural choice."2

McKenna's work has gone a long way toward helping parents who do choose to cosleep keep their babies safe. Here is a list of rules for family bed safety:

• For parents who smoke, drink, or are unusually heavy sleepers, or use any kind of drugs that inhibit arousal from sleep, cosleeping on the same surface with a baby is not recommended, said McKenna. For these parents, having their child sleep on a separate surface near them, such as a cradle or bassinet, will protect the baby from overlaying while still providing the baby with many of the same benefits as cosleeping.
• Make sure the surface your baby sleeps on is firm. "There are many adult mattresses that can match the stiffness of CPSC recommendations," McKenna said. Avoid waterbeds, lambskins, and other soft bedding for your baby. Stuffed animals and toys should be kept out of the baby's sleep environment.
• Don't give pillows to babies or young toddlers, and keep their faces away from your pillow. Keep blankets away from babies' faces, too.
• Cosleeping babies are kept warmer than solitary sleeping babies, so they need lighter blankets and pajamas. (Being too warm may be a factor in SIDS.)
• Toddlers should not be allowed to sleep next to infants, said McKenna, because "They are too unaware of the dangers their bodies pose." Instead, either the infant or the toddler can sleep on a separate surface next to the family bed—the infant in a cosleeper, crib, or bassinet; the toddler in a toddler bed or mattress on the floor.
• Headboards, footboards, and side rails can be unsafe, especially if a baby is left alone in bed with these trappings. One of the most dangerous situations for young children is getting their heads wedged in furniture, said McKenna. He suggested making sure the child's head can't fit between the side rail and any surrounding surfaces. If a parent is using a crib as a sidecar, make sure the two mattresses are on the same level and held tightly together, so there is no space that a baby could slip into. If a bed is up against a wall, ensure that there are no gaps in which a child's head can get trapped. Another option is to put the mattress right on the floor, so that side rails are not necessary to prevent a baby from falling off the bed.
• Do not sleep on the sofa with your baby, or leave a sleeping baby alone 
on a sofa.
• Do not leave a baby unattended in an adult bed. The benefits of the family bed exist only when the parents are there with the child; if the parents want some adult time while baby sleeps, the child should be put somewhere else—such as a crib, bassinet, or mattress on the floor—until the parents are ready for him to join them, McKenna said.

NOTES
1. M. S. Gall, "Infant Sleeping Study: A Case of Agencies Overreaching," USA Today (12 October 1999).
2. Personal communication, May 2000.

Stephanie Nakhleh is a writer and at-home mother who lives in Santa Fe, New Mexico, with her husband, Charlie, their daughter, Julia (7), and their son, Aidan (4).