Sleeping Close

A Midwife’s Thoughts on Babies, Bed-Sharing, and the Long Nights of Early Motherhood

There is a moment I have witnessed more times than I could count.

The birth is over. The room has quieted. The baby has been fed and admired and examined from every possible angle. Eventually everyone settles down and someone places this brand-new person into a bassinet.

And very often, within minutes, the baby wakes.

Pick them up and tuck them back against their mother and—there it is.

The whole little body softens.

I don't find this particularly mysterious.

A baby has just spent the entirety of their existence inside another human being. They have never been alone. They have never been cold. They have never experienced hunger. They have never known silence.

They know the sound of their mother's heart. They know her voice from the inside. They know movement, warmth and containment. They know the particular smell of her before they even know what a mother is.

And then we bring them earthside and sometimes become concerned that they don't particularly want to sleep alone.

Of course they don't.

They are babies.

I think we have made infant sleep considerably more complicated than it needs to be, while at the same time learning some very important things about how babies can die during sleep. Both of those things deserve our attention.

Because sleeping close to your baby and sleeping safely with your baby are not opposing ideas.

We just need to understand what we are talking about.

Babies are built for proximity

When people say “co-sleeping,” they can mean several different things.

Sometimes they mean a baby sleeping in a bassinet right beside the bed. Sometimes they mean a sidecar crib. Sometimes they mean bed-sharing—mother and baby actually sleeping on the same mattress.

Those aren't all the same thing, and they don't carry the same risk.

The safest recommendation we have is beautifully simple: baby in the parents' room, on their own firm, flat sleep surface, on their back. The American Academy of Pediatrics recommends room-sharing without bed-sharing for at least the first six months.

And for many families, that works wonderfully.

But I also want to talk about bed-sharing because families do it. (I did it. My daughter finally decided at 16 she was done. Now I miss her.)

Lots of families do it.

Some decide to from the beginning. Some swear they never will and discover their baby has other ideas. And some mothers simply wake at 3:17 in the morning and realize that they fell asleep while nursing.

Pretending that doesn't happen doesn't make babies safer.

Teaching parents what increases risk does.

There is a reason nighttime breastfeeding and closeness go together

A breastfeeding mother often develops an almost ridiculous sensitivity to her baby.

She hears the tiny grunt nobody else hears.

She wakes when the baby begins moving their hands.

She smells them.

Sometimes she wakes moments before the baby does.

Partners frequently sleep through all of this, which feels both scientifically interesting and occasionally deeply unfair.

But there is a biological conversation happening between a breastfeeding mother and her baby, particularly in those early months.

When baby is close, a mother can often respond while they are still in those early stages of waking—turning the head, opening the mouth, bringing hands toward the face—long before there is a full-blown hungry cry.

The baby nurses.

Everyone stays sleepy.

And hopefully everyone goes back to sleep.

For some mothers this is the difference between nighttime breastfeeding feeling manageable and feeling completely brutal.

Breastfeeding and bed-sharing are strongly associated in the research, although that doesn't prove that one necessarily causes the other. What I find more interesting is that mothers and babies seem to repeatedly find their way toward nighttime proximity even when nobody tells them to.

That should at least make us curious.

I also care about the mother's sleep

We talk endlessly about infant sleep and sometimes barely mention the woman who gave birth to the infant.

She matters too.

Postpartum sleep deprivation can be profound.

A woman may be recovering from a thirty-hour labor or major abdominal surgery. She may be feeding every two hours. Her nipples hurt. She's bleeding. She's ravenously hungry. Her hormones are reorganizing themselves. Her partner may be returning to work. She may have another child waking in the next room.

Then we tell her not to fall asleep.

That isn't much of a plan.

This is one reason I like babies close to their mothers at night. A bedside bassinet can be wonderful. Mother hears baby beginning to stir, reaches over, feeds, settles them and returns them to bed without completely waking herself.

Some mothers find that bed-sharing allows them considerably more sleep.

That does not automatically mean bed-sharing is appropriate for every mother and baby.

It means maternal sleep deserves to be part of this conversation.

Because there is another reality I want families to understand.

Sometimes the most dangerous sleep situation isn't the one anyone planned.

It is the one exhaustion created.

Please don't feed your baby on the couch because you're afraid you'll fall asleep in bed

I wish we talked about this more.

A mother has been told she absolutely must not sleep with her baby, so at 2 a.m. she gets out of bed and goes to the couch or recliner to nurse.

She is determined to stay awake.

Until she isn't.

An adult falling asleep with a baby on a couch or armchair is an especially dangerous situation. Babies can become wedged against cushions or between the adult and the furniture, and the risk of suffocation is substantially higher.

So if you are so tired that there is a reasonable chance you will fall asleep while feeding your baby, I would much rather you understand how to remove hazards from the bed beforehand than accidentally wake up with your baby tucked into the cushions of a sofa.

That isn't me saying an adult bed is the safest place for an infant to sleep.

It isn't.

A separate, firm, flat infant sleep surface is the safest recommendation.

I'm saying that parents deserve information for what actually happens at three o'clock in the morning.

There are times when I would say no to bed-sharing

This part matters.

I am very comfortable talking about the biological beauty of mothers and babies sleeping close together.

I am equally comfortable saying that there are circumstances where a baby simply should not be sharing an adult bed.

If either adult has been drinking alcohol, the baby sleeps separately.

If someone has used cannabis, recreational drugs, sleep medication or anything else that makes them unusually sleepy or difficult to wake, the baby sleeps separately.

If either parent smokes—or there was significant smoking during pregnancy—I would not recommend bed-sharing.

If baby was born premature or at a low birth weight, I would choose a separate infant sleep surface.

And I don't consider couches, recliners, waterbeds, deeply cushioned mattresses or beds piled with pillows and heavy duvets appropriate places for an infant to sleep.

This is also not the time for the family bed with the toddler, baby, Labrador and both parents piled together.

Newborns need some boundaries around their sleep space.

No pillows around baby's face.

No loose blankets or heavy comforters around them.

No stuffed animals.

No swaddled baby in the adult bed.

No cracks beside the mattress, headboard or wall where a tiny body could become trapped.

Baby goes on their back.

Baby's face stays completely uncovered.

And the adults need to be sober and able to wake normally.

These details matter far more to me than whether a family identifies themselves as “co-sleepers.”

Breastfeeding mothers often do something interesting in their sleep

If you have ever watched a breastfeeding mother sleep beside her baby, you may have noticed the position she naturally assumes.

She's on her side facing the baby. Her knees come up beneath the baby's feet and one arm is usually above the baby's head.

Her body almost makes a little letter C around them.

Researchers studying mother-baby sleep sometimes call this the C-curl.

I have seen women do it who have never heard the term in their lives.

The position helps keep baby near the breast and away from pillows while making it more difficult for the mother to roll forward.

I find that fascinating.

It is one of those places where physiology quietly reminds us that mothers and babies have been doing this for considerably longer than we have been writing parenting books about it.

But I want to be careful here too.

A biological behavior is not automatically a guarantee of safety.

Modern beds are not ancestral sleeping surfaces.

We have thick mattresses, memory foam, pillow tops, down comforters, mountains of pillows and gaps between beds and walls. We take medications that didn't exist for our ancestors. Alcohol and cannabis matter. Smoking matters.

So “humans have always slept with their babies” isn't quite enough.

We need to bring our biology into conversation with the environment we actually live in.

And then there is SIDS

This is understandably the part that frightens parents.

SIDS—Sudden Infant Death Syndrome—is not the same thing as accidental suffocation, although they are often lumped together in conversations about sleep-related infant deaths.

We do know some things that meaningfully reduce risk.

Put babies to sleep on their backs.

Keep their faces uncovered.

Keep soft bedding away from them.

Don't smoke around them.

Don't let them overheat.

Breastfeeding itself is associated with a lower risk of SIDS.

Room-sharing while baby sleeps on their own surface is also associated with lower risk.

A pacifier during sleep is associated with lower SIDS risk as well and can be introduced once breastfeeding is established, if you're using one.

None of this needs to become terrifying.

It is simply information worth knowing.

Your baby isn't manipulating you

I wish I could somehow whisper this into the ear of every exhausted mother sitting in the dark wondering why her three-week-old wakes every time she puts them down.

Your baby isn't manipulating you.

You haven't created a bad habit.

They aren't “too attached.”

They have been on this planet for three weeks.

Their entire nervous system is looking for the things it recognizes: warmth, milk, heartbeat, smell, movement, touch. But most of all…you.

Sometimes I think we ask extraordinary independence of very immature little nervous systems.

There will be plenty of time for independence.

Right now they are learning something much more fundamental.

When I need someone, does someone come?

When I am hungry, am I fed?

When I am frightened, am I gathered up?

Is this strange new world safe?

Those answers are being written into the body long before a child has words for them.

You don't have to bed-share to give your baby this connection

This is important too.

There is sometimes an almost ideological quality to conversations about infant sleep. As though the loving, attached mothers bed-share and everyone else has put their baby in exile.

Nonsense.

A bassinet pulled right alongside the mother's bed can be wonderful.

Baby is close enough that you hear the first little noises.

You can reach over and place a hand on them.

You can scoop them up to nurse without walking across the house.

And then baby returns to their own firm, flat sleep surface.

For many families this is exactly the right arrangement.

Attachment is not measured by the number of inches between your mattress and your baby's mattress.

It is built all day long.

After all these years, this is what I believe

I have spent a good portion of my life watching women become mothers.

And one thing I have learned is that mothers and babies are remarkably good at finding each other.

The baby roots.

The mother brings them to her breast.

The baby cries.

Her arms reach out.

She smells the baby's head approximately four hundred times a day without anyone ever suggesting that she do so.

The baby settles into the particular curve beneath her chin as though the space was designed specifically for them.

Maybe it was.

I don't think we need to train this closeness out of mothers or babies.

I think we need to make it safe.

Bring the bassinet right up against your bed.

Hold your baby as much as you want while you're awake. Contact naps are positively dreamy and they are the moments you will miss the most when your child is on the loose.

Nurse them when they're hungry.

Let them fall asleep against your chest while you're sitting there marveling at the fact that you somehow made fingers that tiny.

And if bed-sharing becomes part of your family's nights, intentionally or occasionally, learn the circumstances that make it more dangerous. Don't mix it with alcohol, drugs, smoking or sedating medications. Don't put a newborn beneath a fluffy duvet. Don't sleep with them on the couch. Don't assume that because something is natural, every modern version of it is safe.

And please don't spend these precious, exhausting months worrying that responding to your baby too much will somehow ruin them.

You cannot spoil a newborn with closeness.

They are learning you.

And you are learning them.

Somewhere between the midnight feeds, the damp pajamas, the tiny noises, the aching breasts and that warm little body tucked beneath your chin, the two of you begin to find a rhythm.

It doesn't look exactly the same in every family.

It isn't supposed to.

The goal isn't to prove that babies belong in beds or bassinets.

The goal is a baby who is safe, a mother who is supported, and a family that is getting enough rest to find its way through these tender first months together.

Keep them close.

Just make that closeness thoughtful.