Infant co-sleeping expert sheds light on controversial practice

Author: Arts and Letters


If sleepless nights and stretch marks aren’t enough, new mothers also can expect a litany of unsolicited and often uncompromising opinions and judgments on the best way to care for their babies.

Even the medical community is divided on questions of infant care, with conflicting information and shifting directives issued every few years to new parents.

Should babies be breast-fed or bottle-fed? For how long? Is it safe to sleep with newborns? If so, for a few months or for several years? Are babies safest sleeping on their backs or their tummies?

The American Academy of Pediatrics (AAP), regarded by many as the authority on infant well-being, recently reversed recommendations it issued earlier this year, and now cautions against “any and all mother-infant bed sharing.” Along with that reversal came the recommendation that all babies use pacifiers during sleep—quite a change from its earlier position issued in February of this year that encouraged, among other things, “exclusive breast-feeding for approximately the first six months and support for breast-feeding for the first year and beyond as long as mutually desired by mother and child.”

Confusing, isn’t it?

Anthropologist James McKenna, director of Notre Dame’s Mother-Baby Behavioral Sleep Laboratory and a renowned expert on infant co-sleeping, breast-feeding and sudden infant death syndrome (SIDS), served as one of three expert panel members for the AAP committee that made this most recent recommendation against bed-sharing. However, he voted against the recommendation.

Based on his scientific studies and familiarity with how mothers bed share and what it means to families, McKenna points to the differences among contemporary cultural practices, personal preferences and just good science.

“The truth is, not all families and babies are the same,” he said. “Bed sharing is a heterogeneous practice with outcomes ranging from lethal when practiced unsafely to being beneficial and protective when practiced safely.”

McKenna considers infant co-sleeping unsafe when either or both parents are chemically impaired; if the mother smokes, sleeps in a chair,sofa orrecliner with a baby; when babies are placed on thick pillows; when other children are permitted to sleep in the same bed; or if the baby is placed in the prone—or tummy—position to sleep.

“The AAP `one-size-fits-all’ recommendation certainly shows that Western medical authoritative knowledge has failed to learn tragic lessons from our past,” says McKenna.

“Without a full understanding of what it meant to dismantle an age-old integrated biological system … that is, infants sleeping on their backs, to breastfeed, next to their mothers, Western medical science created the conditions within which hundreds of thousands of babies died from SIDS. The AAP now seems set on perpetuating aspects of this tragedy by assuming that American parents, in contrast to mothers everywhere in the world, are uneducable as to how to lay safely next to their infants to successfully breastfeed, nurture and sleep with their infants. It is not bed-sharing that is dangerous but how it is practiced. The AAP chose not to be forthcoming about this important distinction.”

Rather than abdicating decisions about caring for babies to external medical authorities, McKenna stresses the importance of parents trusting their own knowledge about their infants’ needs.

“These new AAP recommendations insult and dismiss the special contributions and knowledge that mothers and fathers bring to their infants’ lives,” he said, “and the authoritative tone is sure to undermine both parental confidence and parental judgments to make informed choices as to how and where they will provide care for their infants.”

A video presentation by McKenna on caring for newborns is available on the Web at:



Originally published by Susan Guibert at on November 23, 2005.