Co-sleeping

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Sleeping family.

Co-sleeping ( English co-sleeping ) is the practice that children in the immediate vicinity of a parent sleep or both parents. This term includes sleeping in a shared room ( English room sharing ) as well as sleeping in a shared bed (in a family bed or, more generally, in a common lying area, English bed sharing ), which is often also known as co-bedding or co-sleeping narrower sense). The sleeping of a child in the nursery therefore only falls under this term if one of the parents is also staying there.

The anthropologist and head of the mother-child sleep laboratory at the University of Notre Dame (Indiana) , James J. McKenna, names sleep in direct body contact (e.g. in the arms or with passive contact while lying down) or as a definition of co-sleeping close enough to perceive sensory stimuli such as sound, movement, touch, sight, gas, olfactory stimuli , CO 2 or temperature, to react to them or to exchange them.

Cultural history

Sleeping together with parents is widespread worldwide and is common due to cultural factors and reasons of limited living space.

Germany

In Germany, many children did not have their own bed until the beginning of the 20th century. In the German Empire , urbanization made living space scarce and expensive for the poorer classes ; Working-class families lived in small apartments with a heated room used for cooking, eating and staying and one or two unheated bedrooms. The parents usually had their own bed, while the children were forced to share a bed with their parents or siblings. In many cases, apartment tenants improved their scarce income by accepting “ sleepers ” and sub-tenants.

Sweden

According to a study, co-sleeping with both parents is common up to school age in Sweden.

Theories of Psychological Meaning

Co-sleeping is also said to have an impact on child development and the bond with parents. Analyzes showed that in comparison within a test group of 3 to 8-year-old children, those children had lower levels of cortisol who had spent comparatively less time in childcare up to the age of four or who had slept in their parents' room.

Further studies deal with the influence on breastfeeding and the sleep behavior of mother and child. Sleeping in a family bed makes it easier for the mother to breastfeed the child at night according to his hunger and sleep rhythm. It has been reported that longer periods of peaceful sleep are observed in separately sleeping children and that breastfeeding mothers have more sleep periods when sleeping with their child. Promoting breastfeeding is seen as one of the main arguments in favor of co-sleeping .

Nocturnal breastfeeding can help to maintain the flow of milk, especially in working mothers, so that sleeping together with the child is a way of combining breastfeeding, work and sleep. The pediatrician Martin Stein emphasizes that night co-sleeping in the second year of life can strengthen the mother-child bond and the child, on the other hand, can experience its abilities as independent during the day. Such a specialization of the day-and-night experience could release energies for the activities of the day leading to individuation . Based on Margaret Mahler's terminology, he interprets co-sleeping as a continuous "refueling" or "rapprochement" available beyond the first year of life.

One study indicated that preschoolers who slept separately from infancy fell asleep alone more easily, slept more often and weaned earlier , whereas children who slept with their parents showed greater independence in practical matters and in socializing. The role of the father was also examined, and there are indications that in the mother-father-child triad, co-sleeping can reduce the effect of a subjectively greater distance between the father and the child caused by breastfeeding. Pediatrician William Sears regards co-sleeping as a possible option for parents in the context of attachment parenting .

Researchers assume that a sleep arrangement in no way "produces" certain character or personality traits in the child. Rather, it is an element of the relationship and attachment system that must be viewed in its entirety and in interaction with the characteristics of the child. Comparisons between US and Japanese families showed that when examining whether certain sleep arrangements were associated with lower or higher child sleep problems, the cultural environment played a significant role.

The psychotherapist Jean Liedloff reported in the book In search of lost happiness: against the destruction of our ability to be happy in early childhood (original title: The Continuum Concept ) on the way of life of the Yequana in Venezuela. The early childhood of the Yequana is characterized by characteristics such as constant body and social contact, being carried, breastfeeding “as needed” and sleeping in the parents' bed for as long as the children wish. Her account of the Yequana, which she described as friendly, peaceful, and self-confident, had a lasting impact on attitudes towards raising children in North America and Europe.

In the Western industrialized nations, the practice has become in recent decades established immediately after birth the mother and the child in the baby-friendly hospital the rooming-in to allow for breastfeeding from birth and the relationship to the newborn to promote. Sometimes hospitals offer as a special service that mother, father and child can be accommodated together in a family room after the birth. The presence and consolation of the parents is also assumed to play an important role in older children : When children are hospitalized as an inpatient, attempts are made to reduce the psychological stress on the child by rooming-in and to prevent psychological deprivation .

A long-term study showed that sharing the bed with the parents was not associated with sleep problems, sexual pathology or any other problematic consequences. Rather, children who had slept in their parents' bed in early childhood showed slightly but significantly higher cognitive competence by the age of six. At the age of 18 there was no longer any connection with problematic or positive consequences.

Child safety

Opinions differ on the question of whether parents and children sleep together in one bed or not, and the degree to which it affects breastfeeding behavior and the child's safety.

An attempt was made to prevent parents and small children from sleeping together at an early stage because of a possible risk of suffocation and the associated connection to covert infanticide . Pope Stephan V asked Archbishop Liutbert of Mainz in 887/888 to warn parents to refrain from sleeping together. In the “common land ordinance of the Duchy of Prussia” of 1526 it is stated that “[h] ierauf we seriously, the one marriage that children have with each other, is here with everything seriously, ire children at no time in ire Put a bed [...] ", whereby parents and toddlers sleeping together apparently remained common, so that it was explicitly stated in 1794:

Ҥ 738 Mothers and wet nurses should not take children under two years of age into their beds at night and let them sleep with themselves or others.
§ 739 Those who do this have, depending on the circumstances and the prevailing danger, forfeited prison sentences or corporal punishment. "

- General land law for the entire Prussian states , section bodily harm (II 20 ALR)

In particular, the question of whether and how it affects the risk of sudden infant death syndrome (SIDS) is a matter of dispute among experts. ( See also: Recommended Actions .) In 1999, the US Consumer Product Safety Commission published and identified data on the number of accidental deaths in the US from 1990 to 1997 among infants and young children in whom the child slept in their parents' bed 515 total as caused by entanglement or being run over by a parent. Based on this, she took a stand against the practice of bed sharing . Cases that were classified as SIDS were not included in the study. The way in which the US Consumer Product Safety Commission data was analyzed and the conclusion was very controversial. It was u. a. highlighted that in the United States, the number of crib-related accidents is several times higher than that of a parent's bed-related accident.

Since the number of cases of SIDS in the parents' bed and of SIDS in the cot are unknown and the total number of families who practice co-sleeping cannot be determined, it is not possible to draw up precise risk assessments from a consideration of the total number of SIDS cases. There is clear evidence that sleeping together in one room ( room sharing ) increases the child's safety. There are doubts as to whether a universally valid recommendation can be made for or against sleeping together for the child and parents in one bed. In some countries, such as Japan and Hong Kong, it is common practice for young children to sleep in close contact with their parents; at the same time, the rate of SIDS cases there is significantly lower than in the USA, for example. The American Academy of Pediatrics (AAP) working group on SIDS found in 2005 that there was increasing evidence that sleeping together for parents and children in one room, but not in a bed, was associated with a lower risk of SIDS. The President of the Academy of Breastfeeding Medicine said the AAP's recommendations against co-sleeping failed to take into account the reality of breastfeeding and were "a truly amazing triumph of ethnocentric assumptions over common sense and medical research."

Anthropologists added an evolutionary perspective to the debate about child safety , particularly examining the formation of sleep, breathing, and wakefulness patterns in mother and child.

According to one study, sleeping in the parents' bed only increases the risk of SIDS if the mother smokes or alcohol abuse is present. A study carried out over eight years provided evidence that sleeping in the parents' bed only in certain circumstances in which the risk of SIDS is increased from the outset - in children of smoking mothers, in children with a low birth weight based on the age of maturity, or when using highly insulating materials Bed linen (with thermal resistance greater than 1.0 m 2 K / W) - is associated with a further increase in the risk. A meta-study, on the other hand, identified the infant's sleep in bed with their parents ( "bed sharing" ) as a risk factor for sudden infant death syndrome, whereby this risk is particularly higher in young infants or in children of smoking mothers, according to the results. The authors of this meta-study drew the conclusion that prevention campaigns should point out “that children sleep safest in their own cot in their parents' bedroom”.

Under no circumstances must the sleeping area have dangerous cracks or strangulation risks; Co-sleeping in a water bed or similarly soft beds or on a couch (with a backrest) is not recommended. In certain parent-related circumstances, family cot advocates also advise against the child sleeping in the parents' bed, especially if one of the parents sharing the bed is a smoker , drunk, or uses other drugs , is epileptic , or takes sedatives . It is also not advisable to share the bed with the child if you are extremely tired due to lack of sleep or if you are extremely overweight . Co-sleeping arrangements in the same bed with a babysitter or with older children are not recommended.

In the recommendations of the Government of Western Australia from November 2013, co-sleeping in a shared bed is not recommended. Premature babies or very small babies and babies under four months of age are at an increased risk of sudden infant death syndrome, as are babies whose parents smoke, are overtired, drunk or influenced by drugs or medication, and if the baby can be rolled over or trapped in a crack fall or come into contact with duvets or pillows. Under no circumstances should a baby sleep with pets or other children. Should parents nevertheless decide to co-sleep in a shared bed, the baby should sleep in its own sleeping bag next to one of the parents, away from the parents' pillows and blankets and with enough distance from the edge of the bed to be protected from falling. If the mattress is on the floor, there must be enough space to the wall and other furniture to protect the baby from being trapped.

A study from 2014 showed for the first time a protective effect of co-sleeping against sudden infant death syndrome, provided that known risk factors (sleeping on the sofa, previous alcohol consumption, parent smoker, etc.) were excluded.

As an alternative to sleeping an infant in the parents 'bed or in their own bed, specially made devices (" baby balconies ") have recently been propagated in which an infant has its own sleeping place, secured on one side with bars, which is seamlessly attached to the parents' bed . They reduce the risk of falling out of bed, but at the same time give the child their own space.

child protection

In the 1990s, individual studies examined the possible psychological disadvantages of co-sleeping. One study found that co-sleeping had more to do with child and parent fears, separation and sleep behavior issues than inappropriate sexual contact. Another study specifically looked for empirical data that could support the thesis that children could be psychologically harmed by the nudity of their parents, co-sleeping in their parents' bed or by observing parental sexuality. Very little empirical data was found on this, and the only negative effect that could be demonstrated was sleep disorders in the case of co-sleeping, for which, however, no causality was proven.

Web links

Wikibooks: Baby book: Sleeping  - learning and teaching materials

Individual evidence

  1. ↑ a b J.J. McKenna, EB Thoman, TF Anders, A. Sadeh, VL Schechtmann, SF Glotzbach: Infant co-sleeping in an evolutionary perspective: Implications for understanding infant sleep syndrome and the sudden infant death syndrome , Sleep, April 1993, 16 (3): 263-82, PMID 8506461 , p. 264 ( Memento from September 17, 2011 in the Internet Archive )
  2. ↑ Wolfgang König: History of the consumer society , VSWG supplements, Franz Steiner Verlag Stuttgart, 2000, ISBN 3-515-07650-6 , p. 209
  3. ^ B. Welles-Nystrom: Co-sleeping as a window into Swedish culture: considerations of gender and health care , Scand J Caring Sci. 2005 Dec; 19 (4): 354-60, PMID 16324059
  4. ↑ D. Waynforth: The influence of parent-infant cosleeping, nursing, and childcare on cortisol and SIgA immunity in a sample of British children , Dev. Psychobiol., September 2007, 49 (6): 640-8, PMID 17680611
  5. ↑ Melissa Hunsley, Evelyn B. Thoman: The sleep of co-sleeping infants when they are not co-sleeping: Evidence that co-sleeping is stressful , Developmental Psychobiology, Volume 40, No. 1, pp. 14-22, January 2002 , Abstract
  6. ^ SI Quillin, LL Glenn: Interaction between feeding method and co-sleeping on maternal-newborn sleep , J. Obstet. Gynecol. Neonatal Nurs., September / October 2004, 33 (5): 580-8, PMID 15495703
  7. ↑ Stephanie D. Buswell, Diane L. Spatz: Parent-Infant Co-sleeping and Its Relationship to Breastfeeding , Journal of Pediatric Health Care, Vol. 21, No. 1, pp. 22-28, January 2007, abstract
  8. ^ A b Martin T. Stein, Calvin A. Colarusso, James J. McKenna, Nancy G. Powers: Cosleeping (Bedsharing) Among Infants and Toddlers , Journal of Developmental and Behavioral Pediatrics, April 2001, Volume 22, pp. 67-71 .
  9. ^ Meret A. Keller, Wendy A. Goldberg: Co-sleeping: Help or hindrance for young children's independence? , Infant and Child Development, Vol. 13, No. 5, pp. 369-388, December 2004, abstract
  10. ↑ Helen L. Ball, Elaine Hooker, Peter J. Kelly: Parent-infant co-sleeping: fathers' roles and perspectives , Infant and Child Development, Volume 9, No. 2, pp. 67-74, June 2000, abstract
  11. ↑ J. Mosenkis: The Effects of Childhood Cosleeping On Later Life Development , Masters Thesis, University of Chicago, Department of Human Development, 1998. Quoted in What are the long term effects on my baby of sharing a bed? Mother-Baby Behavioral Sleep Laboratory, University of Notre Dame, archived from the original on April 16, 2014 ; accessed on August 23, 2014 .
  12. ^ Sara Latz, Abraham W. Wolf, Betsy Lozoff: Cosleeping in Context: Sleep Practices and Problems in Young Children in Japan and the United States , Archives of Pediatrics and Adolescent Medicine, Vol. 153, No. 4, pp. 339–346, 1999, abstract
  13. ^ Paul Okami, Thomas Weisner, Richard Olmstead: Outcome Correlates of Parent-Child Bedsharing: An Eighteen-Year Longitudinal Study , Journal of Developmental & Behavioral Pediatrics: August 2002, Vol. 23, No. 4, pp. 244-253, abstract
  14. ↑ Simone Winkler: "Kindserzüge". From canon law to state law of the Duchy of Prussia . Zugl .: Hannover, Univ, Diss., 2005 (=  Stephan Meder , Arne Duncker (Hrsg.): Legal history and gender research . Volume 7 ). Böhlau, Cologne 2007, ISBN 978-3-412-15106-5 , chapter 2.3.1.8. Child expressing as covert infanticide ?, p. 59–61 ( full text of chapter 2.3.1.8. In the Google book search).
  15. ↑ Simone Winkler: "Kindserzüge". From canon law to state law of the Duchy of Prussia . Zugl .: Hannover, Univ, Diss., 2005 (=  Stephan Meder, Arne Duncker (Hrsg.): Legal history and gender research. Volume 7 ). Böhlau, Cologne 2007, ISBN 978-3-412-15106-5 , pp. 48 ( limited preview in Google Book search).
  16. ↑ Simone Winkler: "Kindserzüge". From canon law to state law of the Duchy of Prussia . Zugl .: Hannover, Univ, Diss., 2005 (=  Stephan Meder, Arne Duncker (Hrsg.): Legal history and gender research. Volume 7 ). Böhlau, Cologne 2007, ISBN 978-3-412-15106-5 , pp. 185 ( limited preview in Google Book search).
  17. ↑ Simone Winkler: "Kindserzüge". From canon law to state law of the Duchy of Prussia . Zugl .: Hannover, Univ, Diss., 2005 (=  Stephan Meder, Arne Duncker (Hrsg.): Legal history and gender research. Volume 7 ). Böhlau, Cologne 2007, ISBN 978-3-412-15106-5 , pp. 194 ( limited preview in Google Book search).
  18. ↑ a b E.B. Thoman: Co-sleeping, an ancient practice: issues of the past and present, and possibilities for the future , Sleep Med. Rev. December 2006, 10 (6): 407-17. Published online November 16, 2006 PMID 17112752
  19. ↑ Sally A. Baddock et al. a .: Differences in Infant and Parent Behaviors During Routine Bed Sharing Compared With Cot Sleeping in the Home Setting , In: Pediatrics Volume 117 No. 5, May 2006, pp. 1599–1607, doi: 10.1542 / peds.2005-1636 , Abstract, full text
  20. ^ A b c Elmar R. Grossmann: Less than meets the eye: The Consumer Products Safety Commission´s campaign against bed-sharing with babies , Birth, Volume 27, No. 4, pp. 277-280, December 2000, doi: 10.1046 / j.1523-536x.2000.00277.x
  21. ↑ a b c d e f Sleeping safely with your baby , AskDrSears.com.
  22. ^ DA Drago and AL Dannenberg, “Infant Mechanical Suffocation Deaths in the United States, 1980-1997,” Pediatrics 103, no. 5 (1999). Quoted from Scientific Benefits of Co-sleeping. (No longer available online.) AskDrSears.com, archived from the original on November 24, 2010 ; accessed on November 28, 2010 (English). Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. @1@ 2Template: Webachiv / IABot / www.askdrsears.com
  23. ^ JJ McKenna, T. McDade: Why babies should never sleep alone: ​​a review of the co-sleeping controversy in relation to SIDS, bedsharing and breast feeding. In: Pediatr Respir Rev , June 2005, 6 (2): 134-52, PMID 15911459 p. 141 f. ( Memento from May 13, 2013 in the Internet Archive )
  24. ^ JJ McKenna, T. McDade: Why babies should never sleep alone: ​​a review of the co-sleeping controversy in relation to SIDS, bedsharing and breast feeding . In: Pediatr. Respir. Rev. , June 2005, 6 (2): 134-52, PMID 15911459 p. 148 f. ( Memento from May 13, 2013 in the Internet Archive )
  25. ↑ ABM Clinical Protocol # 6: Guideline on Co-Sleeping and Breastfeeding, Revision, March 2008 ( Memento of the original from August 26, 2014 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. , Breastfeeding Medicine, Volume 3, No. 1, 2008. @1@ 2Template: Webachiv / IABot / www.bfmed.org
  26. ^ A b Scientific Benefits of Co-sleeping. (No longer available online.) AskDrSears.com, archived from the original on November 24, 2010 ; accessed on November 28, 2010 (English). Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. @1@ 2Template: Webachiv / IABot / www.askdrsears.com
  27. ↑ "There is growing evidence that room sharing (infant sleeping in the parent's room) without bed sharing is associated with a reduced risk of SIDS." Policy Statement: The Changing Concept of Sudden Infant Death Syndrome: Diagnostic Coding Shifts, Controversies Regarding the Sleeping Environment, and New Variables to Consider in Reducing Risk. (PDF) (No longer available online.) American Academy of Pediatrics, archived from the original on November 22, 2010 ; accessed on December 18, 2010 (English). Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. P. 1248 ( Memento of the original of November 22, 2010 in the Internet Archive ) Info: The archive link has been inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. and references cited therein: (i) Blair PS, Fleming PJ, Smith IJ, et al .: Babies sleeping with parents; case-control study of factors influencing the risk of the sudden infant death syndrome . BMJ. 1999; 319: 1457-1461 (ii) Carpenter RG, Irgens LM, Blair PS, et al .: Sudden unexplained infant death in 20 regions in Europe: case control study . Lancet. 2004; 363: 185-191 (iii) Mitchell EA, Thompson JMD: Co-sleeping increases the risk of SIDS, but sleeping in the parents bedroom lowers it . In: Rognum TO, ed .: Sudden Infant Death Syndrome: New Trends in the Nineties . Oslo, Norway: Scandinavian University Press; 1995: 266-269 (iv) Tappin DM, Ecob R, Brooke H. Bedsharing, room sharing and sudden infant death syndrome in Scotland. A case-control study . J Pediatr. 2005; 147: 32-37. @1@ 2Template: Webachiv / IABot / aappolicy.aappublications.org  @1@ 2Template: Webachiv / IABot / aappolicy.aappublications.org
  28. ↑ News. In: BIRTH 33: 2 June 2006. Retrieved on April 10, 2018 : “The Academy of Breastfeeding Medicine, an international organization of physicians, also released a statement noting that breastfeeding itself is protective against SIDS, and strongly disagreed with the AAP regulations, which were contrary to even the recommendations of its own Section on Breastfeeding. Recommendations that advise against parent-infant bed-sharing and support the generic use of pacifiers imply a `` truly astounding triumph of ethnocentric assumptions over common sense and medical research, '' according to Nancy Wight, MD, president of The Academy of Breastfeeding Medicine . " P. 161.
  29. Jump up ↑ JJ McKenna, HL Ball, LT Gettler: Mother-infant cosleeping, breastfeeding and sudden infant death syndrome: what biological anthropology has discovered about normal infant sleep and pediatric sleep medicine , Am. J. Phys. Anthropol., 2007, Suppl 45: 133-61 PMID 18046747
  30. ^ RG Carpenter et al. a., Sudden Unexplained Infant Death in 20 Regions in Europe: Case Control Study , Lancet, 363, pp. 185–191, 2004. Quoted from Scientific Benefits of Co-sleeping. (No longer available online.) AskDrSears.com, archived from the original on November 24, 2010 ; accessed on November 28, 2010 (English). Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. @1@ 2Template: Webachiv / IABot / www.askdrsears.com
  31. ^ C. McGarvey, M. McDonnell, K. Hamilton, M. O'Regan, T. Matthews: An 8 year study of risk factors for SIDS: bed-sharing versus non-bed-sharing , In: Archives of Disease in Childhood , 2006, Volume 91, No. 4, pp. 318-323, doi: 10.1136 / adc.2005.074674 , abstract
  32. ↑ Mechtild M. Vennemann, MD, MPH, Hans-Werner Hense, MD, Thomas Bajanowski, MD, PhD, Peter S. Blair, PhD, Christina Complojer, Rachel Y. Moon, MD, Ursula Kiechl-Kohlendorfer, MD, MSc: Bed Sharing and the Risk of Sudden Infant Death Syndrome: Can We Resolve the Debate? Abstract
  33. ^ Suad Nakamura, Marilyn Wind, Mary Ann Danello: Review of Hazards Associated With Children Placed in Adult Beds , Archives of Pediatrics and Adolescent Medicine 1999, Vol. 153, No. 10, pp. 1019-1023, abstract
  34. ^ Co-Sleeping ( Memento from February 11, 2015 in the Internet Archive ), ferbern.de.
  35. ^ Safe Infant Sleeping. Operational Directive OD 0474/13. Government of Western Australia, Department of Health, November 13, 2013, archived from the original on May 18, 2015 ; accessed on May 11, 2015 .
  36. ^ Safe Infant Sleeping. Information for Parents, Carers and Families. (PDF) Government of Western Australia, Department of Health, September 2013, archived from the original on March 4, 2015 ; accessed on May 11, 2015 .
  37. ↑ Peter S. Blair et al. a., Bed-Sharing in the Absence of Hazardous Circumstances: Is There a Risk of Sudden Infant Death Syndrome? An Analysis from Two Case-Control Studies Conducted in the UK , September 19, 2014, PLOS One, doi: 10.1371 / journal.pone.0107799 .
  38. ^ Bed-sharing, co-sleeping and parent education: a time for change. In: International journal of birth and parenting education, Vol. 2, No. 2, 2015. March 18, 2016, pp. 19-20 , accessed on July 27, 2016 (English, download PDF , 252 kB).
  39. ↑ FH Rath, ME Okum: Parents and children sleeping together: cosleeping prevalence and concerns . In: The American Journal of Orthopsychiatry . tape 65 , no. 3 , 1995, p. 411-418 , PMID 7485426 (English).
  40. ↑ Paul Okami: Childhood exposure to parental nudity, parent-child co-sleeping, and “primal scenes”: A review of clinical opinion and empirical evidence . In: The Journal of Sex Research . tape 32 , no. 1 , 1995, p. 51-63 , doi : 10.1080 / 00224499509551774 (English).