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Do not pump & dump without reading first. It is rarely, if ever, necessary.

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If you are going to bring your baby into your bed, please make an informed decision about whether your living situation is appropriate for bed-sharing. Read about the seven conditions that need to be met to maximize safe bed-sharing. The Academy of Pediatrics does not endorse bed-sharing but does say that if you are going to fall asleep with your infant, to do it safely in bed. Couches & lounge chairs pose a risk of suffocation.

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Diane Wiessinger, Diana West, Linda J. Smith, Teresa Pitman

Photo: Weaver by Lisa on Location Photography
Excerpted fromSweet Sleep: Nighttime and Naptime Strategies for the Breastfeeding Family, Chapter 2: The Safe Sleep Seven, by Diane Wiessinger, Diana West, Linda J. Smith, Teresa Pitman, a La Leche League International book, Ballantine Books, 2014.
Wah! Wah! Wah! Drag yourself out of your nice cozy bed, pick up your screaming baby, sit down to nurse, try to stay awake, put him back in the crib, stagger back to bed, and hope, hope, hope he stays asleep for at least two hours. I had no idea I could feel that exhausted. I could not understand how other mothers survived this, because I didn't think I was going to.
My friend who's a La Leche League Leader came over and saw how worn down and bleary-eyed my husband and I looked. She asked if we'd thought about bedsharing to get more sleep. No. Not for us. Never. But she laid out seven things that make it safer. That night, out of pure desperation and sleep deprivation, I brought my son into my bed for part of the night . . . and I started the next day a bit brighter. He spent more and more time in my bed at night, and lo and behold, we both got more and more sleep. -Monica

Today's culture says you should keep the baby in your room... but not in your bed. Feed him in bed and get really drowsy...but then get out of bed again. Two trips out of bed for every feeding. By about six weeks, something has to give. (1) Weaning? Leads to short-term and long-term problems. (2) Night weaning? Not healthy for you, your baby, or your milk supply at this age. (3) Supplementing? Ditto. (4) Break out the sleep-training book from the baby shower? Not as harmless as it seems (see Chapter 18).

A mother's first step is usually to find a place where she can relax for night feedings. The American Academy of Pediatrics (AAP) says, "Infants may be brought into the bed for feeding or comforting but should be returned to their own crib or bassinet when the parent is ready to return to sleep." (5) Easy to say. When most of us are "ready to return to sleep," steeped in hormones that make us sleepy, the last thing we want is to get up again. If a mother's afraid to nurse in her own bed, her most likely options are a sofa, recliner, or upholstered chair-all riskier places to sleep with a baby. One study found that 44 percent of mothers who nurse in those places at night fell asleep there at least once. (6) Eventually, many mothers find that bedsharing is a low-risk, long-term solution for sleep deprivation and an unhappy baby. (7) But they often go through several high-risk arrangements along the way.

The Safe Sleep Seven Bedsharing Song

(to the tune of "Row, Row, Row Your Boat")
No smoke, sober mom
Baby at your breast
Healthy baby on his back
Keep him lightly dressed.
Not too soft a bed
Watch the cords and gaps
Keep the covers off his head
For your nights and naps.

Even though most new breastfeeding mothers today don't plan to bedshare, studies show that eventually 60 to 75 percent of them will, at least some of the time. (8) Why? Probably because most breastfeeding mothers get more sleep when they bedshare. (9) In fact, a lot of mothers who say they don't bedshare actually do. If the baby starts the night in the crib, if the baby started the night in the crib last night, if the baby usually comes into his mother's bed at the first waking, even if a family simply owns a crib . . . any of those can lead a mother to say-and believe-that she doesn't bedshare when she actually does. (10)

One of the big reasons that bedsharing is safer when you're breastfeeding is the way you position your body next to your baby. During sleep, you'll automatically go into the same position as breastfeeding mothers all over the world and throughout time. It's called a cuddle curl, and it's nature's way of protecting a baby during sleep. Your knees come up and your arm tucks under your head or pillow, or curls around your baby, creating a protected space. There's no way for you to roll toward your baby because your bent legs won't let you. And no one else can roll into the space because your knees and elbows are in the way. (11) Very cool! (If you're worried about your partner, just sleep between your partner and the baby.)

Even during sleep a breastfed baby will instinctively stay with his face near the breast, because that's the center of his universe (and his kitchen). (12) If your baby homes in on your breast, he's not going to wander up into the pillows or down under the covers (and your arm and legs won't let him).

There's another layer of protection too: normally, we're aware of the edges of our bed and the bodies of our pets, even when we're sound asleep. We don't roll over on a baby any more than we roll off the side of the bed or roll over on the cat. And of course both the cat and the baby would react if you tried.

A mother who has never breastfed loses some of these protections. She tends to move her baby closer to her own face, where those puffy, smothery pillows are. (13) And a baby who doesn't breastfeed is more likely to wander up there himself, even if the bottles are filled with his mother's milk.

What if you're still working out the kinks, maybe pumping for a baby who isn't nursing yet? A newborn will automatically seek his mother's breast. If you've been focused on helping him breastfeed, you'll probably find yourself doing a cuddle curl, at least at first.

If you breastfeed most of the time but give occasional bottles of pumped milk, you'll probably still sleep in a breastfeeding cuddle curl, and your baby will most likely stay at chest level. (14) But if either of you sees a bottle as the more important food source, you and your baby may not automatically "think breast," and your bedsharing risk may increase. (15) If you're just not sure, think carefully about how you cradle your baby when you lie down, and maybe have your partner watch how you interact before you decide for or against bedsharing.

What if your baby gets formula sometimes? Exclusive formula-feeding increases the risk of SIDS (see Chapter 19); partial formula-feeding is a smaller SIDS risk.

By about four months, any responsible adult can bedshare as safely as a responsible breastfeeding mother. (16)

For those who say they don't need to prepare their bed for bedsharing because they'll never, ever do it, think about car accidents. No one ever expects them to happen either. But they do. That's why we wear seat belts. It's not that we're planning to have an accident; it's that accidents are never planned. So we plan ahead, and we don't give it another thought. Simple and safe-or as safe as being in a car can get.

A planned-ahead bed is just a seat belt. Then at 3:00 a.m. when your baby just can't sleep alone even though you've tried everything up, down, and sideways, you can collapse in bed with your baby and stay there snugly until morning. Tomorrow morning you can decide what you want to do tomorrow night. Life is risky, no matter how you live it. A safe bed, like a seat belt, can greatly reduce that risk.

The Key Points for Safe Sleep for All Babies
Stay smoke-free. Stay sober. Stay off sofas, upholstered chairs, and recliners for sleep. Keep your healthy baby lightly dressed, on his back, and near you for sleep. And, of course, keep breastfeeding.

But what about all the warnings against bedsharing? If you meet the criteria outlined in the Safe Sleep Seven, then you're not the mother the warnings are for! Only a small subset of babies with certain preexisting vulnerabilities is at risk for SIDS. The risk for SIDS or suffocation is far, far, far greater in a household where the mother smokes, where alcohol or drugs are involved, where the baby is formula-fed, or in truly chaotic settings where the baby sleeps who knows where or with who knows whom (see Chapter 19). In an attempt to reach certain mothers and protect certain babies, the warnings have be en made very clear, very strong, and very simple. The answers for you are just as simple.

The Key Points for Applying the Key Points
Every situation is different. Life is never 100 percent safe. And everyone balances risk and benefits differently. Take the information we present and use your mother-wisdom to decide what's best for you, your baby, and your family.

All those scary warnings are about only the first four months. Beyond that? Even the researchers behind the bedsharing cautions agree that by about four months bedsharing by any responsible, nonsmoking adult is as safe as having your baby sleep separately in a bassinet or crib. (11)

If you and your baby fit the Safe Sleep Seven criteria, your baby's risk of SIDS is what one sleep researcher calls vanishingly small. And you'll virtually eliminate overlying and other suffocation risks.

If you are:
1. A nonsmoker
2. Sober and unimpaired
3. A breastfeeding mother and your baby is:
4. Healthy and full-term
5. On his back
6. Lightly dressed
and you both are:
7. On a safe surface

Then your baby in bed with you is at no greater risk for SIDS than if he's nearby in a crib. The Safe Surface checklist explains number 7 and practically eliminates breathing risks no matter where he sleeps. Rolling over on your baby is virtually impossible because you have the cuddle curl (see above) and responsiveness of a breastfeeding mother. By the time the baby is about four months old, research indicates that bedsharing with a healthy baby by any responsible nonsmoking adult on a safe surface is as safe as any other sleep arrangement.

The Safe Surface Checklist

Avoid these possible smothering risks:

Sofas and recliners

Softness or sagging that rolls your baby against you or keeps him from lifting his head free

Spaces between mattress and headboard, side rails, or wall where a baby could get stuck

Pets that could interfere

Clear your bed of:

Unused pillows

Stuffed toys

Heavy covers and comforters

Anything nearby that dangles or tangles (such as cords, strings, scarves, ribbons, elastics)

Check your bed for possible hazards:

Distance to floor

Landing surface

Sharp, poking, or pinching place

The remainder of Chapter 2 explores the details of each Safe Sleep Seven criteria, including the research and common sense behind them.

Something to Sleep On

Research on infant sleep risks, which we go over in depth in Chapter 19, shows again and again that the big risks of shared sleep are a mix of SIDS risks that affect vulnerable babies and breathing hazards that affect all babies: smoking, alcohol or drugs, risky surfaces like sofas, baby on his front (unless he's on an adult's chest), and formula-feeding. Combine two or more of those, and the risk can skyrocket.

If you and your baby meet the requirements in the Safe Sleep Seven checklist, you've already eliminated all the biggest SIDS risks. And if you prepare your bed, then your baby's overall nighttime risk becomes vanishingly small. It's like putting your seat belt on and then driving slowly on a deserted (and lovely!) country road. Enjoy having your baby beside you for the journey.

Sleep: Bedshare
Sleep: Safe Sleep
Sleep: Safe Surface
Sleep: Talking With Your Doctor About Bedsharing
Infant Sleep
ORDER YOUR COPY TODAY, NORTH AMERICAN EDITION ORDER YOUR COPY TODAY, BRITISH EDITION

References

1 Ball, H. L. Breastfeeding, bed-sharing, and infant sleep. Birth 30, no. 3 (2003): 181-188. Ball, H. L., Hooker, E., Kelly, P. J. Where will the baby sleep? Attitudes and practices of new and experienced parents regarding cosleeping with their newborn infants. American Anthropologist 101, no. 1 (1999): 143-151.

2 U.S. Department of Health and Human Services. Executive summary: the surgeon general's call
to action to support breastfeeding. Breastfeeding Medicine 6, no. 1 (2011): 3-5.

3 Imong, S. M., Jackson, D. A., Wongsawasdii, L., et al. Predictors of breast milk intake in rural northern Thailand. Journal of Pediatric Gastroenterology and Nutrition 8, no. 3 (1989): 359-370. Kent, J. C. Volume and frequency of breastfeedings and fat content of breast milk throughout the day. Pediatrics 117, no. 3 (2006): e387-e395.

4 Howel, D., Ball, H. Association between length of exclusive breastfeeding and subsequent breastfeeding continuation. Journal of Human Lactation 29, no. 4 (2013): 579-585.

5 Moon, R. Y., et al. SIDS and other sleep-related infant deaths: expansion of recommendations for a safe infant sleeping environment. Pediatrics 128, no. 5 (2011): e1341-e1367.

6 Kendall-Tackett, K., Cong, Z., Hale, T. W. Mother- infant sleep locations and nighttime feeding behavior. Clinical Lactation 1, no. 1 (2010): 27-30.

7 Colson, E. R., Willinger, M., Rybin, D., et al. Trends and factors associated with infant bed sharing, 1993-2010. The National Infant Sleep Position Study. JAMA Pediatrics 167, no. 11 (2013): 1032-1037.

8 Ball, H. L. Breastfeeding, bed-sharing, and infant sleep. Birth 30, no. 3 (2003): 181-188. Ball,
H. L. Bed-sharing practices of initially breastfed infants in the first 6 months of life. Infant and Child Development 16, no. 4 (2007): 387-401.

Ball, H. L. Reasons to bed-share: why parents sleep with their infants. Journal of Reproductive and Infant Psychology 20, no. 4 (2002): 207-221.

Kendall-Tackett, K., Cong, Z., Hale, T. W. Mother- infant sleep locations and nighttime feeding behavior. Clinical Lactation 1, no. 1 (2010): 27-30.

Lahr, M. B., Rosenberg, K. D., Lapidus, J. A. Maternal-infant bedsharing: risk factors for bedsharing in a population-based survey of new mothers and implications for SIDS risk reduction. Maternal and Child Health Journal 11, no. 3 (2007): 277-286.

Blair, P. S. The prevalence and characteristics associated with parent-infant bed-sharing in England. Archives of Disease in Childhood 89, no. 12 (2004): 1106-1110.

9 Quillin, S. I. M. Interaction between feeding method and co-sleeping on maternal-newborn sleep. Journal of Obstetric, Gynecologic, and Neonatal Nursing 33, no. 5 (2004): 580-588.

10 Ball, H. L., Hooker, E., Kelly, P. J. Where will the baby sleep? Attitudes and practices of new and experienced parents regarding cosleeping with their newborn infants. American Anthropologist 101, no. 1 (1999): 143-151.

11 Ball, H. Parent-infant bed-sharing behavior. Human Nature 17, no. 3 (2006): 301-318.

Ball, H. L., Klingaman, K. Breastfeeding and mother- infant sleep proximity. In Trevathan, W. R., Smith, E. O., McKenna, J. J. (eds.), Evolutionary Medicine. New York: Oxford University Press, 1999.

12 Richard, C., Mosko, S., McKenna, J., et al. Sleeping position, orientation, and proximity in bedsharing infants and mothers. Sleep 19, no. 9 (1996): 685-690.

Baddock, S. A., Galland, B. C., Bolton, D. P. G., et al. Differences in infant and parent behaviors during routine bed sharing compared with cot sleeping in the home setting. Pediatrics 117, no. 5 (2006): 1599-1607.

13 Ball, H. Parent-infant bed-sharing behavior. Human Nature 17, no. 3 (2006): 301-318. Ball, H. L., Klingaman, K. Breastfeeding and mother-infant sleep proximity. In Trevathan, W., Smith, E. O., McKenna, J. J. (eds.), Evolutionary Medicine and Health: New Perspectives. Oxford: Oxford University Press, 2008.

14 Ball, H. Parent-infant bed-sharing behavior. Human Nature 17, no. 3 (2006): 301-318. McKenna, J. J., Ball, H. L., Gettler, L. T. Mother-infant cosleeping, breastfeeding and sudden infant death syndrome: what biological anthropology has discovered about normal infant sleep and pediatric sleep medicine. American Journal of Physical Anthropology 134, suppl. 45 (2007): 133-161.

15 Volpe, L. E., Ball, H. L., McKenna, J. J. Nighttime parenting strategies and sleep-related risks to infants. Social Science and Medicine no. 79 (2013): 92-100.

16 Blair, P. S., Fleming, P. J., Smith, I. J., et al. Babies sleeping with parents: case-control study
of factors influencing the risk of the sudden infant death syndrome. CESDI SUDI Research Group.
BMJ 319, no. 7223 (1999): 1457-1461. Carpenter, R. G., Irgens, L. M., Blair, P. S., et al. Sudden unexplained infant death in 20 regions in Europe: case control study. Lancet 363, no. 9404 (2004): 185-191. Tappin, D., Ecob, R., Brooke, H. Bedsharing, roomsharing, and sudden infant
death syndrome in Scotland: a case-control study. Journal of Pediatrics 147, no. 1 (2005): 32-37. Vennemann, M. M., Bajanowski, T., Brinkmann, B., et al. Sleep environment risk factors for sudden infant death syndrome: the German Sudden Infant Death Syndrome Study. Pediatrics123, no. 4 (2009): 1162-1170. Ruys, J. H., De Jonge, G. A., Brand, R., et al. Bed sharing in the first four months of life: a risk factor for sudden infant death. Acta Paediatrica 96, no. 10 (2007): 1399-1403. Moon, R. Y., et al. SIDS and other sleep-related infant deaths: expansion of recommendations for a safe infant sleeping environment. Pediatrics 128, no. 5 (2011): e1341-e1367.

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The Safe Sleep Seven - La Leche League International

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Diane Wiessinger, Diana West, Linda J. Smith, Teresa Pitman Photo: Weaver by Lisa on Location Photography Excerpted from Sweet Sleep: Nighttime and Naptime Strategies for the Breastfeeding Family, Chapter 2: The Safe Sleep Seven, by Diane Wiessinger, Diana West, Linda J. Smith, Teresa Pitman, a La Leche League International book, Ballantine Books, 2014.

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Bedsharing and Breastfeeding

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Safe Cosleeping Guidelines // Mother-Baby Behavioral Sleep Laboratory // University of Notre Dame

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Professor James J. McKenna's Mother-Baby Behavioral Sleep Laboratory at Notre Dame studies how sleeping and co-sleeping environments affect mothers, breastfeeding, and infants' physiological and psychological well-being and development.

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​The American Academy of Pediatrics (AAP) says that when done correctly, swaddling can be an effective technique to help calm infants and promote sleep.

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Listen to the world's foremost authority on infant sleep.  McKenna is director emeritus of the Mother-Baby Behavioral Sleep Laboratory at the University of Notre Dame.

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Genevieve Howland (a.k.a. Mama Natural) talks with Adriana about ways you can navigate the emotions that come with gaining weight during pregnancy, identify possible triggers, and explore seeing it as an opportunity to connect with and appreciate your body in a new...

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Baby-led weaning is a method of introducing solid food to babies whereby purées and spoon-feeding are skipped entirely in favor of finger foods that a baby self-feeds.

Coined by Gill Rapley, a former public health nurse in the U.K., baby-led weaning (or baby-led feeding as it is sometimes referred to) offers parents a way to bypass the idea of baby food entirely. Growing in popularity, baby-led weaning is particularly popular with parents who want to avoid raising picky eaters, as well as parents who subscribe to Montessori-type philosophies of child-rearing where children are encouraged to be self-sufficient.

At its core, baby-led weaning emphasizes independence of the baby. A parent is to wait for their baby to show signs of readiness for eating and to follow the baby's cues in all matters of introducing solid food. Babies are brought to the table for family meals, encouraged to pick up food with their own fingers, and trusted to eat as much or as little as they need. Babies introduced to solids with baby-led weaning also continue breast or bottle feeds and are permitted to determine when those milk feeds should be reduced.

Benefits of Baby-Led Weaning

Research studies are just beginning to analyze the impacts of baby-led weaning, but we know there are many benefits to letting your baby self-feed.

Of primary importance is fostering independence: with baby-led weaning, your baby will learn to eat on their own and have control over what---and how much---they eat. Our experience is that babies who are given this control over what they eat early on are less likely to become picky eaters in the toddler years and beyond. With baby-led weaning, food is less likely to become a lever for control or power in the child-parent relationship because the child is in control from day one of starting solids.

Other benefits of baby-led weaning include the opportunity for your baby to practice critical motor and oral skills. Self-feeding a variety of food consistencies and textures enables your baby to work on tongue movements, jaw strength, and swallowing as well as the fine motor skills required to pick up different sized pieces of food with their fingers.

Lastly, current research shows that babies who are started on solids with finger foods (or "baby-led weaning") are no more likely to choke on food than babies who are spoon-fed.

Benefits of Letting Your Baby Self-Feed

Independence: Baby learns to eat independently and is in total control.

Development: Baby practices critical motor and oral skills.

Appetite Control: Baby is in charge of how much to eat and learns to stop when full.

Ease: Baby (mostly) eats what you eat. Less special meals.

Variety: Baby can eat a variety of textures and flavors, which may reduce picky eating later on.

Less Expensive: Baby eats real food. No pricey jars, pouches or blenders required.

Family Meals: Baby is part of your family meal, eating with you.

Dining Out: It's easier to eat in restaurants as baby can eat whole food.

Fun! Babies enjoy touching, inspecting, and tasting a different flavors and textures.

With self-feeding, you can employ a combination of feeding methods, with an emphasis on letting your baby self-feed a variety of textures and flavors.

Hungry for more? Head over to our comprehensive Startng Solids course with topics from how to get started with baby-led weaning to how to prevent picky eating.
This page has been created with typically developing infants and children in mind. If your baby/child has underlying medical or developmental differences, including but not limited to: prematurity, developmental delay, hypotonia, airway differences, chromosomal aThese pages have been created with typically developing infants and children in mind. The information here is generalized for a broad audience and is for informational purposes only. Your child is an individual and may have needs or considerations beyond generally accepted practices. If your child has underlying medical or developmental differences, including but not limited to prematurity, developmental delay, hypotonia, airway differences, chromosomal abnormalities, craniofacial anomalies, gastrointestinal differences, cardiopulmonary disease, or neurological differences, we strongly recommend and encourage you to discuss your child's feeding plan and when and how to start solids and finger food with the child's doctor, health care provider or therapy team. Close consultation with a feeding and swallowing specialist can provide safe guidance for the child's feeding journey. Always seek the advice of your doctor, health care provider or therapy team with any questions you may have regarding your child's development and capacity for starting solid foods.

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