|
COPYRIGHT 2002 Mothering Magazine
Mothers and infants sleeping side by side, also known as cosleeping, is the evolved context of human infant sleep development. Until very recent times, for all human beings, it constituted a prerequisite for infant survival; outside of the Western industrialized context, for the majority of contemporary people, it still does. Because the human infant's body continues to be adapted only to the mother's body, cosleeping with nighttime breastfeeding remains clinically significant and potentially lifesaving.
**********
This is because, of all mammals, humans are born the least neurologically mature (25 percent of adult brain volume), develop the most slowly, and are the most dependent for the longest period of time for nutritional, social, and emotional support, as well as for transportation. Indeed, in the early phases of human infancy, social care is synonymous with physiological regulation. That is, holding, carrying, and/or caressing an infant, and emitting odors and breath in his or her proximity, induce increased body temperature, less crying, greater heart rate variability, fewer apneas, lower stress levels, increased glucose storage, and greater daily growth. (1)
Moreover, since the content of human milk is relatively low in fat and protein and high in sugar, which is metabolized quickly, and since human infants are unable to locomote on their own, continuous contact and carrying, with frequent breastfeeding day and night, is required. Thus, any biological scientific study that attempts to understand "normal," species-wide, human infant sleep patterns without considering the vital role of nighttime contact in the form of breastfeeding and maternal proximity must be considered inadequate, misleading, and/or fundamentally flawed. (2)
Cosleeping: The Importance of Taxonomic Distinctions
Much of the controversy surrounding the question of the safety of mother-infant cosleeping involves the ways in which investigators define and conceptualize it. Cosleeping is not, as the Consumer Product Safety Commission (CPSC) assumes, a single, coherent practice. Rather, it is best thought of as a generic, diverse class of sleeping arrangements composed of many different "types" of practices, each of which requires proper description and characterization before the issue of safety and "outcomes" can be understood.
A safe cosleeping environment must provide the infant with the opportunity to "sense" and respond to the caregiver's signals and cues, such as the mother's smells, breathing sounds and movements, infant-directed speech, invitations to breastfeed, touches, and any "hidden" sensory stimuli, whether intended or not. (3) Moreover, to be designated "safe," the physical and social cosleeping environment must involve a willing and active caregiver who chooses to cosleep specifically to nurture, feed, or be close to the infant in order to monitor or protect him or her.
The cosleeping environment also must be carefully constructed to avoid known hazardous conditions, recently revealed by epidemiological studies. (4) Dangerous types of cosleeping include sleeping with infants on sofas or couches, bedsharing with mothers who smoke, and positioning toddlers next to infants. Parents or caregivers desensitized by drugs or alcohol create an unsafe cosleeping environment. Other dangerous cosleeping environments occur when an infant sleeps with a larger person on a soft mattress or is placed on large pillows in a bed with a parent. (5,6,7)
While all forms of bedsharing are examples of cosleeping, bedsharing is only one of perhaps hundreds of different ways to cosleep practiced around the world. For example, some parents in Latin America, the Philippines, and Vietnam sleep with their infant in a hammock, or place the infant in a hammock to sleep next to them, while they sleep on mats or beds. Some parents place their infant in a wicker basket and put the basket on a bed, between the parents. Other parents sleep next to their infants on bamboo or straw mats or on futons (as in Japan). Some place their infant on a cradleboard, keeping the infant within arm's reach; others cosleep by roomsharing, having the infant sleep on a different surface, such as in a crib or bassinet, which is kept next to the parental bed, within arm's reach.
Cosleeping Has Not Outlived Its Biological Usefulness
Although forms of infant sleeping vary enormously from culture to culture, the potentially beneficial physiological regulatory effects of maternal contact on human infants during sleep do not. Up to one degree of temperature can be lost when a newborn human is removed from the mother's stomach following birth, even when the infant is placed in an incubator with ambient temperatures set to match the mother's body temperature. (8) Richard found that among 11- to 16-week-old infants, solitary-sleeping infants exhibited lower average axillary skin temperatures than breastfeeding infants sharing a bed with their mothers. (9) Thoman and Graham discovered that even mechanical breathing teddy bears placed next to apnea-prone human newborns have the effect of reducing apneas by as much as 60 percent, in addition to physically drawing the infant subjects to sleep in direct contact. (10) Moreover, when resting on their mothers' (or fathers') chests, skin-to-skin, both premature and full-term infants breathe more regularly, use energy more efficiently, grow faster, and experience less stress. (11,12,13)
Clinical Outcomes Depend on How Cosleeping Is Practiced
Exactly how cosleeping may be beneficial or dangerous to the infant varies as a function of the particular social and physical environment (family circumstances) within which it is expressed. This is why there is no single outcome associated with forms of cosleeping, especially in urban Western cultures, and why there is so much debate about whether cosleeping, especially in the form of bedsharing, is safe.
For example, in industrialized urban societies, among middle- to upper-class families where bedsharing and breastfeeding occur among nonsmoking mothers, infant mortality, including deaths from SIDS,...
Read the full article for free courtesy of your local library.
|
Bookmark this article
Print this article
Link to this article
Email this article
Digg It!
Add to del.icio.us
RSS
