Tired parents shouldn’t stress out about baby’s sleep, SIDS safety advisory

babysleepIf the nation’s pediatricians panicked already exhausted and stressed out parents with their recent advisory about keeping babies in the same room at night, there’s some sensible counsel from New York Times columnists. Moms and dads need to strike a thoughtful balance between their nighttime needs and those of their infants, Aaron E. Carroll, a pediatrician and Indiana University medical school professor has advised in an “Upshot” column with writer Carol Cain Miller.

They looked at the underlying research that led the American Academy of Pediatrics to issue new guidelines aimed at preventing Sudden Infant Death Syndrome (SIDS). The academy suggested, among other items, that parents keep their babies in their same bedroom for at least six months, and even better, for up to a year. That upset enough already sleep-deprived moms and dads to prompt the column on SIDS, which medical science has made major progress in reducing, and the research as to where infants should sleep and why.

The writers points out that SIDS kills 3,500 American babies annually. But experts have more than halved SIDS fatalities with public campaigns to get parents to take steps like placing babies on their backs to sleep in their own cribs (the motto is “Back to Sleep”), and eliminating loose bedding and extraneous items like plush toys there.

Still, is it too much to ask of parents to share a room at night with babies, whom the columnists note, “grunt, flail and hiccup.” How long can parents handle sleeplessness, and lack of privacy and sex? It may be common in other countries to bond deeply with newborns by sleeping in the same room with them. It’s less so in America, so what are the risks and benefits?

The columnists noted that the pediatricians had to rely in drafting their guidelines on “case-control” studies from overseas and from the 1990s, when SIDS deaths were more common. As they described these:

Researchers compiled records of babies who died of SIDS and matched them as closely as possible, based on things like age or geography. Then, by comparing the groups, they tried to identify factors that might place babies at higher risk. Case-control studies are among the weaker designs used in human research. They can only indicate association, not causation, and they are especially susceptible to ‘recall bias,’ when people remember things differently based on outcomes. People who have had a baby die, for instance, are more likely to have pored over any details that might have contributed.

Babies benefit markedly, especially in the first six months, from their parents’ watchfulness and the attention they get by sharing a bedroom, the New York Times columnists say, partially based on their own child-raising experience. At some point, though, infants can benefit from learning to and sleeping more deeply on their own, in a separate room.

The pediatricians, they note, also did not consider the effects on parents of a year’s sleeping with baby. It’s worth quoting what the columnists said about the downsides:

Depriving parents of good sleep can also endanger babies. Sleep-deprived people can have decreased empathy. Sleep deprivation is associated with an increase in car accidents (which are a top killer of older children). It stresses marriages and families and is significantly associated with an increased risk of postpartum depression. Hawley Montgomery-Downs, a professor of psychology and pediatrics at West Virginia University, has found that sleep-deprived parents have impairments similar to drunkenness. Americans are unlikely to have much paid parental leave, if any, and going to work exhausted serves no one well.

The columnists suggest that parents talk with their pediatricians so they’re fully informed about as vital an issue to them as SIDS, and their rest and that of their babies. A quick internet search will show that babies and sleep are a huge concern for parents, and Carroll has written another Upshot column recently on the latest thinking on just how to do so. I’ve written about the importance of sleep to our health, and I know from my practice and experience just how much parents will sacrifice to ensure their youngsters have the best, including for their health. As I’ve written, moderation and compromise are always good approaches, and finding the middle ground between the sleep needs of infants and their parents makes sense to me.

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