Safe Sleep : TBSTP Position Statement

As a group who supports a shift in the way families manage this time in their lives and seek to move beyond sleep training, any talk of Safe Sleep simply must include the biologically normal way for babies to sleep throughout human history- with their mothers on a shared surface.

This does not mean that this is the ONLY way Safe Sleep can / will be found and it most certainly does not mean that bedsharing can be practiced safely by all families in our modern society.

What it does do is give us is a base understanding about why so many families struggle with sleep.

This base understanding acknowledges that the idea of a solitary sleeping human infant in a cot in their own room is a social and cultural construct, not a given and most certainly not ‘normal’ from a biological, and anthropological standpoint.

This is important for how we frame our view of infant sleep and what is/ isn’t a ‘problem’ and why normal infant behaviour can seem to be problematic for families.

When we recognise our babies all start with an intense need for care and closeness by day and night we can work with their natural needs to make it work for our families.

SIDS AND SUDI are real risks we face as parents and there are factors that have been recognised to increase risk of it occurring.

Life is all about risk management and the best risk management can be achieved when we are fully informed about the risks so we can make decisions based on our unique situation. No activity will ever be risk free. No sleep set up is entirely risk free.

Risk reduction is the name of the game.

So, as a group, we will advocate for sleeping in situations and on surfaces that have been properly prepared for shared sleep (please read how to do this in documents linked at the bottom).

We will advocate for those who can and wish to safely bedshare to have access to information about this.

How do I safely bedshare?

• Articles- http://evolutionaryparenting.com/bedsharing-risks-and-realities/

• https://cosleeping.nd.edu/safe-co-sleeping-guidelines/

• https://kellymom.com/parenting/nighttime/cosleeping/

• https://www.breastfeeding.asn.au/system/files/Safe%20sleeping%20leaflet%20%28PDF%20pageturning%20version%20for%20website%29.pdf

• https://www.askdrsears.com/topics/health-concerns/sleep-problems/sleep-safety/cosleeping-safely

• https://www.basisonline.org.uk/parents-bed/

• http://evolutionaryparenting.com/bedsharing-and-formula-feeding/

• http://evolutionaryparenting.com/does-bedsharing-increase-the-risk-of-death-for-younger-infants/

• https://www.bellybelly.com.au/baby-sleep/co-sleeping-baby-safe-co-sleeping-tips/

• https://neuroanthropology.net/2008/12/21/cosleeping-and-biological-imperatives-why-human-babies-do-not-and-should-not-sleep-alone/

We promote the important message that babies should roomshare for at least the first 6 months of life and optimally one year (or longer) to reduce their SIDS risk. This is one of the most key risk reduction strategies for reducing risk of SIDS for families.

Roomsharing also supports the breastfeeding relationship and makes night time care much easier for most families.

Breastfeeding is protective against SIDS and night nursing is part of this.

We will advocate for a range of Co-Sleeping options that keep the baby on a separate surface for those who can not or do not wish to bedshare. Side-carred cots, cots in the same room, floor beds to name a few.

If I can’t / don’t want to safely bedshare, what else can I do?

• Articles- https://www.basisonline.org.uk/room-sharing/

• https://rednose.com.au/article/room-sharing-with-baby

• https://kellymom.com/parenting/nighttime/cosleeping/

• http://evolutionaryparenting.com/bedsharing-and-formula-feeding/

• https://www.basisonline.org.uk/parents-bed/

• https://www.basisonline.org.uk/side-car-cribs-bedside-cots-and-co-sleepers/

• https://www.breastfeeding.asn.au/blog/simonecasey/boobies-bed

We will encourage parents to place their babies on their backs to sleep until their baby is strong enough to turn themselves over, this is what the evidence suggests is safest, therefore, as a group, this is what we can safely advocate for.

Please note, that a baby who really struggles to sleep unless they are on their tummy may be experiencing symptoms of discomfort and this could be a sign that something else is at play and it is worth looking in to.

Sleeping on a parent’s chest is often a fabulous way to settle an unsettled baby, particularly little people who have reflux and other discomfort. It must be acknowledged however, that there is risk attached to chest sleeping. Prone positioning (on their tummy) reduces baby’s arousal mechanism, which is protective of baby’s airway. Baby’s nose or mouth could become obstructed by clothing or their parent’s body, and an unsupervised baby could become positioned with their chin to their chest, which obstructs their airway.

Many of us here can relate to the desire to help our little ones rest in anyway they can, including chest sleeping, but it would be careless and irresponsible to not mention the risks associated. There is additional information on chest sleeping available in the book Sweet Sleep by La Leche League International for those interested to know more.

We will share up to date research articles on this topic and highlight gaps in the current research (formula feeding and bedsharing is one such example where more research is needed- see this article by Dr Tracy Cassels- http://evolutionaryparenting.com/bedsharing-and-formula-feeding/ ).

Other gaps in advice currently include-

• Twins– safe bedsharing and co-sleeping options and risk reduction

• Siblings– sleeping arrangements to keep both infants and older children safe while co-sleeping/ bedsharing

• Dealing with gaps and edges in co-sleeping and bedsharing arrangements

• Side car cots – no current risk reduction advice other than to say there are no product standards in many countries

• Premature babies– what age is it safe to share a surface with a baby born preemie?

We will continue to work to see that these gaps are remedied.

Further advice we do have-

There is information about safety concerns with the use of baby sleep positioners and wedges- read more here- https://www.lullabytrust.org.uk/are-sleep-positioners-safe-for-babies/ 

Baby nests and pods (small, portable beds for an infant that have padded or soft sides), such as Dock-A-Tot/Sleepyhead and the many other names used for these items, do not meet Safe Sleep Standards for most countries including- Australia, UK and Canada.

There are ‘boxes’ that may be used in co-sleeping arrangements such as the Finnish Baby Boxes, Wahakura and Pēpi Pod, these have been specifically designed to create a low risk sleep space for baby.

This is BASIS’s advice regarding Baby Hammocks and Swings–https://www.basisonline.org.uk/baby-hammocks-swings/

Above all, we will advocate for families to keep responding to their little one in the night. What could possibly be safer than attending to your child day/night?

So please, let’s keep our support, advice and advocacy in line with safer sleep guidelines.

Each family ultimately takes responsibility for deciding what is acceptable or unacceptable in their unique setting. We are not here to tell you what to do. We will share up to date advice and empower you to make an informed decision.

This quote from Professor James McKenna explains this beautifully-

“Aside from never letting an infant sleep outside the presence of a committed adult, i.e. separate-surface cosleeping which is safe for all infants, I do not recommend to any parents any particular type of sleeping arrangement since I do not know the circumstances within which particular parents live. What I do recommend is to consider all of the possible choices and to become as informed as is possible matching what you learn with what you think can work the best for you and your family.”

Here are some of our go to articles and sites on all things Safe Sleep-

https://www.basisonline.org.uk/basis-information-sheets/

https://www.basisonline.org.uk/sleep-health-safety/

https://kellymom.com/parenting/nighttime/cosleeping/

http://www.llli.org/sweetsleepbook/thesafesleepseven

http://cosleeping.nd.edu/safe-co-sleeping-guidelines/

https://www.bellybelly.com.au/baby-sleep/4-unsafe-places-for-baby-sleep/