Sleeping Like A Baby Attitudes and Experiences of Bedsharing in Northeast England

Medical Anthropology
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Sleeping like a baby: Attitudes and experiences of

bedsharing in Northeast England
Elaine Hooker , Helen L. Ball & Peter J. Kelly
To cite this article: Elaine Hooker , Helen L. Ball & Peter J. Kelly (2001) Sleeping like a baby:
Attitudes and experiences of bedsharing in Northeast England, Medical Anthropology, 19:3,
203-222, DOI: 10.1080/01459740.2001.9966176
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Sleeping Like a Baby: Attitudes and

Experiences of Bedsharing in
Northeast England
Downloaded by [University of Guelph Library] at 13:17 23 October 2017
Elaine Hooker, Helen L. Ball and Peter J. Kelly
This paper reports findings from a study that investigated infant care practices
in a small population of Northeast England in order to determine whether
parent-infant bedsharing is common parenting behavior. In a year-long
prospective study we examined the opinions and practices of parents with
regard to their infants' nighttime sleeping strategies before and after the birth
of their babies. Results confirm that parents pursue a heterogeneous array of
nighttime parenting strategies and that 65 percent of the sample had actually
bedshared. Parents with no previous intention to do so slept with their babies
for a variety of reasons. One of this study's most important findings is that
babies were being brought into bed with both parents. Ninety five percent of
the bedsharing infants slept with both mother and father. This study has
shown that bedsharing is a relatively common parenting practice. Despite
initial worries and fears, mainly concerning overlaying, some parents found
bedsharing an effective option yet were covert in their practices, fearing the
disapproval of health professionals and relatives.
ELAINE HOOKER is a postgraduate research associate in the Department of Anthropology,

University of Durham, and is presently completing her Ph.D. Together with Dr. Helen Ball,
she is studying parent-infant interactions during the night in the homes of families in
Northeast England. Their studies have concentrated on both the cultural environment in which
bedsharing occurs in Britain and the behavioral interactions of bedsharing parents and
infants (captured with infra-red video).
DR. HELEN L. BALL is a lecturer in anthropology at the University of Durham, and she
directs the North Tees Parent-Infant Sleep Project. She has previously published on various
aspects of parent-infant bedsharing, parenting behavior, infant mortality, and infanticide.
DR. PETER J. KELLY is the director of the Centre for Health and Medical Research at the
University of Teesside.
203
204 E. Hooker etal.
INTRODUCTION
In Euro-American society the moment of birth is commonly viewed

as the beginning of autonomy for a baby who is suddenly no longer
connected to the mother (McKenna 1995). Early independence is
a developmental goal that is to be achieved rapidly by infants and
that is also reflected in our perception of parenting skills (Spock
1976; Kagan 1984). Successful parenting is often gauged by profi-
cient "nighttime parenting," particularly as it relates to sleep man-
agement, where a "good" baby is one who sleeps right through the
night. Less than 20 years ago inexperienced mothers in Britain were
told: "don't pick him up all the time, you'll spoil him," or "leave
her cry and she'll eventually go to sleep" (Newson and Newson
1966). But babies in other cultures are not indiscriminately left to cry
themselves to sleep (Gantley et al. 1993). Clearly, there are major
differences in cross-cultural attitudes toward infant autonomy.
In non-Western cultures newborn infants commonly sleep with
their mothers (Barry and Paxson 1971). Infants are treated as an
extension of their mothers and are generally carried in a sling, which
gives them continuous human contact as well as access to the breast
(Liedloff 1975). However, in the West newborn infants are isolated
and are expected to sleep in their own cots, often in different rooms
from their caregivers. A study of 126 families in the United States
determined that 74 percent of children (aged between six months
and four years old) slept in cribs in separate rooms from their par-
ents and that 55 percent had no adult company at bedtime (Lozoff,
Wolf, and Davis 1984). Medical anthropologists are now questioning
these paradoxical differences in infant care practices.
Some would argue that cosleeping (infants and parents sleeping
together on the same surface) is a questionable practiceone that
has been abandoned by modern health professionals and parents
because of health and safety concerns (Mitchell and Scragg 1993).
However, those in favor have shown that cosleeping may be
advantageous to the survival and well being of human infants.
McKenna suggests that there is what evolutionary biologists call an
"adaptive fit" between parent-infant sleep contact and the physio-
logical vulnerabilities of newborns (McKenna 1990a, b). With sub-
stantial physiological evidence, underpinned by evolutionary theory,
McKenna demonstrates that parent-infant cosleeping may help
infants resist some types of SIDS (cot death) (McKenna and Mosko
1990, 1993; McKenna et al. 1990, 1997). He challenges infant care
Parent-Newborn Bedsharing 205
practices that ignore the infant's evolutionary history in favor of

rapidly changing cultural practices that promote the social best
interests of the parents rather than the biological best interests of the
infant. Furthermore, cosleeping is an important component in
successfully sustaining breast-feeding and is advocated by breast-
feeding support groups such as La Leche League. Proponents of
attachment parenting advocate cosleeping as a means of promoting
infant attachment (Sears 1989; Iiedloff 1975). However, the purported
risk implications of prolonged close contact between parents and
their infants during sleep have generated much debate and led to
confusion and concern among parents and health professionals. The
form of cosleeping most commonly practised in Western industrial-
ized societies is parent-infant bedsharing (infants sharing an adult
bed with their parent[s]). While parents who bedshare with their
infants are adamant, albeit often covert, in their strategies, health
professionals and childcare experts have raised concerns regarding
infant safety when cosleeping takes place in an adult bed, which
may not have been designed with infant safety in mind. For
instance, infant cribs or cots have to conform to specific safety stand-
ards regarding width of spaces between bars, tight fit of mattress,
type (firmness) of mattress, etc. There are no infant safety standards
for adult beds, therefore in some cases there are spaces between
rails in brass headboards that are large enough for infants' heads to
pass through, gaps between mattresses and bed frames that may be
large enough to trap an infant, while on waterbeds and other soft
sleeping surfaces depressions may occur within which infants could
becomes suffocated.
The bedsharing debate has intensified over the last decade, with
media interest and popular advice books (e.g., Jackson 1990;
Thevenin 1987) fuelling the controversy and increasing interest. All of
this has added to the queries of doctors, midwives, health visitors,
and parents regarding the benefits or risks of bedsharing with new-
borns. Bedsharing is not considered to be part of mainstream British
or American parenting ideology (Davies 1994), but little research
has been conducted to determine the extent to which actual parent-
ing practices conform to this model. A variety of studies have
examined parent-child bedsharing in older infants and in toddlers
with sleep problems (Hayes et al. 1996), while others have examined
bedsharing in older children with serious psychiatric problems
(Rath and Okum 1995). A few researchers have used telephone or
waiting-room surveys in an effort to gather quantitative data on
206 E. Hooker et al.
bedsharing (e.g., Johnson 1991; Chessare et al. 1995), but these

methods commonly fail to determine all of the places that a baby
sleeps through the night (Ball et al. 1999).
Our study was carried out in a postindustrial region of northeast
England within an economically and educationally heterogeneous
population. It was designed to gather information on parents'
attitudes and practices regarding infant sleep strategies, the circum-
stances under which prospective parents thought they might bed-
share with their infants, and the circumstances under which they
actually did so. Our findings are discussed in relation to the mess-
ages parents receive from health professionals concerning infant
sleep in general and bedsharing in particular.
METHODS
In a year-long study (October 1995 to October 1996) we examined

parental attitudes and experiences regarding parent-infant night-
time sleeping strategies in the North Tees Health Area, northeast
England. The North Tees Local Research Ethics Board granted
approval for this study. Prospective parents were contacted through
antenatal hospital wards, clinics, and parent-craft classes at North
Tees Hospital and were subjected to semi-structured face-to-face
interviews. The parents, who were unaware of the bedsharing focus
of the research, were approached by the investigator and told the
general purpose of the study. Confidentiality was guaranteed, and
all participants were required to sign a consent form before the
initial interview.
A semi-structured interview design allowed for the simultaneous
collection of quantitative and qualitative data. At the initial interview
we gathered information regarding the parents' age, employment,
educational status, health status (if relevant), and, if applicable, smok-
ing habits. After discussing caregiving strategies used for previous
children (where relevant), we obtained information on the inten-
tions, expectations, and arrangements being made for the product of
the current pregnancy, including information regarding infant
sleeping arrangements, feeding arrangements, and intended care-
taking strategies during infant illness. We also asked parents how
these caregiving strategies had been decided upon and what sources
of information they had obtained before making infant care choices.
The initial interviews lasted 30 to 60 minutes, and we wrote our
field notes both during and immediately after them. We obtained

contact phone numbers, along with permission to recontact the
parents for a further interview around three to five months after the
birth. Through prior arrangement, we conducted recontact inter-
views, again with one or both parents, in their respective homes. In
these follow-up interviews the original investigator gathered birth
details and discussed the actual caregiving strategies that the parents
now employed, specifically focussing on sleeping arrangements,
feeding, information concerning the reality of infant caregiving as
opposed to the expectations, advice received from professionals,

relationships, the disruptiveness of a new baby to ordered lifestyles,
and coping strategies. Again, we wrote up the interviews as field
notes. All interview data were coded and entered into a computer
spreadsheet.
RESULTS
Sixty families were interviewed prior to the births of their babies.

There was very little opposition to the initial interviews, as most of
the parents were very keen to discuss their babies (still in utero).
Forty of the original 60 families were re-interviewed after the births.
Of the 20 missing families, 14 could not be contacted (due to tele-
phone number changes subsequent to a cable company entering the
area), 5 were unwilling/too busy to carry out a recontact interview,
and 1 experienced a still birth. Table I illustrates the characteristics
of the 40 families who were interviewed twice and provides details
on the 20 families who dropped out or were otherwise lost for com-
parative purposes. It can be seen that the study sample represented
a varying cross-section of age, parity, occupations, and so on. The
number of cesarean deliveries is high in this sample, presumably
due to the recruitment of some families from the antenatal ward
(where one might expect to find mothers with potential complica-
tions). The parents completing both interviews were, on average,
two years older than were the parents who were lost to the study
following the initial interview, however t-tests confirmed no statist-
ically significant differences between the ages of the final study
population and those of the drop-outs. A slightly greater proportion
of the drop-outs consisted of single mothers, families containing
smokers, and families within which the current pregnancies were
unplanned. There were three school-age mothers in the study
TABLE I. Description of study sample.
40 families completing 20 families completing

2 Interviews 1 Interview
Mean age of fathers 30.4 (19-42) 28.3 (19-40)
Mean age of mothers 27.8 (15-42) 25.8 (19-37)
Mothers aged under 18 7.5% 0%
Single mothers 5% 15%
Primiparous mothers 57.5% 50%
Average number of other children 0.8 (0-10) 0.7(0-2)
One or both parents smoke 10% 25%

Planned pregnancy 72.5% 65%
Father's occupation:
Professional 35% 20%
Skuled/semi-skffled 40% 35%
Unskilled 20% 25%
Unknown 5% 20%
Babies' mean age at re-contact interview 10 weeks
Sex ratio (iruf) 23:19 -
Singleton:twin births 38:2 -
Normalrcesarean delivery 26:13 -
sample, and all three completed both interviews. Using Chi Square
and Fisher's Exact Tests, we found no statistically significant associ-
ations between the variables presented in Table I and the participants'
completion of both interviews. Because antenatal and postnatal
comparisons are being made, the quantative results presented here
refer only to the 40 familes who completed both sets of interviews.
Antenatal Expectations
What to expect regarding sleep was, for some parents (especially new
parents), an unknown at the time of the antenatal interview. Many
were aware that their sleep would be disrupted and that lack of sleep
was an obvious concern, but they seemed to view it as one of those
"unpredictable" factors of childbirth that necessitated a "wait-and-see"
attitude. Some parents-to-be had instigated steps to ensure the least
amount of sleep disruption. One set of first-time parents banished their
dog from their bed so that it would be accustomed to being downstairs
after the baby was born. Another experienced mother was trying to get
her two young children into a bedtime routine that would facilitate life
with a new baby and a husband who worked nights.
When asked at the antenatal interview "where will your baby
sleep during the night?" 33 families (82.5 percent) said they intended
TABLE II. Infant sleep locations employed by families in this sample.
Separate room By parental bed In parental bed

Where will this baby sleep? 5% 82.5% 7.5%
(asked prenatally)
Where had previous babies 11.8% 70.6% 17.7%
slept? (where relevant)
Where did this baby sleep? 125% 45% 42.5%
(asked postnatally)
to have their babies in cribs by their beds; two families (5 percent)

were going to place their babies in separate rooms; and three famil-
ies (7.5 percent) intended to cosleep (the remaining two families
hadn't thought about where the babies would sleep), as is shown in
Table II. Many parents felt that they wanted to keep their babies
close for practical reasons and to "keep the baby safe." One father
spoke of his anxiety for his unborn infant. He attributed this anxiety
to the fact that one of his family members had suffered a cot death,
and he said that he would keep his baby very close during the night.
He also felt that this need to keep his baby close was instinctive,
a feeling that was reiterated by other parents. One single school-
girl mother had decided (or had been persuaded) that her baby
would sleep by its grandmother's bed so that she could continue
with her schooling and not be interrupted during the night. The
desire to keep infants close is also reflected in the previous strat-
egies of the 17 experienced parents, as is shown in Table II.
Only in two families had previous babies been placed in solitary
sleeping environments at night. The parents who did not anticipate
wanting current babies with them through the night were those
who had used the "baby alone" strategy with previous children.
One mother commented: "It seemed to work fine for the last one,
so we'll do it again." Other parents, who anticipated moving the
babies into their own rooms after a few weeks, still wanted to have
the babies close initially. These parents felt that the babies would
"become used" to being in the parental bedrooms and wanted to get
them established in their own rooms as soon as possible. As one
mother commented: "The baby mustn't become accustomed to
being in our bedroom." The time period that parents posited as
acceptable for room-sharing varied from six weeks to a year. In a
few cases, circumstances such as lack of bedroom space determined
where a baby would sleep after the initial period. The size of the
210 E. Hooker etal.
baby in relation to the sleeping place was also identified as a

possible marker for independence during sleep (e.g., parents anti-
cipated moving their baby into another room when s/he outgrew
her/his newborn crib or moses basket). However, developmental
milestones such as sleeping through the night, not having to feed
during the night, and "establishing a routine" were all thought to be
indicators for determining when a baby would be moved from
the parents' bedroom into a nursery.
Attitudes Toward Cosleeping

At the antenatal interview, questions that specifically focused upon
bedsharing produced interesting responses. Toward the beginning
of the interview, when parents were asked whether they intended to
bedshare with the infant that they were expecting, 30 (75 percent)
families answered definitely not; 7 (17.5 percent) replied maybe
("I can imagine it will happen"); and 3 (7.5 percent) expected that
they would employ cosleeping as a strategy (see Table III). Toward
the fend of the interview, when parents were asked whether they
imagined ever taking the baby into bed with them their answers
were in complete contrast to those given to the earlier question (see
Table m).
As far as parents were concerned, the potential negative con-
sequences of bedsharing outweighed any potential benefits. The
main reason given for not wanting the baby in the parental bed was
a fear of overlaying. Parents commented: "I'd be scared I'd roll and
squash the baby," and "Oh no, I'd be afraid of falling asleep with
the baby in bed." Entwined with this fear was the idea that the baby
could suffocate. "No I wouldn't put the baby in bed with me, I'd
be scared I fell asleep, and then it could suffocate or be squashed
when we both roll over." Other parents had similar fears: "We'll
possibly cosleep when the baby is older but the thought of cosleeping
TABLE in. Anticipated and actual bedsharing practices.
No Maybe Yes
Antenatal intention to bedshare 75% 17.5% 7.5%

Imagined having baby in bed (antenatally) 20% 42.5% 37.5%
Never Occasional Regular
Actual practice postnatally 38% 19% 43%

with a newborn makes us very nervous." One experienced mother

commented about the practicality of the bedsharing arrangement:
"There won't be enough room in the bed for all of us." Another
major concern was that the baby would develop "bad habits" and
want to remain in the parental bed for an indeterminate amount of
time. "We don't want the baby to become too accustomed to being
in our bed" or "we don't want to spoil it" were common comments.
Some parents had anecdotal evidence concerning other peoples'
experience of bedsharing, and this had put them off: "My friend
coslept with her baby and her child is five years old now and she's
still in the bed." One mother (who was a nurse) had a "horror" story
to relate regarding her experience of nursing a patient who had
a baby with brittle bones. Contrary to medical advice, the mother
slept with the baby; the baby suffered severe multiple fractures and
died. Even those who felt that their baby would be in their bed for
a cuddle imagined that they would stay awake until she/he fell
asleep and then they would put her/him back in the crib. The
circumstances under which parents thought that bringing a baby
into the parental bed was acceptable involved feeding and illness:
"I'd have the baby in the bed for feeding and during any illness but
not for sleeping as we'd worry about causing any injury." One
mother had very mixed feelings about bringing the baby into bed:
"If the baby was ill then I'd bring it into bed but would have to kick
the father out of the bed because he's a heavy sleeper and I'd fear for
the baby's safety."
The parents who imagined some bedsharing at the antenatal
interview anticipated that "it could happen a lot." Although one
mother said that the baby would probably come into the bed for the
morning feed, she was dubious about the baby sleeping between
both parents. She then, however, related a story about her previous
baby who, at five weeks old, was in the bed when the mother fell
asleep, nudged him out of the bed and he fell on the floor. After this
experience she always put something soft on the floor to catch the
baby should he fall. For some, the idea of bedsharing inspired very
positive comments. One pair of first-time parents said: "Yes, we
wouldn't mind the baby sleeping in the bed with us. We quite like
the idea, especially when the baby is new and the novelty value is
still quite high." This mother also thought that "cosleeping will be
more convenient for breastfeeding but I can imagine that there will
be times when my partner sleeps elsewhere when I've got the baby
in bed."
222 E. Hooker et d.
Nighttime Caregiving
Antenatally, few fathers believed they would have much involve-
ment in nighttime caregiving. Many appeared willing to help but
felt that it would be more practical for the mother to be the primary
caregiver. Such comments as "well I'll be at work" and "I'll help on
a weekend or days off but I can't feed the baby [a reference to
breast-feeding]" were common. Most of the parents acknowledged
that they had discussed the strategy they anticipated employing
and had reached a decision together. However, there were a few

mothers-to-be who felt that the fathers would just have to go along
with their decisions about the babies (e.g., "my partner would put
the baby in his own room if he had his own way"). And there was
one father who was adamant that he would not be involved with
bedsharing: "No chance, I'll get out of the bed if the baby comes in."
Most parents were aware that, according to the current "Back to
Sleep" campaign, new babies should sleep in a supine position.
When asked "what position will you place your baby to sleep?"
28 (70 percent) parents intended to place their babies on their backs
to sleep, 5 (12.5 percent) stated that they would place them on their
sides, and 7 (17.5 percent) parents had not decided (or thought
about) the position in which their infants would sleep.
If we examine the results of the recontact interviews, we find that
parents' expectations, especially those of new parents, are very differ-
ent from their actual experiences of nighttime parenting. "Nothing
can prepare you for this, I was like a zombie for the first couple of
weeks, barely functioning at all" was one mother's answer to our
query about the experience of parenthood. Overall, the 40 families
interviewed postnatally had pursued a heterogeneous array of night-
time parenting strategies: baby alone, baby in parents' room, baby
in parents' bed. But the predominant nighttime strategy was to keep
the baby close for the first few months of life. The regular sleeping
arrangements of the 40 families (42 babies) are shown in Table TL.
Sleeping Arrangements After Birth
With regard to those families where babies did not sleep near the
parents at all during the night (five in total), two consisted of experi-
enced parents who had employed this strategy before (placing the
babies in their own rooms straight from hospital) and three con-
sisted of first-time parents who had intended (and tried) to keep their
babies close but found that they "made too much noise and kept us
awake." In a particular case, one mother (whose baby was a special

care baby born with an undeveloped lung) planned to have the
baby close. However, after spending two nights with the baby by
the parental bed, she moved it out of the parents' room because she
was too anxious: "I was just not sleeping, I could hear the baby
breathing and I was just laid listening, almost imagining breathing
problems." The baby's grandparents had commented that this
seemed a little harsh, but the parents explained that it was the only
way they felt they could cope.
Table III shows that, for these 40 families, their antenatal expecta-
tions regarding bedsharing were very different from their actual
experiences of it. For all their concerns at the antenatal interviews, at
the postnatal interviews 64 percent of the parents were found to be
at least occasional bedsharers. Parents who had not intended to bed-
share had ended up finding it to be a very convenient and practical
way to care for their babies. One of the most important results of
this study shows that most bedsharing babies were being brought
into bed with both parents: 95 percent of the bedsharing babies slept
with both their mother and father simultaneously, while only two
babies slept with their mother only. "More cosleeping has occurred
than I ever would have expected," commented one first-time mother.
"I felt that I was barely functioning for the first six weeks. I was so
tired, and in desperation I kept the baby in bed with me after a feed.
Yes, I was very nervous about it, but after the first time I began to
relax and could actually get some sleep. My husband was much more
relaxed about the baby being in the bed." The bedsharing father of
twins did not find the initial experience so relaxing; he spent the
first few nights with one foot out of bed, "firmly anchored to the
floor," because he felt that this would keep him from moving about
in the bed. Another father found that bedsharing with his infant
when the mother was readmitted to hospital was, for him, a useful
strategy for coping with the baby at night. However, both of the
baby's grandmothers took him to task for bedsharing. In all, 16 sets
of parents spontaneously commented that they were surprised at
the ease/convenience of bedsharing with their newly bom infants.
Breast-Feeding and Bedsharing

As Figure 1 illustrates, we found a statistically significant relation-
ship between breast-feeding and bedsharing (^ = 17.28, d/=l,
p< 0.001). Comparing the feeding strategies for the 26 bedsharing
214 E. Hooker etal.
Bedsharers
Non-Bedsharers
Breast-feeding Bottle-feeding
(Z2= 17.28, df=l,p< 0.001)
Figure 1. Frequency of bedsharing with breasi-feeding and bottle-feeding.
babies, 23 (88.5 percent) were breast-fed while the remaining 3 (11.5

percent) were exclusively bottle-fed. Twelve of the breast-fed bed-
sharing infants slept in their parents' beds following their early
morning feeds. We refer to these infants (who begin the night sleep-
ing in cots or cribs and who are regularly moved into their parents'
beds during the course of the night) as "combination bedsharers."
Those babies who slept all night, every night, in their parents' beds
are referred to as "habitual bedsharers," while babies who shared
their parents' beds on two or fewer occassions a week are referred
to in this study as "occasional bedsharers." Non-bedsharers are
defined here as those babies whose parents reported that they had
never let their babies sleep with them. Out of the 16 non-bedsharers
identified in this sample, 15 (93.8 percent) were bottle-fed, while
only one breast-fed baby had not bedshared by the time of the post-
natal interview.
In 24 families babies were regularly fed in bed, and 23 of these
families also acknowledged being bedsharers. Many of the mothers
involved found that they could feed lying down and, therefore,
found bedsharing an easy option. Indeed, 10 mothers began
bedsharing in hospital because it facilitated feeding. One first-time
mother explained how she continued bedsharing at home after
leaving hospital. She stated that, as she became more proficient at
breast-feeding, when feeding through the night she felt that she was
not actually fully awake but, rather, was in a "restful, half awake/
half asleep state." The ease of caring for breast-fed babies in bed is
also emphasized by the tendency in this sample for bedsharing to
occur after the early morning feed (usually between 2:00 a.m. and
4:00 a.m.). As can be seen in Figure 2 (a descriptive breakdown of
bedsharing arrangements), in almost half (46.2 percent) of the
bedsharing families, parents were taking the babies into bed with
them on a regular basis for the early morning feed (combination
bedsharing).
There were other circumstances that led to bedsharing. Parents

tended to take ill or unsettled babies into their beds. Fifteen babies
were snuggled into parental beds when they were experiencing
periods of illness or when they were unsettled. But not all parents
used this strategy. Seven parents had walked the floor at some point
with their unsettled, crying infants, while two babies, during an
unsettled spell, were left to cry themselves to sleep. One set of first-
time parents talked about how they and their baby had not had any
sleep for two nights due to the infant's "bad attack of colic." They
found that the only way they could get him to stop crying was
to place him in the car seat and take him for a drive in the car. Then,
in desperation, and against their "better knowledge," they finally
took him into their bed, whereupon they all managed to get some
much needed sleep.
Follow-up interviews at three months also revealed a parental
tendency to engage in "covert bedsharing." Such statements as
Occasional
bedsharing
19%
Combination
bedsharing
297.
Non-Bedsharing
38%
Habitual bedsharing
14%
Figure 2. Breakdown of bedsharingfrequency by "type" (definitions in text).

"I wouldn't tell the midwife or health visitor, but he usually sleeps
in bed with us" were common. Some parents were so unsure of the
reaction they would face that they admitted lying about bedsharing
to their own mothers and mothers-in-law. One bedsharing mother
recalled her anxiety during the community midwife's postpartum
visits, her nervousness around possibly being asked about sleeping
arrangements for the baby, and her relief that the subject was never
mentioned. Another mother commented: "We have taken to lying to
anyone who inquires about our arrangement, with the exception of
a few trusting friends and my mother who don't use the opportun-
ity to criticize our decision."
When we questioned parents about their sources of information
regarding infant caregiving, and particularly infant sleep, the major-
ity of them reported that they were predominantly influenced by
family members and friends (57 percent family, 27 percent friends),
and by the media and popular literature (48 percent) (categories not
mutually exclusive). Health professionals constituted a source of
advice on infant sleep (mostly cot-death information) for 28 percent
of parents, while 20 percent predominantly relied upon what they
termed their "own instincts." It was the latter group that contained
the greatest number of parents who slept with their babies "in secret,"
as they put it. They felt that cosleeping was "natural" but feared
that they would be criticized for engaging in it.
DISCUSSION
If we consider a continuum of cosleeping, where would we place

the parents and the infants examined in this study? McKenna
describes a cosleeping continuum as ranging from same-bed contact
at one end to the complete elimination of any parent-infant sensory
exchange (e.g., infant alone in a different room with the door shut)
at the other (McKenna et al. 1993). The majority of parents in this
study would certainly be positioned more toward the bedsharing
pole than the solitary one. This in itself is a radical postmodern
move away from the isolated infant sleeping arrangement of the
"Spock" years and the advice of Erna Wright (1972). In this study
only five sets of parents managed nighttime caregiving by expecting
their babies to sleep alone in separate rooms. The majority of par-
ents, therefore, acted on their prebirth desire (expressed during the
antenatal interviews) to keep their babies close, and they employed
one or more variants of this option as their primary nighttime care-

giving strategy.
Many of the parents oriented themselves at the same-bed point,
employing bedsharing as a coping strategy despite never imagining
that they would do so. Contrary to the opinion of Davies (1994) (who
believes that cosleeping is unfamiliar to the white ethnic majority of
the U.K.), our results suggest that parent-infant cosleeping (particu-
larly in the form of bedsharing) is a more prevalent practice than
has been generally recognized. Regarding antenatal intentions, 75
percent of parents stated adamantly that they would not bedshare. In
the final analysis, however, by 12 weeks over 65 percent had

bedshared at least occasionally. This adoption of bedsharing as
a parenting strategy contrasts with the findings of other studies
(e.g., Lozoff, Wolf, and Davis 1984), which show that only a small
percentage of white Western families bedshare with their infants.
Unlike ours, however, these studies were devoted to comparing
ethnic/cultural variation. The ethnic makeup of our sample was fairly
homogenous, as it included only one non-white family.
From the comments of parents who participated in this study, we
find that the reasons they bedshared ranged from practical caregiv-
ing to instinctive bonding. Many mothers spoke of the ease with
which they could care for their babies during the night: "It's so
much easier to feed her in bed, I don't even have to wake up properly";
"I have fallen to sleep whilst feeding and have woken the next
morning, shocked that I've gone back off to sleep." Their experiences
reflect the soporif effect of breast feeding on mothers and infants.
Parents who bedshared felt that it gave them the ability to bond
with their infants, and many commented that "it just felt right to
keep the baby close." One mother had returned to work soon after
her baby was born, and she found that bedsharing gave her the
contact with the baby that she missed through the day: "If I sleep
with the baby, I can feel closecuddled up and it somehow helps
me not to feel so guilty about leaving her through the day." Similar
comments came from two bedsharing fathers, but for them there
were no feelings of guilt. They were happy being dose to their infants
during the night because they were away from them during the day.
Our findings pertaining to the obvious relationship between bed-
sharing and breast-feeding are consistent with those of other studies
(e.g., Morelli et al. 1992). Breast-feeding and the discovery that feed-
ing the baby in bed provided the least disruptive way of conducting
nighttime feeds were both precursors to bedsharing. One family's
experience of bedsharing meant undisturbed sleep for the father:

"I can attend to the baby without disturbing my partner, I always
seem to wake just before the baby does, it's as if I instinctively know
she wants feeding." In hospital several mothers had been shown
how to breast-feed lying down (particularly following c-sections),
and they found that they could successfully feed their babies
through the night without fully waking up. Many of the mothers in
this study who had not envisaged bedsharing had employed it as a
strategy purely because it facilitated breast-feeding. Bottle-feeding
parents were not so inclined to stay in bed, as they had to get up to

prepare or collect a bottle.
Several studies have highlighted this trend of breast-fed infants
being bedsharers and bottle-fed infants being solitary sleepers (Elias
et al. 1986; Pinilla and Birch 1993; Hayes, Roberts, and Stowe 1996).
Breast-fed infants do not develop the same sleep/wake patterns as
do bottle-fed infants or even adults. It is well documented that
breast-fed babies sleep in short bouts, that they do not have the long
unbroken night sleep of their bottle-fed counterparts. If breast-
feeding is to be encouraged, as it is with current educational pro-
grams for new parents attending antenatal classes, then it should be
accompanied by advice on bedsharing. Many women cease breast-
feeding because of lack of sleep (Pinilla and Birch 1993; Ball 1999).
Rather than employing one of the complicated training programs
that have been proposed to make the continuation of breast-feeding
easier for new mothers (by teaching newborn infants to lengthen
their nighttime sleep bouts) (Gillham 1998), parents in this study
found it easier to take their breast-feeding infants into bed to feed
and then to sleep. This is reinforced by the trend that sees many
North Tees bedsharing infants being placed initially in a cot, then
being taken into the parental bed for the early-morning feed
(combination bedsharers), and then being left there to resume sleep.
This finding has important implications for the promotion of breast-
feeding, both because bedsharing will likely increase as breast-feeding
rates increase and because all families of newborns need to receive
adequate advice on bedsharing safety (Ball 1999).
Another of this study's important findings is that bedsharing in
Northeast England is triadic. This is crucial, as research into the
physiological effects of bedsharing has concentrated on infants
sleeping with their mothers only (McKenna et al. 1990,1994; Young
1999). Ninety-five percent of the babies in this study were taken into
bed with both parents; only two bedsharing mothers slept with the
baby alone. One of these was a Bangladeshi mother who slept down-
stairs with the newborn infant whilst her husband slept upstairs
with the other children. The other bedsharing mother was adamant
that the father not be in the bed at the same time as the baby; as soon
as she brought the baby into bed, she "threw her husband out."
Bedsharing is not encouraged or supported in mainstream
parenting ideology in the U.K. Some of the parents we inter-
viewed were criticized by health visitors, midwives, and relatives
when they revealed their bedsharing practices. This resulted
in them being covert about their behavior. Rath and Okum

(1995:412) report that studies of cosleeping (bedsharing) make
"frequent reference to parents' reluctance to report cosleeping
because of the common belief that it is outside the norm." In
another study Forbes et al. (1992:199) noted: "Parents are uncer-
tain about the relative harm and merits of cosleepingyet
frequently allowed it. The high percentage of reported cosleeping
in the face of pediatric and psychiatric prohibitions may indicate
that experience has taught parents that under certain conditions
cosleeping is a benign practice and that advice to the contrary can
be ignored."
Health professionals have a responsibility to ensure that infant
health and safety are paramount, and they have a duty to advise
parents regarding infant care practices that may have detrimental
consequences. The practice of parent-infant bedsharing is an inter-
esting example of contested ground. Here "received wisdom" is
that babies will be "spoiled," "bad habits" will be promoted, and
parents will be making "a rod for their back" by sleeping with their
infants. This reflects child-rearing fashions that promote early infant
independence and the avoidance of "over-indulgence" rather than
evidence-based concerns for infant health and safety. It is also
a viewpoint that is in direct conflict with the new parents' instinc-
tive tendency to cuddle their babies and keep them close (mirroring
the worldwide pattern of infant care). The latest U.K. data on the
relationship of bedsharing and SIDS (Sudden Infant Death Syndrome)
found no increased risk of SIDS for infants under 14 weeks who
bedshare with non-smoking parents, and no increased risk for any
infant over 14 weeks of age, regardless of parental smoking (Blair
et al. 1999). Rather than opposing bedsharing outright, we argue that
health professionals need to discuss with parents how to bedshare
with their infants in a safe physical and social environment, taking
each family's circumstances into account and providing information
that will help parents make informed choices regarding infant

sleeping arrangements.
We conclude, from our research, that, especially for breast-
feeders, bringing newborn babies into the parental bed is a night-
time strategy that many parents find effective. This being so, we
would like to see more discussion of bedsharing practices and safe
bedsharing environments as well as increased education for health
visitors, midwives, and so on regarding bedsharing frequency and
the reasons for its occurrence.
NOTE
1. The University of Durham and the Centre for Health and Medical Research,
University of Teesside, funded this project. We are grateful for the cooperation
of North Tees Area Health Trust, especially the staff of the antenatal wards at
North Tees Hospital and all the North Tees midwives and health visitors who con-
tributed to the study. We particularly wish to thank the parents and their
newborns who participated in the research and the colleagues whose comments
improved this manuscript.
REFERENCES
Ball, H. L.
1999 Bed-sharingA Missing Element in Breastfeeding Promotion? Paper
presented at BreastfeedingPutting the Evidence into Practice Conference,
South Tees Acute Hospital Trust, Middlesbrough, May 20, 1999.
Ball, H. L., E. Hooker and P. J. Kelly
1999 Where Will the Baby Sleep? Attitudes and Practices of New and Experi-
enced Parents Regarding Cosleeping with Their Newborn Infants. American
Anthropologist 101(2):1-9.
Barry, H. and L. M. Paxson
1971 Infancy and Early Childhood: Cross-Cultural Codes 2. Ethnology 10:
466-508.
Blair, P. S., P. J. Fleming, I. J. Smith, M. Ward-Platt, J. Young, P. Nadin, P. J. Berry and
J. Golding
1999 Babies Sleeping with Parents: Case-Control Study of Factors Influencing
the Risk of the Sudden Infant Death Syndrome. British Medical Journal
319:457-462.
Chessare, J. B., C. E. Hunt and C. Bourguignon
1995 A Community-Based Survey of Infant Sleep Position. Pediatrics 96:893-996.
Davies, D. P.
1994 Ethnicity and SIDS: What Have We Learnt? Early Human Development
38:215-220.
Elias, M., N. Nicolson, C. Bora and Johanna Johnston.
1986 Sleep-Wake Patterns of Breast-Fed Infants in the First 2 Years of Life.
Pediatrics 77(3):322-329.
Gantley, M., D. P. Davies and A. Murcott
1993 Sudden Infant Death Syndrome: Links with Infant Care Practices. British
Medical Journal 306:16-19.
Gillham, P.
1998 A Randomised Control Trial to Compare Alternative Strategies for
Preventing Crying and Sleep Problems in the First Three Months of Life.
Paper presented at the Inaugral International Conference on Women's
Reproductive Health at Churchill College, Cambridge, U.K., July 16-17,
1998.
Hayes, M. J., S. M. Roberts and R. Stowe
1996 Early Childhood Co-Sleeping: Parent-Child and Parent-Infant Night-Time
Interactions. Infant Mental Health Journal 17:348-357.
Johnson, C. M.
1991 Infant and Toddler Sleep: A Telephone Survey of Parents in One Com-
munity. Developmental and Behavioral Pediatrics 12(2):108-114.
Jackson, D.
1990 Three in a Bed. New York: Avon.
Kagan, J .
1984 The Nature of the Child. New York: Basic.
Liedloff, J.
1975 The Continuum Concept. London NW1: Duckworth.
Lozoff, B., A. W. Wolf and N. S. Davis
1984 Cosleeping in Urban Families with Young Children in the United States.
Pediatrics 74:171-182.
McKenna, J. J.
1990a Evolution and Sudden Infant Death Syndrome (SIDS): Part 1: Infant
Responsivity to Parental Contact. Human Nature 1:145-177.
1990b Evolution and Sudden Infant Death Syndrome (SIDS): Part II: Why
Human Infants? Human Nature 1:179-206.
1995 The Potential Benefits of Infant-Parent Co-sleeping in Relation to SIDS
Prevention: Overview and Critique of Epidemiological Bed-Sharing
Studies with Notes on Future Research Directions. In SIDS in the '90s. Torl
O. Rognum, ed. Pp. 256-265. Scandinavian.
McKenna, J. J. and S. S. Mosko
1990 Evolution and Sudden Infant Death Syndrome (SIDS): Part III: Infant
Arousal and Parent-Infant Co-Sleeping. Human Nature 1(3):291-330.
1993 Evolution and Infant Sleep: An Experimental Study of Infant-Parent
Co-Sleeping and Its Implications for SIDS. Acta Paediatrica Supplement
389:31-36.
McKenna, J. J., S. S. Mosko and C. A. Richard
1997 Bedsharing Promotes Breastfeeding. Pediatrics 100(2):214-219.
McKenna, J. J., S. S. Mosko, C. Dungy and J. McAninch
1990 Sleep and Arousal Patterns of Co-Sleeping Human Mother-Infant Pairs:
A Preliminary Physiological Study with Implications for the Study of
Infant Death Syndrome (SIDS). American Journal of Physical Anthropology
83:331-347.
222 E. Hooker etal.
McKenna, J. J., S. S. Mosko, C. Richard, S. Drummond, L. Hunt, M. B. Cetel and

J. Arpaia
1994 Experimental Studies of Infant-Parent Co-Sleeping: Mutual Physiological
and Behavioral Influences and Their relevance to SIDS. Early Human
Development 38:187-201.
McKenna, J. J., E. B. Thoman, T. F. Anders, A. Sadeh, V. L. Schechtman and S. F.
Glotzbach
1993 Infant-Parent Co-Sleeping in an Evolutionary Perspective: Implications for
Understanding Infant Sleep Development and the Sudden Infant Death
Syndrome. Sleep 16:263-281.
Mitchell, E. A. and R. Scragg
1993 Are Infants Sharing a Bed with Another Person at Increased Risk of Sudden
Infant Death Syndrome? Sleep 16(4):387-389.
Morelli, G. A., B. Rogoff, D. Oppenheim and D. Goldsmith
1992 Cultural Variations in Infants' Sleeping Arrangements: Questions of Inde-
pendence. Developmental Psychology 28(4):604-613.
Mosko, S., J. J. McKenna, M. Dickel and L. Hunt
1993 Parent-Infant Cosleeping: The Appropriate Context for the Study of Infant
Sleep and Implications for Sudden Infant Death Syndrome (SIDS) Research.
Journal of Behavioral Medicine 16:589-611.
Mosko, S., C. Richard and J. McKenna
1997a Infant Arousals during Mother-Infant Bedsharing: Implications for Infant
Sleep and SIDS Research. Pediatrics 100(20):841-849.
1997b Maternal Sleep and Arousals during Bedsharing with Infants. Sleep
201(2):142-150.
Mosko, S., C. Richard, J. McKenna and S. Drummond
1996 Infant Sleep Architecture during Bedsharing and Possible Implications for
SIDS. Sleep 19:677-684.
Newson, J. and E. Newson
1966 Patterns of Infant Care in an Urban Community. Middlesex, U.K.: Penguin.
Pinilla, T. and L. Birch
1993 Help Me Make It through the Night: Behavioural Entrainment of Breast-Fed
Infants' Sleep Patterns. Pediatrics 91(2):436-444.
Rath, F. H. and M. E. Okum
1995 Parents and Children Sleeping Together: Cosleeping Prevalence and Con-
cerns. American Journal of Orthopsychiatry 65:411-418.
Sears, W.
1989 Night-Time Parenting: How to Get Your Baby and Child to Sleep. Plume.
Spock, B.
1976 Dr. Spock's Baby and Child Care. New York: Pocket.
Thevenin, T.
1987 The Family Bed. Wayne, N.J.: Avery.
Wright, E.
1972 The New Childhood. London: Tandem.

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Medical Anthropology

ISSN: 0145-9740 (Print) 1545-5882 (Online) Journal homepage: http://www.tandfonline.com/loi/gmea20

Sleeping like a baby: Attitudes and experiences of

Elaine Hooker , Helen L. Ball & Peter J. Kelly

To link to this article: http://dx.doi.org/10.1080/01459740.2001.9966176

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Sleeping Like a Baby: Attitudes and

Elaine Hooker, Helen L. Ball and Peter J. Kelly

ELAINE HOOKER is a postgraduate research associate in the Department of Anthropology,

In Euro-American society the moment of birth is commonly viewed

practices that ignore the infant's evolutionary history in favor of

bedsharing (e.g., Johnson 1991; Chessare et al. 1995), but these

In a year-long study (October 1995 to October 1996) we examined

field notes both during and immediately after them. We obtained

opposed to the expectations, advice received from professionals,

Sixty families were interviewed prior to the births of their babies.

TABLE I. Description of study sample.

40 families completing 20 families completing

One or both parents smoke 10% 25%

Sex ratio (iruf) 23:19 -

Singleton:twin births 38:2 -

Normalrcesarean delivery 26:13 -

TABLE II. Infant sleep locations employed by families in this sample.

Separate room By parental bed In parental bed

to have their babies in cribs by their beds; two families (5 percent)

baby in relation to the sleeping place was also identified as a

Attitudes Toward Cosleeping

TABLE in. Anticipated and actual bedsharing practices.

Antenatal intention to bedshare 75% 17.5% 7.5%

Actual practice postnatally 38% 19% 43%

with a newborn makes us very nervous." One experienced mother

and had reached a decision together. However, there were a few

Sleeping Arrangements After Birth

awake." In a particular case, one mother (whose baby was a special

Breast-Feeding and Bedsharing

(Z2= 17.28, df=l,p< 0.001)

Figure 1. Frequency of bedsharing with breasi-feeding and bottle-feeding.

babies, 23 (88.5 percent) were breast-fed while the remaining 3 (11.5

There were other circumstances that led to bedsharing. Parents

Figure 2. Breakdown of bedsharingfrequency by "type" (definitions in text).

If we consider a continuum of cosleeping, where would we place

one or more variants of this option as their primary nighttime care-

the final analysis, however, by 12 weeks over 65 percent had

experience of bedsharing meant undisturbed sleep for the father:

parents were not so inclined to stay in bed, as they had to get up to

in them being covert about their behavior. Rath and Okum

that will help parents make informed choices regarding infant

McKenna, J. J., S. S. Mosko, C. Richard, S. Drummond, L. Hunt, M. B. Cetel and

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