What do co-sleeping and condoms have in common?

Edited to add:  The author of this piece is very PRO-CO-SLEEPING.  Look at the references cited, look at the risks of cribs pointed out.  This article is about how we don’t tell families how to safely co-sleep and nothing more.  It’s not a statement about religion, teen sex or anything, despite what the commenters may say.  You can sum this article up as: Dear Establishment, Just because you won’t talk to us about co-sleeping doesn’t mean we won’t do it, we’re going to do it anyway.  Therefore, please tell parents what safety precautions we can take to make it even safer.  Thank you, Co-sleeping Parents.

Abstinence versus birth control education.  I like to think that this is a done deal when it comes to health educators and public health officials.  While abstinence can prevent pregnancy and sexually transmitted infections, it is simply not an obtainable goal for the vast majority of people through out the course of their life time.  This means that something else has to come into play to help keep them as safe as possible as they make reproductive choices.  This means we teach them about birth control methods and condoms to help prevent pregnancy and sexually transmitted infections.  We empower them to speak up and given them choices, including abstinence.

Sharing sleep surfaces with your baby is the exact same argument.  You can tell a family that they shouldn’t sleep with their baby.  You can explain all of the reasons why your organization or you as an individual do not believe in it.  But when you fail to explain to them that should they choose to sleep with their baby anyway, that they can do it in a way that is safer than not following a few guidelines, then you are missing an opportunity to empower them to make choices that might be life saving for them as a family.  You also prevent them from talking to you about the truth.

Some co-sleeping facts:

  • Co-sleeping is having your baby sleep closely to you, as in, in the same room or potentially on the same surface, or in a co-sleeper
  • The American Academy of Pediatrics recommends that your baby co-sleep in your room, but not on the same sleep surface, for at least the first few months.
  • Never sleep with your baby on a couch or recliner
  • Talk to all caregivers about safe sleep practices with your baby
  • If you choose to sleep with your baby in your bed there are guidelines that you should follow.  These include, but are not limited to:
    • A firm mattress
    • No fluffy bedding or pillows, quilts etc. used
    • Do not place the baby near the head board or the wall
    • Do not sleep with your baby on a water bed
    • Do not sleep with your baby if you are taking any medications, even over the counter medications, that may make you sleepy or disoriented
    • Do not sleep with your baby if you have been drinking or using drugs
    • Sleeping with your baby on your bed is safest when you do not smoke
    • Breastfeeding helps you be responsive to your baby when sharing a sleeping surface
  • Babies are safest when sleeping on their backs
  • Don’t leave your baby alone on the bed, even if you think that they can’t roll over or move
  • There are safety rules for cribs, cradles and co-sleepers as well, particularly having to do with the make and set up of the actual equipment.  11 million cribs have been recalled in the last two years alone.  56% of deaths associated with safety products are related to cribs, cradles, etc. 77,000 injuries are reported due to nursery products with the vast majority being related to sleep surfaces like cribs, play yards, etc.

The point is to open the conversation.  To give parents, providers, educators – everyone, a voice.  Open the bedroom doors and talk about what happens at night when the lights go out.  Parents are faced with choices, and this is one of them.  Not giving them all the information that they need to make a decision, because you don’t like what that choice might be, is not a reason to withhold vital information.


AAP. American Academy of Pediatrics (AAP) Task Force on Sudden Infant Death Syndrome. The changing concept of Sudden Infant Death Syndrome: Diagnostic coding shifts, controversies regarding the sleeping environment, and new variables to consider in reducing risk. Pediatrics 2005; 116: 1245-55.

Ball HL. Reasons to bed-share: why parents sleep with their infants. J Reproductive and Infant Psychol 2002; 20: 207-21.

Gettler, LT, McKenna, JJ. Never Sleep with Baby? Or Keep Me Close But Keep Me Safe: Eliminating Inappropriate “Safe Infant Sleep” Rhetoric in the United States. Current Pediatric Reviews, 2010, 6, 71-77.

Lahr MB, Rosenberg KD, Lapidus JA. Bedsharing and maternal smoking in a population-based survey of new mothers. Pediatrics 2005; 116: E530-42.

McKenna JJ. Sleeping with Your Baby: A Parent’s Guide to Cosleeping. Platypus Media. 2007.

McKenna JJ, Ball HL, Gettler LT. Mother-infant co-sleeping, breastfeeding and sudden infant death syndrome (SIDS): What biological anthropology has discovered about normal infant sleep and pediatric sleep medicine. Yearb Phys Anthropol 2007; 50: 133- 61.

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10 Responses to What do co-sleeping and condoms have in common?

  1. Melissa says:

    It just doesn’t make any sense to liken co-sleeping to condom usage a la the “well, if they’re going to do it (the bad irresponsible risky thing) anyway, we might as well teach them how to minimize the risk” model of thinking. Why? Because at the very least, the jury is still out: some very good research, as well as world-wide practices, show that co-sleeping is already the more safe, more “responsible” choice. If you’re going to make that metaphor work, it’s less distorting to liken co-sleeping to the sexual behavior with the lowest absolute risk, not the “riskier-but-well-everyone-has-to-make-their-own-decision” choice. Perhaps the only insight one can really take away from this post is that crib- and co-sleeping arrangements are both reasonable (if not inherently equal) choices that individual parents should make according to their own situations without needing to fear condemnation from the “other” camp, and that there are “bad” ways to co-sleep, so they should be careful to avoid those.

    There is some very, very good evidence that co-sleeping (safely, of course!) is safer for your baby than being in a (safe) crib, especially with regard to their risk of dying from SIDS. Why on earth would you portray co-sleeping as inherently more risky? Be careful of your sources: the nursery furniture industry succesfully got “crib death” changed to SIDS; they are also the source of much of the “co-sleeping is dangerous!” research.

    Let’s at least compare apples to apples from the get go, shall we? That is, let’s compare safe crib sleeping with safe co-sleeping, and not (safe) crib sleeping as against any arrangement that could possibly be interpreted as co-sleeping (couch, inebriated caregiver, etc.). We also need to remember to address concerns such as the effect different sleep arrangements have on a breastfeeding relationship, given how important that is to both moms and babies, and how many lives it saves.

    Would you be willing to look into this issue a little more deeply? As it stands, the post just muddies the waters and is not terribly helpful.

  2. Tina says:

    This is an interesting analogy, and I completely agree that families should be offered education on safe co-sleeping. However, this analogy does put co-sleeping in a bad light. Abstinence is the only way to 100% avoid pregnancy and STIs, but a sexually active person can use condoms to lower their risk of these things. Using this analogy, you’re saying that sleeping in a crib is the only 100% safe way to sleep (or prevent SIDS), but for people who decide to co-sleep, they can reduce their risk by following the above mentioned safer sleeping habits (which are great by the way!). I don’t mean to attack your article, because I completely agree with your message, I just think it has the potential to backfire.

  3. Cassie says:

    I agree with Melissa, 100%. From my viewpoint, through personal experience, anecdotal evidence, and research evidence, co sleeping, when done responsibly, is safer than crib/solo sleeping. No one would ever say that under some circumstances, when used responsibly, using a condom is safer than abstinence.

  4. Libby says:

    This is certainly not an anti-cosleeping post. I think that the point is, we don’t tell people what safe co-sleeping looks like and that by NOT telling them, that’s where the failure is. I don’t get that anyone is saying that cribs are safer – why would she point out all the crib deaths and stuff?

    Take a deep breath and look at it again.

  5. Melissa says:

    The problem is not the education about how to co-sleep safely. (Of course not!) Nor is it the invitation to be civil about different parental choices.

    The problem is the clear hierarchy this article sets out, contrary to the facts, portraying crib sleeping as safest (no mention of the fact that many, many crib deaths are because of unsafe sleeping arrangements in the crib). Next comes the riskier option: co-sleeping, something that the “experts” are telling parents that they “shouldn’t” do, according to this article. The point of this piece seems to be that, if people are going to ignore the best advice and (engage in risky behavior) co-sleep anyway, at least they should do it the safest way possible. (Hence the references to condoms vs. abstinence.) In other words, if people are going to co-sleep anyway, all evidence to the contrary, then at least they should minimize the risks.

    “Sharing sleep surfaces with your baby is the exact same argument. You can tell a family that they shouldn’t sleep with their baby. You can explain all of the reasons why your organization or you as an individual do not believe in it. But when you fail to explain to them that should they choose to sleep with their baby anyway, that they can do it in a way that is safer than not following a few guidelines, then you are missing an opportunity to empower them to make choices that might be life saving for them as a family. ”

    In contrast to this picture, the facts are:
    (Safe, of course) co-sleeping arrangements have been shown to significantly lower the risk of SIDS. And since nursing is one of the characteristics of the safest ways to breastfeed, doing so has the wonderful side effect of positively impacting breastfeeding, which is in and of itself literally lifesaving. (Safe) crib sleeping in the same room provides a limited amount of the same benefits. (Safe) crib sleeping in another room leaves an infant more at risk of SIDS and can interfere with breastfeeding and healthy sleep, both of which can have serious consequences. There are many, many ways to put a baby down unsafely in a crib, and there are many, many ways to sleep with a baby that are also dangerous. All of those should be avoided. I’d love to see a co-sleeping version of the “back to sleep” campaign that has cut down so effectively on crib death.

    I do very much appreciate the specifics on safe co-sleeping arrangements, but to paint co-sleeping in general as comparable to a teen having sex anyway, and safe co-sleeping to (riskier, in defiance of the authorities) “safe sex”…well, that’s just plain wrong.

  6. DoulaLou says:

    No one said anything about teen sex. I think everyone can’t get past the word condom in the post. No where does this article say co-sleeping is bad or dangerous, in fact the risks I see are about crib sleeping. I’m assuming the point is that you have to tell parents what the “rules” of safe co-sleeping are and not simply say don’t co-sleep. Not sure why that would be construed as anti-co-sleeping.

  7. Melissa says:

    DoulaLou, you wrote: “No one said anything about teen sex”

    It’s in the very first line, and referenced throughout the article. What else could “Abstinence versus birth control education” possibly mean?

  8. Melissa says:

    Also, for those who have missed the author’s preference for crib sleeping as the only truly safe option and “safe” co-sleeping as a relatively unsafe second best, I quote the following:

    “You can tell a family that they shouldn’t sleep with their baby. You can explain all of the reasons why your organization or you as an individual do not believe in it. But when you fail to explain to them that should they choose to sleep with their baby anyway, that they can do it in a way that is safer than not following a few guidelines”

    In other words, if people do decide to do the bad scary sleep arrangement anyway (co-sleeping) the experts should at least tell them how to do it so it isn’t *quite* so dangerous. After all, you can’t make them do what’s best for their baby (crib sleeping)…hence the “should they choose to sleep with their baby anyway”…in contrast to what you’ve just told them is the standard of a truly safe sleeping arrangement.

    The central metaphor to this piece is:
    Putting your baby to sleep in a crib is like abstinence till marriage . It’s the safe, responsible choice.
    Putting your baby to sleep with you (anything that can be remotely construed as co-sleeping) is like teens or young adults (note the “education” reference) choosing to have sex anyway, because they just want to, thank you very much. So at least we should educate them on how to make their risky behaviour less risky: hence the article’s equating education about condoms–safe sex!–to education about how to sleep with your child in a way that mitigates the risk.

    At all times, this central metaphor makes it clear that crib sleeping is the standard and co-sleeping is subpar. No look at the real data, no questions about why the nursery furniture industry has been allowed to shape policy about the safety of its own products against a method of putting your baby to sleep that does not depend upon consumers buying their products at all. No inquiry into worldwide data about the safety of co-sleeping, rates of SIDS, etc. This article is not information, folks; it’s an opinion piece with a flawed (and insulting) central assumption that people who co-sleep do it against the evidence, and not because of it.

    How is anyone missing this?

  9. Hannah L says:

    There are plenty of adults who are not married who may or may not have sex, this could also include them. I’m with DoulaLou – this isn’t about teen sex. Don’t get your hackles up.

  10. AllieLiv says:

    Wow people dont read! The article clear talks about crib sleeping deaths and is obviously pro-co sleeping.

    I think the analogy was to say, people always preach abstience and dont always teach proper ways to protect yourself if youre having sex. Same with co sleeping. There are safe(& nonsafe) ways to co sleep.its not about this is right and thats wrong.

    I think its more of a biological thing. People want to have sex and giving them the knowledge/tools to protect themselves is the better option than saying “dont do it”. Just like parents(i know i would) have a natural(biological) inclination to co sleep and just saying “dont do it” is not a good way for the medical way to approach the subject.

    Have ther been death from co sleeping? Absolutely. Have there been deaths from crib sleeping? You bet. Which one is better? Well its all subjective to what works for you. And thats what the article is about. Giving parents the basic rules of co sleeping to minimized the number of injuries/deaths from unsafe cosleeping. Just like when you buy a crib they give you instructions and safety warnings.

    Botom line: give people all the knowledge to let them make the best decision for themselves.

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