The research from Bristol and Warwick University claims the safest place for baby to sleep for the first six months is in a cot next to the parent’s bed. We completely agree with this statement and it is something we have been recommending to parents since the start of this blog over a year ago.

However, when the tabloids published this story they did not go into enough detail. On closer inspection of the study it is apparent that the extremely high correlation between cot death and co sleeping was observed in a high-risk group. This high-risk group consisted of young, socially-deprived mothers who smoked and many of whom had taken alcohol or drugs at the time of the tragic cot death. In the group studied, there were also many cases where the mother had fallen asleep on the sofa with her baby.

What this study shows therefore is that these risk factors (alcohol, drugs, smoking and falling asleep on the sofa) are lethal when combined with co sleeping. It does not necessarily show that informed cosleeping is much more dangerous than the cot, although there have been studies in the past that have claimed this to be the case.

The study also included a control group which comprised of randomly selected SIDS cases (not just high-risk ones). In this group, 20% of the deaths were associated with a cosleeping arrangement and this control group also had a far lower percentage of alcohol/drug-related risk factors involved. Furthermore, only 1% involved cosleeping on a sofa.

I want to make it clear that I am not advocating cosleeping, I am just trying to give people an objective description of the study and I still stand by my position that the safest place for baby to sleep in the first six months is in a cot next to the parent’s bed.

Although the rate of Cot Death is decreasing in the UK, according to the FSID there are still more than 300 cases a year. The increase in education about the known risk-factors is playing a large part in the declining figures and if you are in any doubt about what you can do to reduce the risk then please read our post on SIDS.

I have spoken to many parents, with first hand experience, who warn others not to adopt a co-sleeping arrangement as baby will never take to the cot. They go on to explain that babies presented with the transition will scream blue murder until you eventually give in to the relentless bombardment and accept them into your bed with the promise to yourself that you’ll be tougher on them the next night!

I’m not going to get into the whole co-sleeping or cot debate for newborns as we have covered this extensively in previous posts. This post is about helping those who are already in the predicament above.

So what do you do when you are co-sleeping and your baby reaches the age where you feel she should be in a cot in her own room? The answer, I believe, is to take things very gradually. The problem is that your baby has got so used to sleeping next to you that if she suddenly finds herself plonked in unfamiliar surroundings, with no sign of you, she is unlikely to be in the frame of mind to sleep! She’ll be worried that she can’t see, touch, smell or hear you next to her anymore. This will undoubtedly result in some serious screaming and crying out. In my opinion, this is an alarming and stressful experience to put your baby through and it certainly should not be attempted using the Ferber technique.

Instead of going from one extreme to the other, you should consider getting hold of a cot that attaches to your bed and letting your baby get used to that sleeping arrangement first. This is a much easier transition to make because you are still close to her and her surroundings haven’t changed a great deal. I wouldn’t advise being tough at this stage. If she complains, comfort her in the same way she is used to until she learns that things haven’t really changed enough to complain about.

Once she gets used to that arrangement you could try moving the cot away from your bed a little bit and seeing how she takes to that. If she is fine with that, keep moving the cot further and further away until you decide the time is right for her to have her own room. Hopefully, the gradual change should make it much less stressful for her.

When she wakes up and finds herself in a new room she will still undoubtedly cry out for you. I would still be inclined, at this stage, to comfort her in much the same way as she has been used to. Once a few nights have gone by, if she is still waking and crying frequently, you could consider starting the Ferber Technique (as long as she is more than six months old).

There are no hard and fast rules for the above and the most important thing is for you to use your instincts to judge how the transition is going and when it’s right to move onto the next stage.

The major problem that parents face when attempting the transition is that they only decide to start once their baby’s sleep has become disrupted. This usually means that just as baby is experiencing teething and other developmental milestones, her parents decide that this is the best time for her to move out! Obviously, this is not going to work and will just make the problem much worse. My advice is to start the transition while your baby is sleeping well. The decision to deliberately sabotage your sleep is a tough one to make but trust me, in the long run, it will be well worth it.

For those parents who have left it too late and are sharing a bed with a baby who is already experiencing the developmental milestones, my advice is to try and wait it out. It will be a very difficult time for all of you but there is no miracle cure for this one unfortunately.

To close, I want to offer one final tip that has been passed on to me by many parents who have described their baby reacting to the cot, during the transition, as if it were ‘electrified’ even if they were fast asleep! They reported after much trial and error that it was often the temperature of the cot that caused the adverse reaction. Babies are very sensitive to temperature and if they have been used to being wrapped up warmly in your bed and suddenly find themselves on a cold, stale matress, they might have something to say about it! You might want to try warming the matress by rubbing it with your hands or using a hot water bottle for a couple of minutes.

Good luck and let me know your own experiences with this!

Advantages

Not only is it far more convenient for breast-feeding mothers but research has shown that babies and mothers sleep much better when they share a bed, with solo baby sleepers being shown to spend four times longer crying each night (McKenna, J., et al 1994). It has also been shown that bed sharing babies have more stable temperatures (C. Richard et al 1996), regular heart rhythms, and fewer long pauses in breathing compared to babies who sleep alone (T. Field 1995). This means baby sleeps physiologically safer.

The results from several studies have suggested that co-sleeping babies grow up with higher self-esteem, less anxiety, become independent sooner, are better behaved in school (P. Heron 1994) and are more comfortable with affection (M. Crawford 1994). They also have been shown to have fewer psychiatric problems (J. F. Forbes et al 1992).

There has actually been research to show that co-sleeping is safer than crib sleeping, despite the media scare stories (Blair et al 1999). The Consumer Product Safety Commission published data that described infant fatalities in adult beds. This data, however, showed more than 3 times as many crib related infant fatalities compared to adult bed accidents (D. A. Drago and A. L. Dannenberg 1999). Another recent large study concluded that bed sharing did NOT increase the risk of SIDS, unless the mum was a smoker or abused alcohol (R. G. Carpenter et al., 2004).

Disadvantages

Tragic accidents, although rare, do occur and you can’t ignore the possibility that:

• you might roll over in your sleep and suffocate your baby
• your baby could get caught between the wall and the bed
• your baby could roll out of your bed and be injured

In the absence of conclusive evidence it’s up to you to decide what works best for your situation. The important thing for you to do is to make your informed decision and then stick by it. Spending hours fretting that you may have made the wrong decision and placed your baby at an elevated risk is only damaging to yourself and your family.

Whichever sleeping arrangement you choose, there are steps you can take to make it as safe as possible which I will discuss in my next post.

Research has proved that infants who sleep in their own room in the first six months are twice as likely to die from SIDS (formerly called cot death) than those who share their parents’ bedroom. (FSID’s Editorial Team, 2007). I strongly advise you therefore to have baby sleeping in your room for the first six months.

However, the choice of whether you want to share a bed with your baby or put him in a cot next to the bed is ultimately for you to decide on your own. The reason I stated that a cot in the parents’ room is generally the safest place to put baby to sleep is because there are certain medically-agreed, risk factors that can make co-sleeping much more dangerous than cot sleeping. Experts agree that you should never share a bed with your baby if:

• The baby is under three months old
• The baby was premature or less than 2.5kg
• You or your partner are smokers (even if you don’t smoke at home)
• You have been drinking alcohol or have taken medications that make you drowsy.
• You are very tired.

If the above rules are followed I have not found conclusive evidence to recommend cot-sleeping over sharing a bed or vice-versa. The fact that the research is contradictory tells us that there is no hard and fast, right or wrong answer and the unfortunate truth is that tragic accidents can happen in any scenario. Fortunately, these accidents are very rare.

To help you make an informed decision, I will discuss the pros and cons of co-sleeping in my next post.