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Re: co-sleeping

>In a message dated 10/4/1999 10:57:00 PM Central Daylight Time,
> writes:
>
><< While there are clearly some adherents to the co-sleeping cult, the vast
> majority of my patients who have kids in the bed express utter frustration
> at their inability to get a decent night's sleep, the lack of privacy, and
> do not find it a rewarding or enjoyable experience. >>

Steve,  I think at least most of us recognized that you were writing
tongue-in-cheek, even before you posted your explanation.  And for those
not in the practice of general pediatrics who don't believe what Steve
wrote, I'll add that for every family who comes in happy and content with
their decision to co-sleep, there are 10-20 others who come in bleary-eyed
asking me how they can get their child out of their bed.  It's especially
tough when the parents don't agree - one wants to continue bed-sharing, the
other wants the baby out of the bed.  I tell them first they have to decide
what *they* want and come to a joint decision - then follow-through.  They
have two choices:  continue until the child makes his/her own decision to
sleep on their own (which could take years), or let the child cry (an
infant or toddler will NOT leave the family bed willingly).  Many parents
say honestly that they'd rather keep the child in the bed (though that's
not what they really want) than listen to the child cry.  To them it's a
lesser of evils;  the child's cry is worse than their negative feelings
about the child in the bed.  For those who actively choose to bed share and
enjoy it - other than the new possible safety issues to discuss - I say
"power to them."



>At 09:44 AM 10/5/99 -0400,  wrote:
>Give me a break!  The Japanese  co-sleep.
>Jan Barger, RN, MA, IBCLC



>At 09:51 AM 10/5/99 -0400,  wrote:
>I practise in Okinawa, Japan.  Most Japanese Don't co-sleep;
>Scott Yang, MD

Jan, if this is correct (and I'd tend to trust a physician practicing in
Japan), it makes it hard to know what else in your post is incorrect.  You
made so many blanket statements as if they were the gospel truth, I'd
really like to see your sources.  Especially the following:

> If there are parents who want their
>babies to 'cry it out', then help them deal with the emotional ramifications
>that will surely surface later because of abandonment issues.  And yes, I
>know whereof I speak.

So "whatof" do you know?  Is this personal experience, anecdotal, or based
on a number of good scientific studies.  You used the word "faulty" to
describe the co-sleep study.  Is your statement that the study is "faulty"
as accurate as your statement that "the Japanese co-sleep"?  Can you, or
anyone else, give references to some "non-faulty" studies showing
conclusively that there will be emotional ramifications and abandonment
issues in babies who "cry it out"?  I will certainly respect that that is
your opinion, just as my opinion is that kids who are permitted to "cry it
out" at a young age will grow up just as well adjusted as kids who
co-sleep, providing that other aspects of parenting are equal and they are
given appropriate nurturing and love while awake.

>
>Co-sleeping is a parenting issue, not a medical issue.

Sorry, but if there is a true potential danger, then it has become a
medical issue.  Seven years ago would you have written that sleep position
is also a parenting issue, and medical professionals have no place telling
parents to put babies to sleep on their backs?  I know a lot of people felt
that way at the time - some still do.

> Using pacifiers is a parenting issue, not a medical issue.

And when the kid needs extra orthodontia due to the pacifier (a strong
possibility if it's continued once the permanent teeth come in), is that
still a parenting issue?

>Families should sleep where they are comfortable sleeping.

Exactly.  And when the parents would choose to sleep without the child but
the child "insists", who should make the final decision?  The parents or
the child?

>  It takes no longer to teach about
>safe co-sleeping than anything else.

Sorry again, but a discussion regarding "safer" co-sleeping is likely to be
anything but short.  And now it will be necessary to add it to the growing
list of topics at a well baby visit.  BTW, for those using the term "safe"
co-sleeping:  if the study is shown to be correct, saying "safe"
co-sleeping will be like saying "safe" sex.  There will still always be a
risk.  I'd rather use the term "safer."

> And opinion should be kept out of it.
>I don't take my kids to the pediatrician to get his/her "opinion" on my
>parenting practices because they may differ from his/her parenting practices.

We give parents facts as much as possible, but our individual opinions (as
has been posted before) are firmly intertwined in our individual styles as
practitioners.  You have made your opinion very clear:  co-sleeping is safe
(not safer, but safe) if done properly (although I'm not sure there is
agreement on what "properly" means), the study is "faulty", and letting a
baby cry at night will have emotional ramifications.   Though I have not
seen facts or studies to back up your opinion, you write as if these are
truths.  Again, I'll respect that this is your opinion, even though I don't
agree with you.  OTOH, You don't seem to want to give the same respect to
those of us who disagree with you (as I've also noticed from other posts
giving opinions similar to yours).  My opinion is that bed-sharing might
carry some risks.   Your opinion is that it can be made safe and carry no
risks.   Do either of us know for certain?  No, but there is now this study
which has used the scientific method to come to a conclusion that there
could be cause for concern.  I'm open to the possibility that the study
could be wrong (and I sure hope it is).  You don't seem open to the
possibility that it could be right.  I'm not going to tell people
"absolutely don't bed share", though it seems you'll tell people
"absolutely bed share if you want to."  But if you're wrong and the study
is right -  and people listen to your opinion - you've put babies at an
increased risk of being killed.    We probably won't know for many years.
While not conclusive, the study should be presented to parents as a piece
of MEDICAL information, not as an opinion, and not as a "parenting" issue.
In my opinion, to not bring this issue up with parents at this time because
it is a "parenting" issue would be poor medical care, and to tell them the
study has no merit could be dangerous.  What the parents do with the
information is up to them.

> Pediatricians didn't go to medical school to learn parenting practices.

Then why, when parents interview with me before their baby is born, do they
ask if my well child visits include discussions on discipline, feeding,
sleeping, behavior, etc?   These issues are a major component of each
visit.   You're right about one thing though - I didn't learn "parenting
practices" in medical school.  Not even much in residency.  I learned
through ten years in general pediatric practice and seven years as a father.

>Parents are terrified of being parents, and empowering them is one of the
>jobs of the health professional.


Absolutely!  We empower them with knowledge, then allow them to make their
own decisions.

Michael Sachs, M.D.
General Pediatrician