Sleep and the Breastfed Baby

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Sleep and the Breastfed Baby

When my first daughter was born, I was lucky if she slept more than 10 minutes after I put her down. Even placing my daughter in the co-sleeper attached to my bed with my hand on top of her was not successful.  Night after night, I held my daughter for hours on my chest. While she slept beautifully, I fought desperately to stay awake out of fear I might harm her.  I had heard the warnings regarding bed sharing and certainly didn’t want to do anything to put my baby at risk.  Sleep deprivation quickly began to set in.  I was dangerously exhausted and in a zombie-like state, too tired to even think straight or enjoy my daughter.

Relief came with a book I was given on infant sleep.  It discussed how cultures all over the world sleep with their babies and why and how it can be safe.  That night, I followed what my instincts and my daughter were telling me to do.  I put my daughter next to me in my bed and we both slept peacefully for the first time ever, waking to nurse and going right back to sleep.  At times bed sharing worked beautifully for us and at times it didn’t, but having the option, especially in the early months was a lifesaver!

No sleeping arrangement is 100% safe.  Every family is different and bed sharing is not the answer for everyone, yet I strongly believe that parents should be given all the information available on mother-infant sleep in order to make the best decision for their family.  Had I been given this information, I would have been able to better enjoy the first weeks of my daughter’s life.  The following is an outline of some key information on mother-infant sleep.  There are some excellent resources listed also.  Please research your options when considering how and where you and your baby will sleep.

“Infants are biologically designed to sense that something dangerous has occurred – separation from the caregiver. They feel, through their skin, that something is different – such as a missing the softness of the mother’s touch, the heat of mother’s body, the smells of mother’s milk, the gentleness of mother’s moving, breathing chest and the feeling of being protected. Infants are alerted because as far as their own body is concerned they are about to be abandoned, and it is therefore time to awaken to call the caregiver back – the very caregiver on whose body the infant’s survival depends.” –James McKenna, Ph.D. Professor of Biological Anthropology, Director, Mother-Baby Sleep Laboratory, University of Notre Dame.11-27-15

Definitions in research:

Bedsharing- mother and baby sleep on the same surface. This should only include safe sleeping surfaces, not chairs or sofas.

Cosleeping- infant sleeps in proximity (sensory range) of a caregiver, in a crib, bassinet, or co-sleeper attached to the adult bed. This may include bedsharing.

What we know:

  • Breastfeeding, especially exclusive breastfeeding, protects against SIDS.
  • Numerous studies have shown that mothers who bedshare breastfeed for longer periods of time than mothers who sleep apart from their babies.
  • When infants and mothers are together, their bodies sleep in synchrony. The infant’s wake and sleep cycle, heart rate, breathing, and body temperature are all regulated by the mother’s body. Babies tend to wake more often and sleep more lightly.
  • Babies and mothers have shared sleep throughout history and in all different cultures.
  • Studies show that 40-80% of parents share sleep with their baby at least some of the time.
  • The most common reason mothers end up bedsharing is breastfeeding.
  • Breastfed babies need to feed at night, often frequently, in order to get enough calories and help the mother make sufficient milk.
  • Anti-bedsharing campaigns may be placing breastfed babies at greater risk as mothers are falling asleep with their babies on unsafe sleeping surfaces.
  • There is not a single study that shows bedsharing is more dangerous than solitary sleep when other risk factors have been accounted for.
  • No infant sleeping method is risk-free. It is important for parents to receive all the information they need in order to make the choice that is right for their family. There is not a one-size-fits-all approach to safe infant sleep! 

Contributing factors to unsafe sleep:

  • Formula feeding
  • Someone in the house smokes
  • Falling asleep in a chair or sofa
  • Alcohol, drug or medications causing fatigue taken by bedsharing mother
  • Infant sleeping with someone other than breastfeeding mother
  • Prematurity or health issues in the baby
  • Overheated baby
  • Pillows, blankets, soft beds, cluttered sleeping surfaces
  • Babies left alone to sleep or left to cry
  • Having other children or pets in the bed
  • Stomach sleeping
  • Obesity in the bedsharing mother 

Safe bedsharing:

  • Place baby on back when not breastfeeding
  • Sleep on a firm, flat mattress with pillows and heavy blankets away from infant
  • Dress infant lightly and make sure he/she is not overheated
  • Consider placing mattress on floor or use mesh guardrails, making sure there are no crevices baby can become wedged in
  • Infant should only sleep next to the mother
  • Never leave baby alone in the bed
  • Baby should be full-term and healthy (if not, using a special wrap may help stabilize the airway) 

Further education:

Sweet Sleep: Nighttime and Naptime Strategies for the Breastfeeding Family by Diane Wiessinger, Diana West, Linda J. Smith, and Teresa Pitman.

Sweet Sleep Handouts 

Nighttime Parenting: How to Get Your Baby and Child to Sleep by William Sears, M.D.

Sleeping with Your Baby: A Parent’s Guide to Cosleeping by James J. McKenna, Ph.D.

The No-Cry Sleep Solution: Gentle Ways to Help Your Baby Sleep Through the Night by Elizabeth Pantley.

Speaking Out on Safe Sleep: Evidence-Based Infant Sleep Recommendations. Bartick Melissa and Smith Linda J.. Breastfeeding Medicine. November 2014, 9(9): 417-422.

Newborns Sleeping Through the Night: A DANGEROUS Myth, Dr. Marcy Axness & Dr. James McKenna

Kangaroo Mother Care: Support for Mothers and Staff of Premature Babies

Mother-Baby Behavioral Sleep Laboratory at University of Notre Dame, James MCKenna, Ph.D.

Parent-Infant Sleep Lab at Durham University, Helen Ball, Ph.D.

Kathleen Kendall Tackett, Ph.D. IBCLC (research on new mothers and sleep)

Attachment Parenting International, Infant Sleep Safety

ISIS (Infant Sleep Information Source)


About the Author:

Leah Segura has been working with breastfeeding parents in the MidMichigan area for over a decade. She works as an International Board Certified Lactation Consultant (IBCLC) in private practice and volunteers through several organizations, advocating for parents in her community.

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