美国国家公共电台 NPR Is Sleeping With Your Baby As Dangerous As Doctors Say?

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DAVID GREENE, HOST:

This morning, how to help newborn babies sleep. Turns out, many moms are going against a medical recommendation that's aimed at saving babies' lives. In our new series How to Raise a Human, NPR's Michaeleen Doucleff explores whether it's time for pediatricians to change their advice.

MICHAELEEN DOUCLEFF, BYLINE¹: About six months ago, Melissa Nichols brought her little baby girl home from the hospital to her apartment in San Francisco. She immediately started hiding something.

MELISSA NICHOLS: I felt guilty, and I felt like I didn't want to tell anyone. I just felt like it's - like you're a bad mom or I don't know. The mom guilt², like, starts right away.

DOUCLEFF: Nichols knew what she was doing went against medical advice. And she felt so ashamed about it that she kept it from her pediatricians.

NICHOLS: It's kind of like this weird³ thing that you're like, are they going to ask me about it?

DOUCLEFF: The way Nichols talks, you'd think she's doing something really dangerous with the baby, like drinking and driving. But, no, what Nichols is ashamed of...

NICHOLS: Bed-sharing.

DOUCLEFF: ...Holding her baby while they sleep. The American Academy of Pediatrics says moms should not sleep with their newborns.

NICHOLS: I just, like, couldn't bring myself to, like, put her far away from me.

DOUCLEFF: She tried putting her newborn in the crib, as the doctors told her. But on the first night, it didn't work.

NICHOLS: She was crying and, like, would absolutely not sleep. And I couldn't sleep either.

DOUCLEFF: Because you wanted to touch her and hold her.

NICHOLS: Yeah. And I also just kind of feel instinctually that, like, she should be on me. Like, she's been in me for nine months. And like, this has to be right.

DOUCLEFF: There's no question many moms have an instinct to sleep with their babies. Humans have been sleeping together for hundreds of thousands of years. And James McKenna, an anthropologist⁴ at Notre Dame⁵, says babies also have a lot to say about the matter, too.

JAMES MCKENNA: Human babies are contact seekers. What they want and need the most is their mother and father's bodies. This is what's good for their physiology⁶. This is what their survival depends on.

DOUCLEFF: Today the practice is widespread. Anthropologists at Yale found that in at least 40 percent of documented cultures, it's a tradition for babies to sleep with their moms. But in the past several decades, there's been a growing concern in Western cultures about whether sleeping in the same bed is safe. Could the mom easily roll over on the baby or could the baby easily move up into the pillows and suffocate⁷? Back in the '90s, McKenna tried to figure out exactly what happens during the night when a mom sleeps with her newborn.

MCKENNA: My laboratory was like an apartment, basically.

DOUCLEFF: He invited dozens of moms and babies to sleep in his lab, hooked them up to all this monitoring equipment and measured...

MCKENNA: Heart rate, breathing patterns, chest movement, body temperature, brain waves.

DOUCLEFF: What McKenna found was remarkable⁸. The mom, when she's breastfeeding, creates this little shell around the baby, almost like an incubator. Inside this shell...

(SOUNDBITE OF HEARTBEAT)

DOUCLEFF: ...The baby hears the mom's heartbeat and in turn, changes her heart rate.

MCKENNA: It's usually slowing.

DOUCLEFF: The baby also hears...

(SOUNDBITE OF BREATHING)

DOUCLEFF: ...The mom breathing, which McKenna says sounds similar to what the baby hears in the womb.

MCKENNA: That contains that shoo-shoo-shoo-shoo (ph).

DOUCLEFF: Which in turn sounds like...

MCKENNA: Hush⁹, hush, hush, little baby.

DOUCLEFF: ...The universal sound to soothe¹⁰ a crying baby. The baby is so drawn¹¹ to the mother at night that she doesn't move all around the bed. Instead, she stays focused on one location.

MCKENNA: The babies are basically staring at their mother's breast almost all night. They just stay there.

DOUCLEFF: By nestling close to her baby, McKenna found the mom is helping¹² regulate the baby's physiology.

MCKENNA: This is the evolved context for a baby to live and experience night after night after night.

DOUCLEFF: So why has sleeping with babies become so stigmatized¹³ that moms are hiding this from their doctors? In 2011, pediatricians in the U.S. started giving parents a strong universal recommendation.

PETER BLAIR: Parents just shouldn't bed share. It was a simple, direct message. Don't bed share.

DOUCLEFF: That's Peter Blair, a SIDS researcher at the University of Bristol. He says pediatricians were trying to cut down the rate of sudden infant death syndrome¹⁴. Some studies suggested that bed-sharing was a big risk for SIDS. There was just one problem. The studies lumped together all types of bed-sharing, including when a baby was put in very dangerous circumstances.

BLAIR: Those infants who were sleeping next to parents who drank some alcohol and those parents that are taking some drugs, normally cannabis or methadone and that sort of thing.

DOUCLEFF: The evidence is strong and clear. Parents who drink or do drugs shouldn't be sleeping with their babies because they are intoxicated¹⁵ and can roll over on the child. Babies who are born premature¹⁶ or whose parents smoke shouldn't sleep in the parents' bed because of potential problems with their respiratory system. And suffocation¹⁷ can also happen when babies sleep on sofas.

BLAIR: The question really was, well, in the absence of these hazardous¹⁸ situations, is there actually a risk of bed-sharing?

DOUCLEFF: So far, there have been only two studies to look at this. Robert Platt is a biostatistician at McGill University. He analyzed¹⁹ the studies for the American Academy of Pediatrics. Both studies found no increased risk for babies over three months of age. And for the younger babies...

ROBERT PLATT: There may be an increased risk and if there is an increased risk, it's probably not of a comparable magnitude to some of these other risk factors.

DOUCLEFF: Let's take Melissa Nichols. Her little girl was born super healthy - full-term, normal weight and Nichols doesn't smoke or drink. So her baby's risk of SIDS, even when she bed shares, is tiny. It's six-thousandths of 1 percent, which means the baby is more likely to get struck by lightning in her lifetime than die of SIDS. In other words, the risk of bed-sharing is not the same for every family. That's why other countries have taken a more nuanced approach. New Zealand has been leading the way.

Dr. Ed Mitchell is a pediatrician and SIDS researcher at the University of Auckland. He says because of this, they've seen huge progress against SIDS.

ED MITCHELL: We've had a 30 percent reduction in mortality since 2010.

DOUCLEFF: Pediatricians there and in Britain are teaching families how to reduce their risk while bed-sharing.

MITCHELL: We are now talking about a safer bed-sharing. And that takes all the steam out of it.

DOUCLEFF: Dr. Lori Feldman-Winter is a pediatrician at Cooper University Health Care and a member of the AAP's Task Force on SIDS. She says the AAP is standing²⁰ by its recommendation against bed-sharing until they get more data. Nevertheless, she knows mothers are hiding and says pediatricians need to be more tolerant of family choices so families don't feel judged.

LORI FELDMAN-WINTER: We don't want families to be saying that they don't feel comfortable saying basically what they're doing.

DOUCLEFF: Because then conversation stops and families are left without any information. Michaeleen Doucleff, NPR News.