We've all heard about the benefits of co-sleeping, with many babies going on to sleep either in their parents' room or with their parents in bed, for years sometimes.
Paediatric experts such as the American Academy of Pediatrics (AAP) also recommend that babies should share their parents' room (but not bed) until at least six months, and ideally for a year in order to minimise the risk of Sudden Infant Death Syndrome (SIDS).
But a new study published recently in Pediatrics is recommending otherwise.
So, at what age should a baby sleep in own room?
The answer, surprisingly, is at just four months.
Ian Paul and his team analysed data from 230 families in a randomised, controlled trial for up to two years.
Half the mums in the trial were encouraged to move their baby at three months old to the room where they wanted to child to be sleeping in by age one.
The remaining 50% "received intensive advice on reducing SIDS risk, in which nurses visited the home and provided specific feedback on improving the safety of the sleep environment."
What they discovered:
- Babies who slept in their own room after four months in general slept for longer. For perspective, Nine-month-old room-sharing infants slept an average 9.75 hours per night, compared to 10.5 hours for those who began sleeping alone by 4 months and 10 hours for those who began sleeping alone between four and nine months.
- Babies sleeping in their own rooms after the age of four months also slept for longer stretches of time. They slept 9 hours compared to 8.3 hours for those infants who slept in their parents' room between 4 and 9 months and 7.4 hours for those who continued to share their parents' room after 9 months old.
In contrast with common recommendations, Paul has concerns about the (unintended) consequences of allowing babies to sleep with their parents for so long. "There are so many other factors in child and parent health that are consequences of this decision," Paul says.
His biggest concern is the impracticality of common advice related to sending kids to their own room at around a year old. "That's the worst time to make a change from a developmental perspective," he says. This is the age when separation anxiety in a child peaks.
Other experts agree... and disagree
Jodi Mindell is associate director of the Sleep Center at Children's Hospital of Philadelphia.
Agreeing with Paul's reasoning, she says, "We want babies and parents to get a good night's sleep because we know that will affect infant safety, infant development and family wellbeing. It's a balance of trying to make sure babies are safe, everyone's getting enough sleep and everyone's developing appropriately."
She also points out previous research that indicates that babies "go to bed earlier and sleep for longer periods at a time when they sleep in their own rooms."
Mindell adds, "I think the AAP guidelines unfortunately scare parents, and we don't want parents scared and avoiding doing what's going to work best for their family. You don't want parents resenting their child because they don't get a break."
She also points out that mums could be at a greater risk for postpartum depression, as well as accidental injuries around the house if they don't get a good night's sleep.
However, Rachel Moon, who is lead author of the AAP recommendations and head of pediatrics at the University of Virginia School of Medicine, prefers to stay cautious.
"We're being as careful as we can," Moon says. "Yes, it's important that families get enough sleep. It's also important that they have a baby that wakes up in the morning."
Paul disagrees again: "One of the surprising things we found was the room-sharing parents had less-safe sleep practices."
He says there was a greater chance of babies being exposed to risky items when they room-share with their parents. These items include pillows, blankets and soft toys.
This is because the likelihood of room-sharing little ones joining their parents in bed is four times higher than those sleeping independently by 4 months and 9 months old.
The AAP, however, remains firm on their recommendations, at least for the time-being.
Parents, are you confused?
With experts in the same field recommending conflicting advice, confusion is to be expected. And Ben Hoffman, a pediatrician who specializes in injury prevention at Oregon Health & Science University in Portland, says that's the nature of creating broad public health recommendations with incomplete evidence.
And if you are thinking, "We just want to know what's best for our baby," then the recommendation is that you need to make the best decision with your baby's well-being and safety at heart, with the available information.
If your baby room-shares:
- Try to ensure he sleeps in his own cot. If he joins you in bed, parents must ensure that baby is not at risk of SIDS.
- Baby should never sleep with his parents if one or both of you has had too much alcohol, or taken sleep-inducing medication.
- If baby sleeps in your bed, take precautions to ensure he does not roll off the bed.
- Do not let newborns bed-share with older siblings.
If you baby sleeps in his own room:
- Ensure his cot is free from unnecessary bedding and clutter. This includes pillows, blankets, bolsters and soft toys. You can control the temperature in the room with a fan/AC and by dressing baby in age-appropriate sleepwear.
- Get a good baby monitor that lets you see as well as hear your little one.
- If you helper sleeps in your baby's room, advise her to never take baby to her own bed.
Safe sleeping, parents and babies!
Republished with permission from: theAsianParent Singapore