Sleep Like A Baby? What
Does That Really Mean?
(In Vermont)
James J. McKenna Ph.D
Edmund P.Joyce C.S.C. Chair in
Anthropology..Director, MotherBaby Behavioral Sleep
Laboratory
University of Notre Dame du Lac
What is “normal, healthy infant sleep”
Do we answer from a biological or recent cultural point
of view? Does it matter? If so, How?
• How and in what ways has
culture by way of social
values and goals mediated
and influenced not only the
study and conceptualizing of
infant sleep i.e. proper
positioning, arrangement,
nighttime feeding patterns,
and appropriate parental
responses
• but the biology of both
maternal and infant sleep in
complex urban western
settings?
• Why do 20-40% of
western babies have
“sleep problems to
solve”?
1.Disarticulated
from mother…
No touch;
No smells;
No
sounds
No
movement;
No body
heat’
No breadth
exchange
Fact: The only
object/surface/entity on
or around which the
baby is “designed” to
sleep remains the
mother’s body.
“There is no such thing as a
baby, there is a baby and
someone.”
D.Winnicott
...in our enthusiasm to view the human infant
(culturally) as a separable, autonomous
organism, we have pushed too far the concept of
the infant’s physiological independence from the
parent…confusing the infant’s preparedness to
adapt, with actual adaptation…
confusing the infant’s abilities to sleep alone
with moral and scientific truths and meanings
Hierarchy of value is imposed:
– On moral grounds…
– the “good” baby vs. the “bad” baby,
– but also, the effective /strong parent vs. the
ineffective/weak parent;
– On scientific grounds…
– The developmentally superior, competent
baby vs. the inferior, less competent
(spoiled/indulged) baby
Limitations of Western Pediatric
Sleep and SIDS Research
adult- centric;
non-evolutionary;
ethnocentric;
(a)theoretical (no theory around which to
interpret clinical events or research results)
Who is the infant? What do infants need? What criteria should be used to
decide, that is... dominant cultural practices?
biological? species-wide? local? Western reductionist science methods have
not served infants well.. Eliminated concept of “the mother-infant dyad” as
the unit of analysis
Western pediatric medicine
suffers from what Professor
George Williams calls…
the “fallacy of medical
normalcy..” if we do it, or
practice it, or value it (in
western society)..it must be
right and/or appropriate
Interacting factors-- (most and least relevant ?)
From: Sally Baddock (New Zealand) Peter Blair and Helen Ball (Great Britain), Caroline
McQuillan (Australia) James McKenna and Lane Volpe (USA)
Cultural
least relevant
Scientific
Public
Health
Where babies
actually
sleep
Infant and Parental
Biology Including
Feeding Method
Family
including economic status
most relevant
“It’s not what we
know that gets us
into trouble….it’s
what we know…that
just ain’t so!
From: Everybody’s Friend (1874)
By Mark Twain
….culturally favored child care practices
change independent of,
and much faster than,
infant biology….
(ideologies or goals that underlie recommendations
are often historical and ideological in origin but
passed off as, if not confused for, scientific
findings)
In the west solitary sleeping arrangements became
entangled with, and one and the same with, “good”
morals
if...sleeping alone through
the night is medically
“good” for babies
then don’t “good”
babies do so, and
“good parents” enforce
it?
Cascading Inter-connections Regarding
Western Parent-infant Sleep Conflicts
•
•
(Infants rarely have sleep problems, parents do..!)
Western parents suffer from a variety of damaging diseases not the least of
which is.. the disease of false and unrealistic expectations..a cultural and not a
biological model of infant’s sleep patterns;
• the disease of confusing parental desires and wishes and “best
interest” with that of their infants
• the “die”model of sleep--the only “good” sleep is an uninterrupted one;
• that infant sleep behavior correlates with good moral character, and
general future social skills and competencies…in domains other than
sleep;
• the presumption of an adversarial relationship existing between infants
and parents as regards sleep..Consider the book title: “Winning
Bedtime Sleep Battles”..and “Babywise” ;
Why Our Babies “Can’t” Sleep and Why
Western Parents Are the Most Exhausted And
Disappointed Parents In The World
• suffer from the disease of misinformed expectations
• devoid of the “relational” familial factors (where baby sleeps
and feeds as regards parental emotions and goals;)
• devoid of intrinsic (infant) factors (temperament, personality
, sensitivities);
• categorizes infant’s inability to follow cultural model
as…”disease”, sleep disorder, immaturity, and, thus, infant
becomes a “patient”;
• promotes one- size- should- fit- all;
• promotes one sleeping arrangement as a moral issue and
gives it a specific set of inappropriate meanings;
Why Do Parents Have Infant Sleep
Problems To Solve?
• Because no two people in any relationship have exactly the same “best’
interests..always trade-offs are involved…sleep is relational..not
medical
• current one-size- must- fit- all model devoid of relational-emotional
aspects including unique infant “intrinsic” factors
– such as infant sleep personality-temperament and how these articulate with
unique needs of parents to respond to perceived infant needs, as well as
the parents own needs for contact with their infants;
• Current models either ignore altogether the critical relationship between
nighttime breastfeeding and sleep, or minimize its significance to infantmaternal health.. seeing breastfeeding as a threat and not added value
– wish nighttime feeding would just go away as it threatens the priority given
to consolidated sleep (the predominant cultural
value)
•
Transition away from thinking of co-sleeping as pathology (psychology) to dangerous (medical)
Until recent, western historic
periods, no human parents ever
asked:
Where will my baby sleep, how will
I lay my baby down to sleep, and
how will I feed my baby?
most human parents still don’t!
For the human infant the three
functionally inter-related (adaptive)
components of normal, healthy infant
sleep include:
• Sleep location
– (next to mother for social or co-sleeping behavior
involving on-going sensory exchanges, monitoring
and mutual regulation)
• Nighttime feeding
– exclusive breast feeding
• Sleep position
– Back (supine)
The cultural-medical dismantling of
this biological system led to the
deaths of thousands of western
infants from, SIDS, accidental
asphyxiations and/or other SUDI
(i.e. from social sleep …to solitary infant
sleep-from breast feeding …to bottle-formula feeding
from supine …to prone infant sleep position
THE UNDERMINING OF MATERNAL CONFIDENCE
AND KNOWLEDGE
Benjamin Spock wrote to mothers in: Baby Care
“You know more than you think you do….
don’t be afraid to trust your common sense.
Bringing up baby won’t be a complicated job if you
take it easy, trust your own instincts, and follow
the directions your doctor gives you!
cited by tina thenevin,1993, mothering and fathering
To understand current debate/discourse over sleep
must understand Bridget Jordan’s delineation of the
place of “authoritative medical knowledge” in our
western culture.
• Decision -making hierarchy
is distributed--physician at
top, lactation consultant,
nurses, parents at bottom;
• “the power of authoritative
knowledge is not that it is
correct but that it counts”
• “Standard Care” enforced by
legal and institutional
actions;
– Examples: prosecution of
Salt Lake City couple whose
infant died after co-sleeping
(child abuse homicide); or
lactation consultants fired if
they give safety information
on bedsharing.
• Invalidates other
knowledge systems;
• Parental knowledge
counts for nothing
• Parents must
override instincts- as
medical personnel
always know best;
Modified from: Birth In Four Cultures by Bridget Jordan
Authoritative medical
knowledge…
“…to legitimize one way of knowing as “authoritative”
devalues, often totally dismisses, all other ways of
knowing. Those who reject authoritative knowledge
systems tend to be seen as backward, ignorant, or
naïve troublemakers…”
Socio-cultural and Historical Factors and Forces
Leading to Erroneous Scientific Understandings
(Undermining Parental Confidences and Empowerment)
•
•
•
•
•
•
•
•
rise of child care experts using moral judgments as a basis of recommending what infants
“need’..what is worth “investing in” as a practice..
belief in superiority of technology, rather than on maternal bodies to stimulate, hold and
nurture;
emphasis on “average expectable population outcomes” rather than on individual variability
or potential.. per any given behavioral parenting strategy;
emphasis on ethnocentric social values and ideologies (not biology) to guide research and
conclusions..”fallacy of medical normalcy” (GWilliams)
improper medicalization of relational (caregiving) issues ..assumed to be best understood by
pediatricians (who generally have no training in human social development or human
evolution…
“Pathologizing” of normal behavior (crying when left alone) ..making infants into patients
(blaming the victim for the crime) in need of correction when they fail to follow cultural
scripts..”Never let a baby fall asleep at the breast” AAP Guidelines For Infant Sleep
social constructions of infancy, not /biological- evolutionary based (influences of Freud,
Klein, Watson..psychology in general);
“Science” of infant feeding (bottle-formula feeding) and sleep pediatrics became one and the same with…
mutually reinforcing moral ideas about who infant should be, or become, rather than who they are…and
how husbands and wives should relate vis a vis distance, authority and separation from children…also,
ideologies about the bedroom as a “sexual place..”
The Complex History of Infant Sleeping Arrangements In
Western Industrial Societies Is Reduced To Simple
Understandings Congruent With Present Cultural
Beliefs:
•
•
•
•
•
inevitable suffocation/overlying/SIDS
inevitable psychic damage to infant
inevitable rupture to conjugal (husband/wife) relationship
inevitable prolonged dependency of infant/ child
inevitable lack of autonomy in infant/child
– NOTE: not one controlled scientific study documents the
benefits of solitary infant sleep, or the alleged deleterious
social/psychological/physiological consequences of safe
cosleeping with breast feeding
How A Folk Myth (normal, healthy babies
sleep alone) Achieved Scientific Validation
#5: To produce
“healthy” infant
sleep, replicate the
test condition
#4: Publish
clinical model
on what
constitutes
desirable,
healthy infant
sleep.
#1: Initial test condition—infant
sleeps alone, is bottle fed, and has
little or no parental contact
“Scientific”
validation of solitary
infant sleep as
“normal” and
“healthy”
#3: Repeat measurements across ages,
creating an “infant sleep model”
#2: Derive
measurements
of infant sleep
under these
conditions
Changing perceptions….of what’s
good for baby…
“The constant handling of an infant is not good for him.
The less he is lifted, held and passed from one pair of
hands to another, the better, as while he is young his
bones are soft and constant handling does not tend to
improve their development nor the shapeliness of his
little body. the newborn infant should spend the greater
portion of his life on the bed”
FROM: THE BABY
MARIANNA WHEELER 1901
HARPER BROS: NEW YPRK LONDON
CHANGING PERCEPTIONS OF WHAT
INFANTS NEED...
THE MOTHERHOOD BOOK (1935)
“Babies should be trained from their earliest days to
sleep regularly and should never be woken in the night
for feeding….”
“Baby should be given his own bedroom from the very
beginning. he should never be brought into the living
room at night”
Richard Ferber, M.D.
Director,
Center for
Pediatric
Sleep Disorders,
Children’s
Hospital, Boston
slide courtesy of Meret Keller and Wendy
Goldberg
Dr. Richard Ferber “changes his mind”..?? But the larger and more
important question is…What is it about our culture that makes us
care, or makes it important what someone who has no familiarity
with our baby or our family thinks about this very personal issue?
•
“If you find that you actually
prefer to to sleep with your baby
you should consider your own
feelings very carefully”.
•
“Whatever you want to do ,
whatever you feel comfortable
doing, is the right thing to do, as
longs as it works….. most problems
can be solved regardless of the
philosophical approach chosen”
(Ferber: 2006: 41)
1976
2006
Changing concepts related to where
babies can or should sleep..the beat goes
on…
(1976, 1999)
“…Sleeping in your bed can make an infant confused and anxious
rather than relaxed and reassured. Even a toddler may find this
repeated experience overly stimulating”
(2006)
“Children do not grow up insecure just because they sleep
alone or with other siblings, away from their parents; and
they are not prevented from learning to separate, or from
developing their own sense of individuality simply because
they sleep with their parents” (Ferber 2006:41).
“Sleeping With Baby: An Internet -based Sampling of
Parental Experiences, Choices, Perceptions, and
Interpretations In A Western Industrialized Context
J.J. McKenna and L.E. Volpe
in press Inf. Child Dev.
Based on self-selected sample of
200 mostly middle class mothers
from Canada, United States,
Australia, and Great Britain….
400 pages of narrative “ethno
histories” in response to nine
questions…
“Sleeping With Baby: An Internet -based Sampling of
Parental Experiences, Choices, Perceptions, and
Interpretations In A Western Industrialized Context”
•
•
•
•
•
•
•
•
•
How did you, do you, co-sleep?
How long did you/have you co-slept?
Why are you co sleeping, or, why did you co-sleep?
If you already have children who moved on from co-sleeping, what do you think
of your experience?
If you are still co-sleeping, what do you think of it now (i.e. as opposed to your
attitude when you began?
How well do your children sleep now?
Are you breast feeding or did you breast feed? If so, for how long?
Do you and/or your partner smoke?
By co-sleeping, do you think you ever saved your child’s life?
–
questions originally posted on
Recurrent parental themes
• awareness of comments concerning “warnings” against
bedsharing and knowledge of bedsharing risks;
• relationship between breast feeding and bedsharing;
• emotional bases of and correlates to co-sleeping for mothers
(parents) and infants alike;
• transition to separate beds;
• co-sleeping and effects on child’s socio-emotional development;
• potential life saving experiences
ON RESPONDING TO
INFANT CRIES...
“A RAPID AND SYMPATHETIC RESPONSE TO OUR
BABIES CRIES IS THE FOUNDATION OF STRONG
FAMILY VALUES, NOT THE UNDERMINING OF THEM”...
FROM: HARVEY KARP…HAPPIEST BABY ON THE
BLOCK (2002)
Ahhh… The question of
promoting infant
“independence”
(three questions)
1) what exactly is “independence
for a 2-3 month old infant?
2) does it really correlate with
solitary infant sleep practices?
3) is “independence of children”
what parents really want?
But, is “independence” really best in the
long run.. that is, is “independence” from
parental intervention at 13 or 14 years of
age as desirable as it is, say, at 2
months?
Does sleeping alone actually correlate with autonomy,
competence, and/or confidence, or happiness or to any other
desirable personality attribute not obtainable through some
other arrangement or other childhood socialization
experiences?
According to Daniel
Stern (1985)
• “..the emotionally disturbed patient is
one whose early experiences lacked
attunement…..the tracking and attuning-which permits one person to be with
another in the sense of sharing likely
inner experience on an almost
continuous basis”
When dependence IS autonomy
“Autonomy in the sense of psychotherapy, implies
taking control of one’s life…emotional autonomy
does not mean isolation or avoidance of dependency.
On the contrary, the lonely schizoid individual who
preserves his “independence” at all cots may well be
in a state of emotional heteronomy, unable to bear
closeness with another person because of inner dread
and confusion.
dependency AS autonomy
A similar state of emotional heteronomy affects the psycho- path
who is unaware of the feelings of others. The emotionally
autonomous individual does not suppress her feelings, including
the need for dependence, but takes cognizance of them,
ruling rather than being ruled by them” (Homes and Lindley
1989)*
* The Value of Psychotherapy (1991) J.Holmes and
R.Lindley. Oxford University Press
Crying
Chimps
have….
..bad
days,
too!
Recent cultural ideologies place
BOTH infants and parents at odds
with their biology (emotions)
• Western Caregiving:
– Child is not in contact with mother
most of the time (crib, stroller)
– Baby is kept supine
– Scheduled separated feedings
– Social pressures not to respond to
infant crying for fear of “spoiling”
– Separation, minimal feedings, is
thought to be “good for baby”
Function of Crying
• primary form of pre-verbal
communication;
• evolved maximize chances of
infant survival and parental
reproductive success.
• signals infant distress, fear,
hunger, pain and/or
discomfort..
• crying ensures proximity to
parent, protection from
predators.. (Bowlby)
• Though crying is not the normal way
by which infants receive breast
milk…crying is a late sign of infant
hunger signals …
Evolutionary Adaptedness
• “A number of studies in human
infants have confirmed the
potential importance of both
contact and nutrients as
regulators of infant behavioral
state…increasing carrying from 3
to more than 4 hours a day
reduces duration…of
crying/fussing behavior by 43% at
6 weeks of age” (41).
Controlled crying (or controlled
comforting..or sleep training)
1.
2.
3.
a technique to manage infants and young children who
do not settle alone or who wake at night, or who settle
only if held or if permitted to sleep in proximity or contact
with their parents….
involves leaving the infant to cry for increasingly longer
periods of time before providing comfort…
the goal is to condition infants or young children to
“sooth” themselves back to sleep and to stop them from
crying or calling out during the night
Australian Association of Infant Mental
Health Position Paper…
• “It is normal and healthy for infants and young children not to
sleep through the night and to need attention from parents. This
should not be labeled a disorder except where it is clearly
outside the usual patterns”;
• “Parents should be reassured that attending to their infants
needs/crying will not cause a lasting “habit”..Waking in older
infants and young children may be due to separation anxiety,
and in these cases sleeping with or next to a parent is a valid
option. This often enables all to get a good nights sleep”
Australian Association of
Infant Mental Health
“The AAIMHI is concerned…
“controlled crying” is not consistent with what infants need for their
optimal emotional and psychological health, and may have
unintended negative consequences”
From “Controlled Crying: AAIMHI Position” Paper November 2002
Traditional Western Pediatric and Clinical
Approaches and assumptions to Infant
Sleep:
• perpetuate the very environmental
conditions that give rise to the parentinfant sleep problems they are asked to
solve…
Controlled crying and or sleep
training techniques and philosophies
…
reflect social ideologies
not scientific findings about who infants are
and what infants need based on empiricallybased, scientific- biological studies;
techniques reflect who we think we want infants
to be (convenient) or become or should
become (autonomous/independent) as early
in life as is possible;
First Question
What cultural assumptions about
infants and their sleep and
developmental needs, lead to
caregiving practices which induce
infants to cry in the first place,
which in turn make “controlled
crying” techniques seemingly
necessary?
Second Question (there is a
choice) :
• What exactly needs to be changed?
– should babies be changed… can they be
changed (biologically?
-or– should the ideas and assumptions which
underlie and justify recent western infant
care recommendations be changed ?
– who gets to decide?
It’s one thing to ask if some infants can be
conditioned or trained to sleep alone,
unattended.. “through the night”
(unsupervised, unfed and unintended)
It’s altogether a different and more
serious matter to ask if they
should be, or if it is not nice,
dangerous or injurious in either
the long or short run…
Misunderstandings by parents often
motivate the use of “controlled
crying” techniques….
“
Parents are led to believe infants will be
cognitively or socially handicapped--no scientific
studies support such predictions..
Infant crying…is it normal or
necessary, or an expectable
behavioral expression found in
daily life ? or
an alarm signal reserved for
critical circumstances involving..
pain, hunger, fear (separation
from the caregiver)--all or some of
these?
Evidence that it is neither expectable
nor beneficial, but deleterious..
• requires considerable physiological
effort with…
• increase heart and lung activity (Rao et
al. 1993; Lester et al 1985),
• increased energy loss through..
• Heart rate increases (Pillai and Jane 1990);
• Augmented plasma cortisol levels;
• Decreased blood oxygenation (Anders et al.
1970;Levesque et al. 1994);
And , yet, from a western cultural
medical (clinical) perspective
protesting infants are considered to be developmentally
inferior, immature, or “spoiled” compared with infants
who comply or acquiesce passively to the cultural
model of separation-----which actually endangers
infants…..
And parents of such infants assume either that their
infants are deficient, or that they lack good parenting
skills…
Evidence -Based Science:
Infants sleeping alone in a room by
themselves are at least twice as likely to
die from SIDS than are infants sleeping in
the company (same room) as a
committed adult caregiver…
Sources: Great Britain (Blair et al 1999), New
Zealand (Mitchell and Scragg 1995), and
European Collaborative Study (Carpenter
et.al.in press, Lancet)
With respect to crying …and
smiling 
• Both these “perceptuo-motor mechanisms” according
to Bowlby…promotes maternal “attachment”..
• turning on , and turning off , of each--- become
socially and psychologically mediated as the infant’s
neocortex myelinates (baby decides whether or not
or if, to cry or smile…and to whom or for whom…and
when to do so….
AAIMHI.. recommends that
parents should be told….
• The method has not been assessed in terms of
stress on the infant or the impact on the infant’s
emotional development;
• A full professional assessment of the child’s health,
and child and family relationships should be
undertaken before initiating a controlled crying
program…
• ….this should include an assessment of whether the
infant’s crying is outside the normal levels
Clinical Application
• Inform parents that early infant crying is
normal and “makes sense” from an
evolutionary standpoint
• Possible “solution” to reduce the prolonged
crying of colic: change “normative
caregiving, rather than treating intrinsic or
extrinsically induced pathology in the infant”
• Maintain contact and proximity to infant.
Infant and Child Development
(Special Issue)
(2007) Vol16, Issue 4: 331-469
“Co-sleeping during infancy and
early childhood: Key findings and
future directions (457-467)
Wendy Goldberg and Meret Keller
***Next few slides modified from and/or courtesy
of…Meret Keller and Wendy Goldberg….UC Irvine Dept
of Psychology
Modeling “co-sleeping” as a medical
disorder
Co-sleeping
Night wakings
=
=
Night wakings
Sleep problems
THEREFORE
Co-sleeping
=
Sleep problems
However…
 Cross-cultural samples…China, India
 Southeast Asia, Japan… and others
 U.S. co-sleeping sub- groups such as
African -Americans, Hispanics, La Leche
League-Breastfeeding mothers
populations..
Night wakings not perceived
as problematic by all mothers!
Courtesy of Meret Keller and Wendy Goldberg
How such nighttime arousals by
infants are evaluated depends on…
Begin in infancy?
A preferred parental
practice?
OR
Begin in toddlerhood/
preschool?
OR
Perceived as a
“necessary evil?”
Courtesy of Meret Keller and Wendy Goldberg
Sleep Groups
(UCI Family Sleep Research Project; Keller & Goldberg, 2004)
• Solitary Sleepers:
Slept alone from 6 months through 3 years
• Reactive Co-Sleepers:
Slept alone by 6 months; began co-sleeping
during second or third year
• Early Co-Sleepers:
Bedsharers for at least the first year
Powerpoint Courtesy of Meret Keller and Wendy
Goldberg
Meret Keller and Wendy Goldberg: Objective and Hypotheses
The primary objective of this study was to provide
empirical data on co-sleeping in relation to reported
sleep problems and preschool children's independence
and autonomy. A secondary aim of this study was to
investigate sub-types of co-sleeping.
(1)Early co-sleeping mothers view solitary sleeping
more negatively and co-sleeping more positively
than either solitary sleeping or reactive co-sleeping
mothers.
(2) Reactive co-sleeping mothers report more childrelated sleep problems and perceive these problems
as more intense than do solitary sleeping and early
co-sleeping mothers.
(3)Solitary sleeping children exhibit greater
independence in sleep and other domains at
preschool age compared to early and reactive cosleeping children.
Results
Mothers of co-sleepers were least supportive
of solitary sleeping.
Reactive co-sleepers had the most sleep
problems (e.g., night wakings) and their
mothers perceived them as problematic.
Solitary sleepers were the most independent
in the sleep domain.
As preschoolers, early co-sleepers were most
independent with peers and in self-care skills.
Measures
Sleep Practices Questionnaire (items
adapted from Crowell et al., 1987;
Greenberger & Goldberg, 1989; Lee,
1992; Lozoff, et al., 1984; Stillman,
1999).
Independence (“not relying on others,”
Deci et al., 1993; Deci & Ryan, 1985) in
domains of sleep, self-reliance, and
social behavior with peers.
Sample and Sleep Groups Defined
Meret Keller and Wendy Goldberg
The sample consisted of 83 preschoolaged children (54% female) and their
mothers, who were well-educated,
middle to upper middle-class, 71%
Caucasian, 18% Asian American, and
5% Latina.
SOLITARY SLEEPERS
SLEPT ALONE BY 6 MONTHS AND
CONTINUED THAT ARRANGEMENT TO
AGE 3
For example…Reactive CoSleeping:
Unwanted, unplanned co-sleeping
Definitions
– Children who start out as solitary sleepers in infancy
and share the parents’ bed as toddlers or preschoolers
– Children who co-sleep (regardless of age) because they
have difficulty sleeping alone even though the parents
prefer separate sleeping arrangements (i.e., unplanned,
unwanted co-sleeping)
Reactive co-sleeping families emerge as a distinct
group from early/intentional co-sleeping families.
Powerpoint Courtesy of Meret Keller and
Wendy Goldberg
Powerpoint Courtesy of Meret Keller and Wendy Goldberg
Criteria for Sleep Groups
Age (months)
36
30
24
18
12
6
Early Bedsharers Solitary Sleepers
Bedshare part/all night
Own room
Reactive CoSleepers
Co-sleeping for at least 6 months (otherwise solitary sleeping)
FINDINGS:
Support for Reactive Co-Sleeper
Group
• Early and reactive co-sleeping
children awakened more
frequently than solitary sleepers
• Reactive co-sleeping mothers
perceived their children’s night
wakings as more problematic
than other mothers
THEREFORE – Early co-sleeping mothers did not
perceive their child’s night wakings as problematic
Powerpoint Courtesy of Meret Keller and Wendy
Goldberg
Child Outcomes
Early co-sleeping
children, as
preschoolers,
reportedly more
independent in nonsleep domains
Powerpoint Courtesy of Meret Keller and
Wendy Goldberg
Independence in Sleep
Domain
Solitary sleepers most independent in sleep domain:
– Solitary sleepers fell asleep on own at earlier age
• Solitary sleepers (M=5.0 months)
• Reactive co-sleepers (M=11.0 months)
• Early co-sleepers (M=26.9 months)
– Solitary sleepers slept through the night at earlier age
• Solitary sleepers (M=6.2 months)
• Reactive co-sleepers (M=13.6 months)
• Early co-sleepers (M=25.5 months)
Powerpoint Courtesy of Meret Keller and Wendy
Goldberg
As preschoolers, early
cosleepers were most
independent in
– Social relations with
peers
– Self-care/daily living
skills
Extent of Independence in Non-Sleep Domins
Independence in
Non-Sleep Domains
42
36
30
24
18
12
6
Solitary Sleepers
Reactive Co-Sleepers
Powerpoint Courtesy of Meret Keller and
Wendy Goldberg
Early Co-Sleepers
Maternal and Family
Outcomes
• Maternal autonomy support:
Early co-sleeping mothers more supportive of
their child’s autonomy and less controlling than
mothers in other groups
• Marital intimacy:
No differences in marital intimacy across sleep
groups
Powerpoint Courtesy of Meret Keller and
Wendy Goldberg
Additional Child Outcomes Research
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No differences in behavioral problems at 2 and 3 years of age for
co-sleepers and solitary sleepers (except difficulty getting to sleep
and night wakings) (Madansky and Edelbrock, 1990)
No differences, at age 6, in behavioral difficulties, emotional
maturity, mood and affect, or creativity (Okami et al., 2002)
No differences, at age 18, on child’s ability to relate to parents,
adults in general, other family members or peers. No link between
bedsharing history and child’s likelihood of using
alcohol/tobacco/hard drugs; having problems with selfacceptance; engaging in vandalism, fights or serious crimes;
being sexually active; or having either positive or negative sexual
experiences (Okami et al. 2002)
Powerpoint Courtesy of Meret Keller and Wendy Goldberg
Three In A Bed:
Where Do Fathers Fit In?
Photo Idea Courtesy of Meret Keller
and Wendy Goldberg
New Research Summer 2008: underlying hormonal basis of social
bond formation and attachment during nighttime care amongst fathers
and their infants and children..Lee Gettler and James McKenna
Fathers…
•
•
•
•
In British sample, most fathers shared bed with infant 3-5 months
post-birth, at least occasionally, even when had not expected to
bedshare
Fathers responded positively to bedsharing at 3-5 months postbirth, even when it was not anticipated prior to the birth of their
child
Fathers (particularly first-time fathers) had fears of rolling over on
their infant and of disrupted sleep due to the infant’s presence in
the bed, but once they adjusted to bedsharing, these fears were
alleviated.
Most fathers appeared to enjoy the experience, and did not
consider the presence of their infant in bed as an intrusion on
their marital relationship (Ball et al., 2000)
Powerpoint Courtesy of Meret Keller and Wendy Goldberg
More on Fathers…
• Fathers and mothers endorsed similar reasons
for their families’ sleep arrangements, although
reasons differed by type of sleep arrangement
• Satisfaction with sleep arrangements was more
likely for fathers and mothers whose attitudes
coincided with their actual sleep practices
• A similar, highly satisfied, stable pattern was
apparent for fathers and mothers of solitary
sleepers and early co-sleepers, but satisfaction
for mothers and fathers of reactive sleepers
waned over time.
Powerpoint Courtesy of Meret Keller and Wendy
Goldberg
Will They Ever Leave…?
Powerpoint Courtesy of Meret Keller and Wendy
Goldberg
WHEN To Move Child To Own Room?
• Depends on family and cultural values
• Does child kick and move around too
much?
• Is child getting too big (not enough
room?)
• Are parents feeling support or pressure
from family/friends/culture?
• Does child feel comfortable/ready to move
out?
Powerpoint Courtesy of Meret Keller and Wendy Goldberg
HOW To Move Child To Own Room?
• As many ways as there are families…
– When child is ready
– Move into room with older sibling
– Parent sleeps temporarily in child’s room until child is
comfortable sleeping on own
– Buy new bunk beds with CARS or DORA THE
EXPLORER bedsheets and blankets
– Futon on floor of parents’ room until child feels
comfortable sleeping on own
– Part-night in own room; part night with parents
Powerpoint Courtesy of Meret Keller and Wendy
Goldberg