Wayne, PA Lactation Consultant Guest Writer

I am excited to post a guest article today, written by my good friend: a mom to two beautiful children from Wayne/Radnor area, wife to amazing chiropractor Paul Sinnott at the Chiropractic Spine Center, a highly skilled lactation consultant at Paoli hospital, and my doula for the birth of both of my babies, Donna Sinnott, IBCLC (aka Boob Donna)

To Sleep or Not to Sleep: That is the Question 
by Donna Sinnott, originally appeared in Nursing Mothers News, a publication of Nursing Mothers Alliance

The birth of a baby is truly a wonderful mystery of life.  The birthing process hasn't changed much over the last 5000+ years.  In the beginning, before there were clocks and schedules, babies were always breastfed by mom, on demand, day and night.  Only in the last 200 years, cultures began adding on more rooms, and only in the last 10 years or so, have we seen the rise of "sleep training" methods.

In a survey of 172 societies, all infants in all cultures do some co-sleeping at night, even of only for a few hours.  The U.S. consistently stands out as the only society in which babies are routinely placed in their own beds and in their own rooms.  But, for many breastfed babies, night waking is normal and necessary.  Night waking is as normal as co-sleeping with your child in almost every culture, except the United States.

In some Western cultures, such as the United States, artificial feeding is a norm and the expectations are different.  Babies are expected to sleep for long stretches alone, often in a separate room, by the time they are three or four month old.  This is an arrangement that has grown over the last 200 years because of cultural reasons, not out of biological appropriateness.  In almost all cultures around the globe, mothers and babies sleep close to each other at night for many reasons, mainly so that the baby can be nursed with less disruption of sleep.  Parents in these cultures expect babies to wake frequently to nurse at night until they have matured enough to naturally outgrow this behavior, a process that may take years.  A wakeful baby - even a wakeful older baby or toddler - is not considered unusual or a problem in these cultures.

Besides the practical reasons of co-sleeping, science is now learning that sleeping with mom is a biological need.  Infants don't develop the ability to easily navigate types of breathing until they are at least three or four months old.  James McKenna, Professor of Anthropology, has published many studies that provide evidence that when mother and baby sleep together, the mother's breathing and movement affect the baby's breathing and arousal patterns. Babies get more practice at the transitions from one kind of breathing to another.  Also, mothers and their breastfed babies can then develop the same sleep cycles which encourages less disruption to sleep for all.  Breastfeeding moms can't get any deep sleep anyway: Lactation women are hormonally programmed not to have the fourth and deepest sleep cycle, possibly to be able to tune in to the waking cycles of our babies.

So, how could we Americans cope with such a change in our cultural norm? A working mom or a stay-at-home mom may be asking, "I need my sleep. How will I function well?"  Well, there are many alternatives to the usual sleeping arrangements that can make night nursing a lot easier.

  • The baby's crib (or bedside co-sleeper) can be attached to the parents' bed in a "side car" arrangement (with one side open).

  • A mattress could be put on the floor in the baby's room or in the parents' room so mom can lie down and sleep while nursing the baby back to sleep.

  • A bed rail can be used (on that floor mattress) or on the parents' bed even if baby simply sleeps in their bed part of the night.

  • Mom can wake and feed the baby every two to three hours in the day if she is constantly nursing at night.

  • Wake and feed your baby just before you go to sleep so you can get a longer sleep cycle before the baby wakes again.
Like many parenting decisions, there are pros and cons to developing a co-sleeping arrangement.  A family bed can help prevent Sudden Infant Death Syndrome (SIDS), it matches breathing, matches body temperature and makes mom more aware if something is wrong.  Co-sleeping creates less disruption to sleep and continues to give nourishment and comfort throughout the night hours.  A family bed can help make the necessary night nursings easier and reconnect a family after a long day.

Yes, there are cons to a family bed.  It can be harder for mom to settle in due to squirming and diapers crinkling.  It can create less privacy, making it harder to turn in later or get up earlier.  A family bed can also create ongoing doubts such as "Am I doing the right thing?"  or "When should it end?"

Just remember, no matter what the sleeping arrangements are in your home, where mom and baby sleep is a personal, parenting decision that should be made based upon what is best for your baby, you and your family.  Like the first of many parenting decisions, trust yourself when making whatever choice is best for you and your family.  Remember, night waking for nourishment and comfort is often a biological need and not a choice to the infant.  In the words of Dr. Sears, author of "Nighttime Parenting" and other books, "In the first few months, the infant's needs are the highest, but his ability to communicate those needs is the lowest."

"Nighttime Parenting" Sears
"Three in a Bed" Jackson
"The Breastfeeding Answer Book" Mohrbacher and Stock
"Mothering" magazine Nov/Dec 1998
Special thanks to Jo Matey  

Main Line Doulas thanks Donna Sinnott for allowing us to reprint her article.