Book review: Sleeping with Your Baby - and a copy to give away.

I have a copy of this book to give away.  See the bottom of this post to learn how to enter to win it.

Dr. James McKenna's new book, Sleeping with Your Baby (Platypus Media, 2007) begins with a quote from D.H. Winnicott: "There is no such thing as a baby.  There is always a baby and someone."

This value runs deep in Dr. McKenna's book and his research.  He is the director of the Mother-Baby Behavioral Sleep Laboratory at the University of Notre Dame, and the nation's expert on what happens when mothers and babies sleep together and apart.  His website has some fascinating clips of how his research works. 

The inspiration for this book was the American Academy of Pediatrics' 2005 policy on Sudden Infant Death Syndrome.  This revised set of recommendations on preventing SIDS contained good news and bad news for those who advocate safe co-sleeping.  The AAP, for the first time, recommended that babies sleep in the same room as their parents, proximate to their beds.  But the AAP also stated that sleeping in a parent's bed was hazardous.  That recommendation prompted Dr. McKenna to write Sleeping with Your Baby.

Dr. McKenna's book is one part passionate defense of co-sleeping, replete with research but still highly readable, and one part guide to safe co-sleeping.  He devotes a chapter to the benefits of co-sleeping to the breastfeeding mother and baby, and also addresses issues of intimacy between co-sleeping couples.  One of my favorite sections is on how other mammals sleep. 

Two central arguments that Dr. McKenna makes are that co-sleeping is normal, and that under the right conditions it is better for babies than solitary sleep.

Normal?  Around the world and historically, of course.  But normal now in the U.S.?  Before you say no, consider a fact I learned from a presentation by the CDC at the ILCA conference last week:  44% percent of babies from 2-9 months old are cosleeping in an adult bed at any given time.  So while you may not hear your friends and family admit it, the data say that it is indeed a normal practice here and now.

Sleeping with Your Baby is full of examples of how co-sleeping under the right conditions is good for babies (better body temperature, less apnea-associated types of sleep) and better for mothers (better sleep, ease of breastfeeding).  He addresses some of the typical objections to co-sleeping and in each case makes a point of separating fact from opinion.

Dr. McKenna is careful to point out that co-sleeping should not be done under some conditions.  Parents under the influence of alcohol or drugs, for example, should not sleep with their babies.  Waterbeds, obese parents, smoking, and heavy bedding are among a number of other factors which should not be present when bedsharing.  Interestingly, he does not recommend sleeping with preterm babies.

To me, one of the most intruiging things about this book is that it points out how far we strayed from traditional methods of infant care in the last century.  In the post-WWII era parents were instructed to 1) put their babies on their stomachs to sleep, 2) formula feed, 3) put their babies in separate rooms for sleep.  Smoking during and after pregnancy was common.

Today it's clear that these practices increase the risk of SIDS.  As I've noted before, breasteeding alone, according to a recent federal study, is estimated to reduce the risk of SIDS by 36%.  Dr. McKenna quotes a study showing that the risk of SIDS doubles when a baby is put to sleep in a separate room.  In fact, as Dr. McKenna points out, SIDS is virtually unknown in countries where these "modern" methods of childrearing were never adopted. 

Sleep in separate rooms and formula feeding runs directly counter to the way babies have been raised for thousands of years - a system I think we can safely assume evolved for the protection of the species.  So, where did these recommendations come from?  Dr. McKenna describes his process of uncovering the answer to that question:

We learned that infant care recommendations were not based on empirical laboratory or field studies of human infants at all, nor on cross-cultural insights as to how human babies actually lived.  Rather, they were based on 70 or 80 year old cultural ideas, uniquely Western and historically novel, mostly reflecting the social values of male physicians who not only had never changed a diaper, but had never - in any substantial way - associated with, or taken care of, their own infants.  These were essentially middle-aged men who preferred to define babies in terms of who they wanted the infants to become, rather than in terms of who they actually were - little creatures who are very much dependent physiologically, socially, and psychologically on the presence of the caregiver...

The more we delved into these areas, the more we discovered that the prevailing wisdom had no basis in science whatsoever.  This discovery changed my career.

It seems to me that, as parents, our responsibility is to try to make informed decisions about how to raise our children.  Isn't that all we can really do?  So if you're trying to decide where your baby will sleep, read the AAP policy, talk your friends who have co-slept, chat with your doctor, and also read this book.  Whatever you decide, you'll hear an important and underrepresented perspective from a man who truly knows what happens when we sleep.

I have a copy of this book to give away.  Send me an email by 8 pm EST on Tuesday, August 28th, and I'll do a drawing and notify the winner by email.

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