Why bedsharing among breastfeeding mothers will not be eradicated and what ethical (harm reduction) steps must be taken to accommodate it
Background: The American Academy of Pediatrics has recommended aggressively against any and all caretaker-infant bedsharing, making no distinctions between breastfeeding and bottle/formula feeding environments, and treating all bedsharing as if it carries a singular inherent risk. However, many experts acknowledge that bedsharing outcomes fall on a continuum ranging from potential benefits to high risk depending on how and by whom bedsharing is practiced. Despite recommendations against it, bedsharing is common in the U.S. (e.g. 70-80% in Los Angeles), and particularly among breastfeeding mothers. For many, this happens without the benefit of information on how to make the adult bed safer for infants, since such information is typically excluded from educational materials in favor of a “just don’t do it” message.
Methods: Data from sleep studies of the physiology and behavior of breastfeeding-bedsharing mother- infant pairs is compared with data collected from two large internet surveys of bedsharing- breastfeeding mothers, illuminating their perceptions, attitudes, practices, and evaluations.
Results: Breastfeeding mothers cite numerous advantages to bedsharing, including increased mother-baby sleep time, compensatory time working mothers spend with their babies, less infant crying, and easier and more frequent nightly breastfeeding with augmented durations. Observational and physiological studies confirm these perceptions. Recent research has found that in the absence of hazardous factors bedsharing does not carry an increased risk, and after three months of age it may be protective for breastfed infants. To be both ethical and credible, the AAP-NICHD sponsored “Safe to Sleep” campaign should modify its unqualified recommendation against bedsharing for breastfeeding mothers.
Learning Areas:Basic medical science applied in public health
Communication and informatics
Diversity and culture
Implementation of health education strategies, interventions and programs
Public health or related public policy
Social and behavioral sciences
Explain the AAP policy on safe sleep and the reasons behind the recommendation against any and all caretaker-infant bedsharing Describe advantages to bedsharing from the perspective of breastfeeding mothers Describe what observational and physiological data reveal about the breastfeeding- bedsharing enviornment Explain the components of a “harm-reduction” approach to safe sleep• Explain the AAP policy on safe sleep and the reasons behind the recommendation against any and all caretaker-infant bedsharing Describe advantages to bedsharing from the perspective of breastfeeding mothers Describe what observational and physiological data reveal about the breastfeeding- bedsharing environment Explain the components of a “harm-reduction” approach to safe sleep messages regarding bedsharing and breastfeeding.
Keyword(s): Breastfeeding, Vulnerable Populations
Qualified on the content I am responsible for because: I have conducted the first pioneering research on the physiology and behavior of bedsharing-breastfeeding mother-infant dyads funded by NICHD, a leading spokespersons/researcher world wide on this subject having won a Shannon Award from the National Institutes of Child Health and Human Development. Fellow in the American Association for the Advancement of Science based on my mother-infant sleep studies in relationship to bedsharing and SIDS.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.