Babies get less sleep at night and sleep for shorter stretches when they sleep in their parents’ room after 4 months old, a new study finds. Parents are also more likely to engage in unsafe sleep practices, such as bringing their child into their bed or leaving pillows, blankets or stuffed animals with the baby when the infant shares their room.
The findings appear to contradict recommendations from the American Academy of Pediatrics for safe infant sleep, creating more confusion for parents trying to choose the safest, yet most practical and realistic, place for their babies to sleep.
The AAP recommends infants share a parents’ room, but not a bed, “ideally for a year, but at least for six months” to reduce the risk of sudden infant death syndrome (SIDS). Approximately 3,700 infants died of sleep-related causes in 2015, including 1,600 from SIDS, according to the Centers for Disease Control and Prevention.
At the time, some prominent pediatricians questioned the evidence behind it. Among the skeptics was Ian Paul, lead author of the new study published Monday in Pediatrics.
“It’s important for the Academy to have strong evidence and not just expert opinion to support our recommendations because these guidelines have such influence on practice and on parenting and child health,” Paul says. “One of the reasons we wanted to explore this is that the evidence is really weak for 6 to 12 months. I think in [the Academy’s] strong desire to prevent every single case of SIDS, they have looked at the data with a biased perspective.”
Paul analyzed data from 230 families participating in a randomized, controlled trial for up to 2 years. Half the mothers were encouraged to consider moving their children at 3 months old to wherever the child would sleep at 1 year old. The other half received intensive advice on reducing SIDS risk, in which nurses visited the home and provided specific feedback on improving the safety of the sleep environment.
The percentage of infants sleeping in their parents’ room at 4 and 9 months old, however, didn’t end up differing between the groups. More than half the infants were sleeping in their own room by 4 months old, and just over a quarter were sleeping independently between 4 and 9 months
And infants who slept in their own rooms after 4 months slept for longer, in general. Nine-month-old room-sharing infants slept an average 9.75 hours per night, compared to 10.5 hours for those who began sleeping alone by 4 months and 10 hours for those who began sleeping alone between 4 and 9 months.
Infants who slept alone after 4 months also slept for longer stretches: 9 hours compared to 8.3 hours for those infants who slept in their parents’ room between 4 and 9 months and 7.4 hours for those who continued to share their parents’ room after 9 months old.
By 2.5 years old, all the children got a similar amount of total daily sleep, although those sharing their parents’ room through 9 months old got 45 minutes less at night.
Given these findings, Paul worries about unintended consequences of encouraging parents to keep children in their parents’ room until 1 year old.
“There are so many other factors in child and parent health that are consequences of this decision,” Paul says. He said it’s completely impractical for parents to start sending children to their own room at 1 year old, when separation anxiety peaks. “That’s the worst time to make a change from a developmental perspective.”
Experts in developmental infant sleep generally agree with him, according to Jodi Mindell, associate director of the Sleep Center at Children’s Hospital of Philadelphia. Mindell founded the Pediatric Sleep Council’s website babysleep.com, a free resource of evidence-based information on children’s sleep.
“We want babies and parents to get a good night’s sleep because we know that will affect infant safety, infant development and family wellbeing,” Mindell says. “It’s a balance of trying to make sure babies are…
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