By BMSG Editorial Team

Early last month, news broke on the tragic death of a 15 –day –old infant while he was co-sleeping with his mother in 2018. In ST Online, dated 7 Oct 2019, it was reported on 7 Oct 2019 that “baby likely died from ‘unintentional suffocation’ after mother fell asleep while breastfeeding”. Today Online, on the same date, also reported that the “baby likely suffocated to death after mother fell asleep breastfeeding him”, according to a coroner finding.

BMSG was particularly saddened to hear of this piece of this unfortunate news and our hearts go out to the baby’s mother and her family in this difficult time.  We can only hope that the family will find closure to this tragedy.

Is Co-Sleeping to Blame?

For many generations and in many parts of the world, mothers have been co-sleeping with their children from the newborn stage to toddlerhood. Losing a child while doing something as natural as co-sleeping must be a tough ordeal for any parent and many discussions and opinions have surfaced on whether co-sleeping is a safe option for new mothers. Particularly for breastfeeding mothers, this incident may incite a lot of fear and negativity towards co-sleeping. While we are not personally acquainted with this particular case, we feel compelled to correct the many misconceptions on co-sleeping and to share some general guidelines for safe bed-sharing.

Co-Sleeping Recommended in the Early Days

The World Health Organization (WHO) and UNICEF continue to recommend safe co-sleeping to breastfeeding mothers. Breastfeeding babies spend much of their initial months at their mother’s’ breasts. Whether it is to practice latching, to receive warmth and comfort from the mother after birth, or even to allow mothers to have ample rest, co-sleeping can be a safe option for both mother and baby.

In fact, safe bed-sharing continues to be recommended by breastfeeding experts, including UNICEF, as a way for breastfeeding mothers to manage night feeds, making it easier for them to sustain breastfeeding in the long run.

Guidelines for Safe Co-Sleeping

It is imperative that these guidelines are closely followed in order for co-sleeping to be safe:

• Babies should be healthy and full-term,
• Both parents need to be non-smokers and not under the influence of alcohol or drugs which may affect wakefulness,
• The mattress should not be overly soft, and the bed space should be free of all loose bedding, soft pillows, blankets and plush toys.
  • Babies need to be sleeping flat on their backs so that risks of them rolling onto their faces are minimised.
  • Babies should not be tightly swaddled so that they can protect themselves with their limbs should they end up face-down onto the bed, where they risk being suffocated.

Most importantly, co-sleeping with newborns should only be practiced by breastfeeding mothers. There are many protective factors in breastmilk that protect babies from cot death or Sudden Infant Death Syndrome (SIDS). Unlike formula, breast milk is easily digested, thus allowing breastfed babies to be more responsive during sleep.

What Mothers Say

We spoke to several mothers who are currently co-sleeping with their babies to find out their views on co-sleeping in light of the incident.

Beryl Tan, a stay-at-home mother who has been co-sleeping with her eight month-old baby since third week postpartum, said that her husband and herself were not “exactly confident at the start” and were worried about injuring the baby. They made sure that there weren’t pillows and blankets near their baby. Beryl takes further precautions by checking and making sure her baby is alright each time she wakes up in the middle of the night. “As time went by, we became more confident about co-sleeping,” said Beryl, who also said that she obtained more rest and baby slept better when they co-sleep. Beryl felt that co-sleeping should not be a taboo topic because there are plenty of benefits for both mother and baby. She added: “It is important for parents to be aware of the safety measures involved, do a thorough risk assessment and to learn from mistakes.”

…co-sleeping should not be a taboo topic because there are plenty of benefits for both mother and baby. – Beryl Tan, mother-of-one

For Shirin Az-Zahra, co-sleeping was a saviour as it provided her sufficient rest when she returned to work after her maternity leave ended. Shirin, who only started co-sleeping with her child around the four to five months mark, said: “It got really tiring to wake up and get out of bed to feed baby at night, so hubby and I decided to just let her sleep on our bed. I felt so much more rested thereafter, so we continued this sleeping arrangement till today,” said Shirin, who is also a volunteer breastfeeding counsellor with BMSG. Even though she is expecting her second child now, she still continues to co-sleep with her older daughter and has done this for almost one-and-a-half years now. “Of course I feel sad for the family, but at the same time, I believe that co-sleeping has many benefits and it has helped me so much. What is important is to practice safe co-sleeping to prevent such events from happening again,” said Shirin.

Clearly, mothers who have been co-sleeping would find it very hard if they were to change their sleeping arrangements as co-sleeping has a lot of benefits for the mother and baby dyad.

Recommendations

Whether you decide to co-sleep or not, we recommend that all breastfeeding mothers learn about safe bed-sharing practices, as research has shown that most breastfeeding mothers will end up bed-sharing at some point, whether intentionally or not. Mothers who are worried about falling asleep while feeding their babies should feed in bed as the risk of harm to babies are much higher if mothers fall asleep with their babies on a sofa or a chair.

Parents can also purchase a co-sleeper crib attachment for their bed, which allows mothers to nurse their babies easily in the lying down position, while having a separate, distinct space for the babies to sleep in when not nursing.

In line with UNICEF and the World Health Organisation, BMSG continues to recommend safe co-sleeping as an option for breastfeeding mothers.

Resources

Here are some other resources with more information on how to practise safe bed-sharing:

https://www.llli.org/the-safe-sleep-seven/
https://www.unicef.org.uk/…/sleep-and…/co-sleeping-and-sids
https://www.basisonline.org.uk/
https://cosleeping.nd.edu/

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