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2003-04-23 - 1.30pm��previous entry��next entry
SIDS and co-sleeping research
It's nearly May!!!! Ash and Erica are due in May!! How exciting! Also exciting is the fact that it's only the month after that we'll be trying to conceive at last!!! Yay! Except also I'm getting a bit nervous. I don't know why, but hmmm, it's there. At the moment I am taking my prenatal vitamins with a new feeling, like since Christmas I've just been "taking them", and now I'm REALLY taking them! Hehe! Or something like that. Do you know what I mean? Now I take them and I think, "This is for you, baby." I know it was before, but what I'm taking right now will make an active difference to a child that I could conceive in the next couple of months - IF I conceive then.
I worked last week, and on the last day, a lady asked me what I'd do next (I do temp jobs). I told her that I would be starting a family this summer. Guess what the first thing out of her mouth was? Yeah, you got it (haven't I ranted about this enough yet?!!) - it wasn't "Ohhh how lovely?!!", or even, "Good luck!" - it was, "Well you can't expect these things to happen just when you plan them." GRRRRR. Fed up with people telling me this!!!! Oh well, what can you do? Not tell anyone I suppose. Tell them all when I'm actually pregnant and that'll shut them up! I really really really really hope I prove them all wrong by getting pregnant right off the bat. But if I don't, I know God is still in control so I guess that's okay.
Today I am due my period so I am hanging around waiting for it to turn up and generally feeling crampy and rubbishy. But after that I will have 2 more periods left. That June period is going to feel kind of weird because it marks the starting point, well, the beginning of that next cycle anyway. The cycle where we actually make something useful out of all these years of periods! We are still thinking about whether to wait till July to try, because July would be the most ideal for us. However we don't know if we'll conceive when we start trying so that's why we brought it forward a month. Earlier than June is too early for us, so that's our start point. Anyway, we'll see.
Okay, now I have to respond to Lizzy's guestbook entry (thanks Lizzy!) which could take me a while!! I was really interested to read it because it's on a subject that I've become really into lately. The reason I want to respond thoroughly is to make sure people know the truth about co-sleeping, based on research. There seem to be a lot of myths out there. I have now done quite a considerable amount of research on it, and what I've learnt has amazed me, and convinced me to try co-sleeping - something I never in a million years thought I'd ever try! So what I am going to write here is NOT going to be based on my opinion, which all the other stuff I've written has been, pretty much. This is all medical research-based. Okay? Right.
There is SO much research that I am leafing through right here at the computer table, that I don't know where to start in summing up the basics for you guys! First off - major myth number one - it is absolutely untrue that co-sleeping gives a baby a higher risk of SIDS. Actually research seems to show that the risk is LOWER for co-sleeping babies, but I'll get onto that in a minute. Like I say, this is not my opinion, it is research-based, and incase anyone wants to make sure, I'll include the research references so you'll see I'm not just trying to sell an idea that I'm interested in. Let me know if you want the exact reference details to look up yourselves. Sooooo many people now have warned me against co-sleeping, and I am beginning to feel frustrated that they clearly don't know the truth about it. So here it is. But there's so much that I will try and keep it short and summarised.
Waaay back in 1988, a UK study on Post Neonatal Mortality published its results in the Foundation of Sudden Infant Death (FSID) newsletter, based on the analysis of several hundred SIDS infants. They stated that, "of the very few babies who were found dead in their parents' beds (and registered as SIDS) there was NO evidence of overlaying (suffocating as a result of co-sleeping) as the cause of death." This is an "across the board" finding in various research studies. There is NO research that has found that babies are more likely to die of SIDS in their parents' beds than in cribs.
Dr. Hugh Jolly, who was a consultant pediatrician at Charing Cross Hospital in London, did a series of research investigations into infant deaths. He found that ALL deaths of infants sleeping with their parents could be explained by drink, drugs, obesity or illness. He found that the annual rate of mechanical suffocation is negligible - it is some 200 times less likely to occur than SIDS, and occurs as frequently in babies sleeping in cots. It is also completely avoidable in the parents' bed. Precautions to take are simple - the co-sleepers (adults or children) should all be well. They should not be drunk, drugged, or excessively overweight. No one should smoke in the bed, or near the baby. Water beds should be avoided, and pillows arranged so they cannot fall or smother the baby. The baby should be free to move. The researcher says this: "Suffocation used to be made the scapegoat for many sudden infant deaths..... Yet at the age when cot deaths are most common - two to six months - a normal baby can lift his head and change his position if he cannot breathe easily."
Deborah Jackson's book "Three in a Bed" states a lot of this research. I think it's not true that books that encourage co-sleeping don't tell you all the facts. I've found quite the opposite. They state the facts and back them up with research (well my books do anyway!). Perhaps they don't state many negatives, but I think that's probably because there aren't actually many (if any!) to state! Certainly the health and wellbeing factors for both mother and baby are greater than if they were not co-sleeping. Okay, more research stuff....
A UK production of a time-lapse film of two adults sleeping with their baby was broadcast on Tomorrow's World, donkey's years ago (!!) in 1978. I know there have been many more recent time-lapse sleep projects but I can't find the details for them so this will have to do. It shows the point anyway - each time the baby rolled towards his parents, they moved away in their sleep. These projects demonstrate (along with clinical research backing the footage up - all published in FSID's newsletters) that a healthy baby is able to shift position in the night, given that he is not tightly swaddled, or that his body is not in a splint.
Two independent groups in Belgium and the USA have shown that babies will switch automatically to mouth breathing if their noses are obstructed, without waking up. 'Medical Anthropology' journal stated that: "Overlying is, of course, possible, but it is not likely, just as strangulation by defective cribs, while known to have happened, also is not common.... soft mattresses, as opposed to hard mats, may change the overall safety picture of parent-infant co-sleeping. Nevertheless, even day-old infants will struggle violently and protest vocally in response to obstruction of their air passages." This is why you have to be drunk or out-cold with a fever or something to sleep through your baby protesting that you are suffocating him/her.
There are a gezillion physical reasons why babies are less likely to die from SIDS sleeping next to their mother. I will try to summarise briefly (it's not really working so far!)!! Regulation of body temperature and breathing in the early months of life seem to be key factors in SIDS. Thomas G. Keens, M.D, from Children's Hospital, Los Angeles, stated in 1996 that most SIDS researchers believe that SIDS is due to some type of brainstem dysfunction or immaturity, which affects breathing and sleep.
Okay, so stuff about breathing:
This is mainly from Dr. James McKenna's paper, "An Anthropological Perspective on SIDS" - "The fetus in its mother's womb begins to make rhythmical breathing movements up to three months before birth. Studies have shown that sensory stimulation (eg. the rocking of the mother as she walks, and the sound she makes) keeps the unborn child "breathing" regularly. At birth, the infant has a natural immunity to cot death because of a natural gasping reflex. This is lost after a few weeks as the higher brain takes over and begins to control the child's development. As this happens, the baby re-engages with the mother, becoming more dependent on her. The child is vulnerable to errors in brain-controlled functions (such as breathing), especially during the shifts from reflexive behaviour to controlled behaviour. One of the most important changes a human baby has to make is in the way it breathes, in order to vocalise speech..... In the first year of life, his breathing slows from 87 to around 47 breaths per minute. And between two and four months of age, the time when a baby is changing his breathing patterns, he is at his most susceptible to SIDS. He is also most responsive at this time to the benefits of touch..... During co-sleeping, vestibular stimulation (eg. breathing movements of the adult's chest when asleep), rocking, touch and heat and gas exchange all help to promote the health and easy breathing of the infant. The baby sleeping next to his parents is likely to breathe in carbon dioxide, a chemical stimulant to take the next breath."
In a seperate publication in 'Medical Anthropology' he suggested that, "Solitary-sleeping infants will breathe differently (less stably) than will social-sleeping infants, and the parents themselves will be in a better position to respond to changes in their infants, such as serious apneas or breathing silence." He studied the breathing patterns of babies when they sleep with their mothers, and when they sleep alone, and found that the baby's breathing follows the mother's, and that co-sleeping helps to protect against breathing lapses.
Temperature regulation stuff:
Same doctor (above) found in various studies that "a baby sleeping alone cannot maintain temperature satisfactorily, no matter how well wrapped, or how warm the nursery is, compared to when the baby sleeps with skin-to-skin contact with another human being. Constant warmth helps to keep a baby asleep and breathing regularly, and it particularly promoted REM sleep. The baby on his mother's skin takes her temperature, and she his. If it gets too warm under the covers, she will feel this herself, and respond by throwing off the cover. Sleeping with his mother, the baby remains at his ideal temperature."
And last but not least (!!!), there is too much research to write about here, about the SIDS rate in countries where co-sleeping is universal. For example, over a 4-year period in China, there were 15 cases of SIDS. And three of those were British. In western countries, 800-1200 cases of SIDS would have been expected over this time period. Yikes! Dr. Michael Odent reported on his time in China in 'The Lancet', where he asked mdeical professionals about the phonomenon of cot death (SIDS) - "Nobody understood my questions; the concept of sudden infant death or cot death was apparantly unknown among professionals and lay people in such different places as Beijing, Hsian, Loyang, Nanking, Shanghai, and Canton. Furthermore I learned that Chinese babies sleep with their mothers, even in the most westernised families. Ever since then I have held the view that, even if it happens during the day, cot death is a disease of babies who spend their nights in an atmosphere of loneliness and that cot death is a disease of societies where the nuclear family has taken over." Some of the countries where SIDS is unheard of, have other factors that could be the reason for the lower incidences of SIDS cases, of course. But they are all different, and the one thing they ALL have in common is co-sleeping. There's loads on multi-cultural stuff.
Dr. Robert Tseng, a pediatrician who worked in Britain and Hong Kong wrote an article in The Lancet, about working in casualty department (ER) in a UK hospital (weirdly enough it's my local hospital!!) - he said that during his 9 month placement here, he witnessed six occasions when parents brought a baby who had died suddenly, into hospital. Back in Hong Kong, for the past 18 months, he has yet to see one incidence.
Anyway, I found all that brain-boggling. Oddly enough, official websites for SIDS don't seem to say much about co-sleeping. They don't advise against it, but I read some of their articles and found that they were saying there's no research that states that co-sleeping decreases the risk of SIDS. But hello?!!! What's this stuff I'm reading - invisible ink?!! That really confuses me, because I am definitely reading genuine research that suggests a clear health benefit when it comes to co-sleeping. Hmmm. So I don't know why they're not acknowledging all of that different research. Oh well. But there you go - make of the above what you will! I hope it's not too long and that people find it interesting. I wanted to write so much so that I could dispell the rumour that the risk for SIDS is increased by co-sleeping, because whatever the strength of conviction over this idea, it's absolutely not true. When a baby dies of SIDS when it's been co-sleeping, the natural thing seems to be to jump up and say ohhh, that's because they were co-sleeping! But actually babies die of SIDS all the time. Most of them were in a crib. But nobody points at a crib baby and says ohhh, that's because it was in a crib! SIDS is tragic in any case and it happens to babies in any setting, but faaaar fewer cases are recorded in co-sleeping babies.
I'm not planning to co-sleep just to bond with my baby. I am planning to do it because of all the many benefits - the baby's health and well-being, my well-being, better sleep/wake routine for all concerned, easier breastfeeding, more and better quality sleep (allegedly!), a child who will grow up without all the bedtime fears and sleep problems, and yes - what a bonus that co-sleeping is excellent for bonding with your baby! I am really looking forward to that part. I feel like I want to be close to my child all the time when it arrives, so I'm looking forward to co-sleeping and baby-wearing and all that stuff. And that's all I'm gonna say, because this entry is way too long! :)
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