How to Sleep Safely with your Baby

In today’s technological society, it’s easy to lose sight of the fact that humans are mammals. We give birth to live young and feed our infants milk from our bodies.

More specifically, we are primates, a “carry” species that is biologically programmed to keep our babies close day and night. Humans have slept next to their children on the ground or on mats for millions of years. Bedsharing is biologically normal.

However, modern comforts like soft mattresses and fluffy pillows have introduced hazards to the nighttime environment. So how can Western parents safely meet our children’s biological sleep needs?

Read Sweet Sleep

There are some great sleep books out there, but if you can only read one, be sure it’s Sweet Sleep. If you have a partner, read it out loud to each other. You will learn the details of the Safe Sleep Seven for bedsharing (no smoking, stay sober, breastfed baby, no sweat/no swaddle, healthy full term baby, safe surface, baby on back) and so much more.

If you don’t meet these requirements, you can still cosleep – just be sure to use a commercial cosleeper or “sidecar” a crib to the bed.  And research has shown that by four months old, a healthy baby can share sleep on a safe surface with any responsible nonsmoking adult.

Learn to nurse in the “cuddle curl”

During the day, babies love to nap on a reclining parent’s chest. Tummy sleeping is fine in this case and it’s a great time to catch up on reading or binge watching! But at night, mothers around the world instinctively curl around their babies to nurse and sleep.

This “cuddle curl” creates a safe space for baby at the breast with mom’s arm above and legs pulled up below. If this position doesn’t come naturally at first, keep working at it – you may need to move baby down so their head tips back, pull their legs into your tummy or elevate your breast with a small folded towel.

Baby Sleep Info Source website – image courtesy of Kathryn O’Donnell

Some parents, even those with small breasts, move their upper leg over on to the bed so they can lean over to nurse with the top breast (stomach sleepers often really like this) or hold baby on their chest while they roll to their other side. Back sleepers sometimes find that a pillow behind them allows them to partly roll on to their backs.

Work on getting comfortable so both you and baby can drift back to sleep while nursing. Firm pillows are ok as long as they are kept away from baby, anchored under your head or between your knees. Dr. James McKenna has found that bedsharing mothers and babies naturally synchronize their sleep patterns, often barely waking together to latch or adjust position before falling back asleep.

Your mattress should be firm – and big

Ditch your waterbed, pillowtop or other soft sleeping surface. If your pillowtop mattress is two sided, turn it over! Or invest in a firm mattress topper – there are quite a few on the market. Futons are a great option for a firm sleeping surface that can be used on the floor or on a low frame.

If you are buying a new mattress, get a king size (or larger!). If you aren’t, consider getting a single mattress and attaching it tightly to your full or queen to make a bigger sleep surface. Pack the crack firmly with a towel if necessary.

Make it safe

For the most part, Western culture views solitary infant sleep as “normal,” so accidents in cribs result in making cribs safer – not getting rid of them. The same should be true for bedsharing – and bedsharing IS biologically normal.

Public health warnings about bedsharing often frighten new parents so much that many end up falling asleep with their babies on far more dangerous surfaces than beds, such as sofas and recliners. Make your bed a safe space and relax knowing that bedsharing while following the Safe Sleep Seven is no more risky than putting baby in a crib nearby.

Tie up dangling cords, strings and even long hair at night. Get rid of extra pillows, stuffed animals and fluffy comforters – use several layers of thin blankets instead and keep them down around your waist. If you are cold, try wearing a soft cardigan sweater and an old shirt with holes cut out for your breasts.

Dockatots and other sleep positioners are not necessary and in fact may pose a suffocation hazard – use them during the day on the floor for naps when an adult is awake in the same room. Babies don’t need silent, dark rooms – in fact, sleeping too deeply is a risk factor for SIDS and ambient noise is thought to be protective.

Check for cracks between the mattress and other parts of the bed – if you find any, pack them tightly with towels or blankets. Do the same if you use a bedrail.

Some parents put a pool noodle at the edge of the bed under the fitted sheet to make a simple guardrail before baby becomes mobile – however, this could also post a suffocation hazard. Pushing your bed against a wall isn’t recommended, as a crack could appear as the mattress shifts.

Put your mattress on the floor

Families around the world sleep on the floor and some doctors even recommend it for back problems. It may take a little getting used to, but this is often the safest option, particularly when baby starts crawling.

If you have solid surface floors, a blanket or quilt underneath that extends out around the sides can cushion the short drop if baby crawls off. With carpet, be sure to vacuum around the mattress regularly to remove dust. Lift up the mattress every week or so to air it out and prevent mold. Be sure to childproof the rest of the room.

Don’t worry – it won’t be long before you can have an elevated bed again. Older toddlers can be taught to get down feet first. When my children were young, we took apart our bedframe and stored it in another room with the box spring for a few years. They are now in their early twenties and I have a hard time remembering what it was like to sleep on the floor!

Try to relax

This is probably the hardest part for modern parents. The internet is full of conflicting information and dire warnings about bedsharing. Remember that our species is biologically programmed to sleep with our babies – if it were inherently dangerous, we wouldn’t be here today.

Follow the Safe Sleep Seven, make your bed a safe space and enjoy cuddling with your baby. In my interview with Dr. James McKenna on the Attachment Parenting podcast, he says, “…one of the greatest joys you can have (is) knowing you are protecting and nurturing your baby in a most healthy way, which is to sleep next to it and, if mothers can, to breastfeed through the night.”

It’s also important to turn your clock around, don’t look at your phone at night and stop using sleep tracking apps. Knowing how often you and your baby wake just leads to more stress and less sleep.

Some parents swear by expensive physiological trackers like the Owlet, but these gadgets are meant for babies sleeping alone, which itself is a risk factor for SIDS. In fact, the American Academy of Pediatrics says not to use these monitors as a SIDS reduction strategy.

The authors of an article in the Journal of the American Medical Association note that healthy babies can have temporary drops in oxygen levels and 80% of these are harmless. Research has shown that when these drops happen, the breathing and movements of an adult sleeping nearby help rouse babies from deep sleep so they breathe normally again.

Is my baby getting enough sleep?

The latest source of worry for new parents are recent articles claiming that children need a certain amount of sleep for normal brain development. But remember that these give the average amount needed – and to be an average, some must sleep more and some must sleep less!

Contrary to popular belief, sleep training doesn’t necessarily result in more or better sleep. Babies and toddlers still wake at night – they just learn not to protest, since no one will respond. And the stress of biologically ABNORMAL separation is likely to do more harm to a child’s brain development than any supposed lack of sleep.

Many kids do just fine with a late bedtime. The authors of Sweet Sleep recommend “front loading” – getting things done early in the day (leave the dinner dishes for morning!) so the family can relax on their floor bed in the evening.

Turn the lights low, read or listen to podcasts, let baby or toddler play and nurse until they are ready to fall asleep. If they wake up in the middle of the night ready to party, play dead until they nod off again. Sweet Sleep also has great ideas on how to “nudge” a baby to sleep longer when they are ready.

Occasionally, very frequent night waking can be caused by ear infections, allergies or other medical concerns. Here’s a screening quiz that can help you decide if your child’s night waking is normal or if a trip to the doctor might be indicated.

Sleep coaches, programs and schools have become big money makers recently in several Western countries. Most are based on cultural (rather than biological) norms of separate infant sleep and encourage sleep training.

Many sleep “problems” go away when parents adjust their expectations and sleep environment to be more biologically normal. Books like Sweet Sleep, Good Nights, Sleeping With Your Baby, The Gentle Sleep Book, Sleeping Like a Baby and The No-Cry Sleep Solution can help (see below for details).

What about older babies and toddlers?

As babies grow into young children, most still need the comfort of a parent’s presence at night. Nighttime is scary! Families often play musical beds, with one parent lying down with an older child in one room while the other nurses a toddler in another.

Some parents find night nursing challenging as babies turn into toddlers. Night weaning is usually not without tears, but talking to your child about it gently for several weeks beforehand can help. So can a wonderful children’s book called Nursies When the Sun Shines. Many families have been successful with Dr. Jay Gordon’s method for night weaning – however, it’s important to keep any night weaning technique gentle and to try again later if your toddler doesn’t seem ready.

Every family finds their own way – older children may come into the parent’s bed in the middle of the night or one parent may go back into their room or siblings may share a bed. Many parents have found that children leave (or stop coming into) the family bed in their own time, be that 2, 12 or anything in between. Rest assured that no college student has ever needed to be nursed to sleep in their dorm room!

Sleeping with your baby is biologically normal. Humans have done it for thousands of years. It’s what babies – and parents – need at night. With a few precautions, Western parents can enjoy this species specific experience – and get plenty of rest too.

Bonafide, C. et al, “The Emerging Market of Smartphone-Integrated Infant Physiologic Monitors,” JAMA, January 24/31, 2017

BASIS – Baby Sleep Info Source

Brief Toddler and Infant Sleep Screening (BTISS)

Good Nights by Dr. Jay Gordon

Dr. James McKenna’s Mother-Baby Sleep Lab at the University of Notre Dame

Dr. Jay Gordon – Changing Sleep Patterns in the Family Bed

How to Side Car Your Crib

Nursies When the Sun Shines: A little book on nightweaning by Katherine Havener and Sara Burrier

Sleeping With Your Baby: A Parent’s Guide to Co-sleeping by Dr. James McKenna

Sleeping Like a Baby: Simple Sleep Solutions for Infants and Toddlers by Pinky McKay

Sweet Sleep: Nighttime and Naptime Strategies for the Breastfeeding Family by Diane

Weissinger, Diana West, Linda J. Smith and Teresa Pitman

The Gentle Sleep Book by Sara Hockwell-Smith

The No-Cry Sleep Solution by Elizabeth Pantley