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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Comments

[Rebekah]

On the 44 percent of parents have participated in co-sleeping statistic, what qualifies as co-sleeping? The reason I ask is I wouldn't consider myself a co-sleeper but there have been times where I'd end up nursing my son in the middle of the night in bed and falling asleep for a couple of hours. This would happen maybe 2-3 times a month when he was between 6-9 months old (and teething). Would I be included in the 44 percent then? I ask because I was really surprised by how high the statistic is.

(And I have many friends who co-sleep and think it can be really wonderful. I may end up co-sleeping with my second myself, so this question isn't coming from an anti-co-sleeping place.)

[Tanya Lieberman]

Rebekah,

Good question. Here's what I have from the book, which is quoting the CDC data. I'll edit the post to make this more clear.

"Roughly 68% of babies enjoyed cosleeping at least some of the time. Further analyses of the data show us that about 26% of infants coslept "always" or "almost always." Combining them with the babies who sleep "sometimes" it appears that 44% of US babies from 2-9 months old are cosleeping in an adult bed at any given time."

Tanya

[Sinead]

What a fasinating post!

It's only in recent months that I've actually realised that my husband and I co-slept with our babies! For me as a breastfeeding mum, bringing each of my babies into our bed during feeds was a completely normal part of breastfeeding, not to mention parent-hood - and if I fell asleep whilst breastfeeding, well that was normal too. The fact that I didn't waken up until the next feed often meant each of my children ended up spending the whole night in our bed. Yet I didn't think of it as co-sleeping - it just was what happened!

[Beth]

Sounds like a really great book, I can't wait to read it. I was also a bit surprised at the 44% co-sleeping rate, but it does make sense as a combined rate.

I began co-sleeping with my first when she was 6 weeks old. I had mastered nursing in the side lying position and begun to hear about co-sleeping in the baby group that I was part of. Until then, I had no idea that babies could sleep with their parents! One night after a nursing session I just didn't want to crawl out of bed to put her in her bassinette. In the morning, it was such a wonderful feeling for both my husband & I to wake up with our baby girl between us! We never looked back. When my son was born, the bassinette never even made it out of the closet!

Sinead, it's so interesting to hear about your thoughts and experiences, especially the normalcy of it. I'm hopeful that more parents(and well meaning, but under-informed grandparents)here in the US will begin to view co-sleeping as a wonderful part of parenting!

[Lilia]

Now I find funny that we made a nursery, expecting that our son would move there after first few months of sleeping in a Moses backet next to our bad. Instead he moved to our bed at around 4 month. He would fall asleep with us before that every other night, but it took us a while to figure our that co-sleeping was safe, beneficial and very sweet. And now his bed serves as a safety rail to protect him from falling from our bed :)

Thanks for the review - I guess this will be another book I buy after reading your blog...

Does it have a section on sleep weaning? I'm not sure if we are ready to have our son sleeping with us till he is 3-4 years old, so I wonder how transition to his own bed will go.

[Jess]

I never intended on co-sleeping. Ever. But then I had my beautiful baby girl and she never left my arms or my bed during our hospital stay. And 14 weeks later, we still happily co-sleep. Her pediatrician has always told me by 16 weeks she'd like her in the crib, but how can I possibly do that to her? That would surely result in a distraught baby and mama. I'm definitely going to read that book.