0:08

This is Live Well Talk on Co-Sleeping. I'm Dr Dustin Arnold, Chief Medical Officer at Unipoint Health, St Luke's Hospital.

0:13

Joining me for today's episode is Dr John Sevining, a pediatrician with Unipoint Clinic Pediatrics, Hiawatha, to discuss the practice of parents co-sleeping with their baby, why it's dangerous and what parents can do to sleep near their newborn without putting him or her in harm's way.

0:29

Dr Sevining, welcome. Thanks for having me.

0:32

Thanks for joining me. How long have you been in town?

0:36

Oh 1996.

0:38

Wow, so I finished my residency from 93 to 96 and came back then.

0:44

That's uh so you.

0:46

I was told there'd be no math, Dustin. Yes, there's no math on the podcast.

0:52

Well, welcome. We're glad you're here today to speak about this.

0:56

Let's start with what is the definition of co-sleeping with a newborn?

1:01

So co-sleeping is as the name might suggest.

1:05

It's just the parent, usually parent, but it does include twins, triplets.

1:10

We really don't want anybody else sleeping with the baby, whether it's a bed, a couch, recliner.

1:18

We just really want that baby in its own space, nice, firm surface with not really anything else in it no pillows, no blankets, none of the baby protectors that we used to have around the crib that when we had kids.

1:34

Yeah.

1:37

I mean I think people you assume the baby's gonna be more comfortable with the quilt that grandma made and one pillow, but that's not true.

1:48

Well, I can't comment on whether they're more comfortable or not, but I can sure tell you they're gonna be more safe without them.

1:54

So co-sleeping itself is what's the danger there?

1:58

I mean the obvious the possible suffocation.

2:01

That's pretty much it. So parent falls asleep too.

2:04

They're comforting the baby, they're nursing the baby, maybe doing that, maybe dad does a bottle feeding while they're in bed or couch.

2:13

When you're a new parent, a young baby, you tend to be sleep depronically, so you fall asleep.

2:20

I'm sure I was guilty of doing that with the baby in my lap or in my arms at one point or another.

2:26

So 99% of the time everything goes fine.

2:33

Obviously Everybody wakes up and is fine.

2:35

But we want to eliminate that small chance that something bad could happen.

2:41

Prior to going on with the podcast, you had mentioned the back to sleep campaign in the 1990s and the effect that it had on sudden infant death syndrome.

2:52

Tell us what the back to sleep campaign was.

2:56

So in the early 90s the AP came out with the back to sleep program to try and cut down on the cases of SIDS.

3:05

The issue there was, I think, probably 70, 80%, if I remember my numbers right at the time.

3:14

Babies at the time were sleeping on their tummies.

3:18

They thought there was correlation, which there certainly was a pretty strong correlation between that and SIDS death in babies.

3:26

After the back to sleep campaign was started the number dropped pretty significantly.

3:31

But obviously that number is not zero.

3:34

Now we're looking at what other kind of modifiable factors are there to help reduce really more.

3:42

Probably correct term now for this is sudden unexplained infant death or more from suffocation, those kind of things.

3:52

There's still going to be issues with babies, preemies.

3:57

There's multiple factors I guess that kind of go into SIDS.

4:02

Does that put at higher risk if they're premature?

4:04

Yeah, premature babies, Babies with some issues with genetic syndrome, certain genetic syndromes.

4:12

There's cardiac issues, lung QT syndrome, probably several others I'm forgetting off the top of my head right now.

4:21

Lack of prenatal care plays a risk for it.

4:24

Single moms play a risk for it.

4:27

Whether mom uses alcohol, other illicit drugs at least.

4:35

So with the co-sleeping and the issue of perhaps suffix, so I'm just going to use my adult internal medicine brain.

4:43

So the baby, the infant becomes hypercarbic, co2 builds in the blood and they're just not strong enough to push themselves away from that.

4:52

Where someone older would wake up, push away.

4:58

So that's the underlying pathology.

5:00

That's the big issue, I mean if you look at the numbers, the highest rates for SIDS or suffocation kind of related issues in that scenario are really three months and under that was my next question.

5:15

What was that?

5:16

You know, babies, just like all of us older people, come in different sizes too and we know there's going to be some developmental issues where, again with premies, where they might not be quite as strong as what a term baby would be.

5:28

But three months is really the big risk zone, but we kind of make sure six months, for sure a year the numbers start dropping, but every now and then a one or two-year-old could have an issue in the right circumstances.

5:49

So really the recommendation is you know, baby sleeps alone on that firm surface really until that first year.

5:59

For sure, even in like we really want them in parents' rooms.

6:05

Most people will say for that first six months, after six months, between six months, 12 months, usually I'm kind of like the parent can sort of choose what they want to do at that point.

6:17

But if they're comfortable with baby kind of transitioning to its own room at that stage, then that would be fine by my recommendations.

6:27

But you know you talk to somebody else.

6:29

They might be a little bit more adamant. Stay in that, you know.

6:32

Stay in parents' room until that one-year mark, but still always, you know, in their own bed on their own surface.

6:40

And a firm surface on their back. That's the easy recommendation to make, I guess.

6:45

And then you transition to they're three years old and your wife is getting in an argument with the three-year-old why they need to go back to their room.

6:55

And if you're me, I'm just like, okay, just everybody go to bed.

6:59

But that's maybe that might be a different podcast.

7:03

Yeah there's, you know when does. When is it okay to kind of sleep or have that older kiddo?

7:08

You know I would say never, but you know there's times when you're as a parent, you know if you have a toddler you don't even know they've you have to wake up with a foot you roll over and you're like, oh, there's something there.

7:25

So I mean, in a perfect world. You know, I always usually recommend to our parents, if they come in and try to kind of figure out what they're upset about, is it?

7:33

You know? We just need a glass of water. Was there a storm?

7:36

Do they have a nightmare? You know, if we can get them back to their own bed, that's ideal.

7:41

Well, this has been excellent advice and firm surface on their back in the parent's room, at least till six months, and perhaps maybe the first year, depending on who recommends.

7:54

Yeah, I think if you look at the recommendations it kind of get a little blurry in that six to 12 month range.

8:01

But you know it really kind of depends.

8:04

If you're breastfeeding probably, you know, in your, in the parent's room bottle fed baby probably is going to be sleeping through the night pretty consistently by six months and will probably be ready to transition to their own own room at that point.

8:18

And no no pillows with older kids until about age two.

8:24

Age two no pillows till age two. Yeah, Good advice.

8:26

Thank you again for joining me and sharing about the dangers of co-sleeping and sudden infant death syndrome, and we've provided parents with some helpful advice Once again.

8:35

This was Dr John Sevinian, a pediatrician with Unipoint Clinic Pediatrics, hiawatha, to learn more about pediatric care.

8:41

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8:45

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8:47

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8:54

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