Entire volumes have been written about the subject of infant sleep — getting babies to sleep, keeping them asleep, making sure their sleep environment is safe.
One topic of continued debate among parents is co-sleeping, or bed-sharing, a common practice in countries outside the U.S. Fueled by increasing evidence, however, more pediatricians and sleep experts are dissuading parents from sharing a bed or a bedroom with their babies, recommending instead that babies be allowed to learn how to fall asleep and stay asleep on their own. Studies suggest that establishing independent and healthy sleep habits early in infancy not only improves babies' daily mood and behavior, but may also have long-term implications for their overall health and well-being. Children who don't sleep enough may be at increased risk of being overweight and having emotional and behavioral difficulties in adolescence and adulthood, for example.
So, where should parents draw the line between goodnight cuddling and unhealthy bedtime coddling? Sleep researcher Jodi Mindell says it has less to do with where the baby's crib is physically situated — although, ideally, it should be in a separate room — and more with what parents are doing when their children fall asleep. "It's parental presence," says Mindell, author of Sleeping Through the Night: How Infants, Toddlers and Their Parents Can Get a Good Night's Sleep. "Even if you're sharing a bed or a room, don't be present, either literally or figuratively. So don't be holding your baby, or nursing or rocking. Have them fall asleep three feet away. If they're slightly separated, they sleep much better."
Mindell, a psychology professor at Saint Joseph's University and associate director of the Sleep Center at the Children's Hospital of Philadelphia, gathered sleep data on nearly 30,000 children up to 3 years old in 17 countries — among them, some that were predominately Caucasian (including the U.S., U.K., Canada, Australia and New Zealand) and others that were predominately Asian (such as China, Thailand, Malaysia, Japan and Korea). In the U.S. and other mostly Caucasian countries, Mindell found that only 12% of parents reported bed-sharing, and 22% reported room-sharing. But in Asian countries the numbers were much higher: fully 65% of parents shared beds with their infants, and 87% slept in the same room.
Consistent with previous research, Mindell found that co-sleeping — sleeping in the same bed or bedroom — led to more disturbed sleep in infants. Accordingly, babies living in Asia got much less sleep overall and significantly less quality sleep than infants in the U.S. But the differences, upon further analysis of the data, were somewhat more nuanced. When Mindell and her fellow researchers examined data on babies in Asia who slept alone, the quality and duration of their sleep were just as low as babies who co-slept with parents.
Why? "In Asia, parents are nearly always with their kids when they fall asleep," says Mindell. In the U.S., by contrast, when babies bed down in a separate room, "you're falling asleep on your own," Mindell says. "Mommy or Daddy puts you down, they walk out and they say goodnight."
Mindell is careful to emphasize that while her research, which was funded by Johnson & Johnson, does not support co-sleeping, it doesn't absolutely condemn it either. One question that remains: if vast numbers of babies in Asian populations are sleeping less than their Western peers — without any apparently society-wide disadvantage — does it truly matter if babies co-sleep or not?
"Do Asian babies need less sleep?" Mindell wonders, adding that understanding how some infants thrive on less sleep is the next step in research: "to figure out why that is, and what's the consequence."
Nevertheless, Mindell believes that parents should build bedtime routines that promote sound rest, though that doesn't necessarily mean babies must sleep through the night. "Waking is normal," she says. "All babies wake somewhere between two and six times per night."
The problem with being present when your baby falls asleep is that they'll also expect you to be there to help them get back to sleep each time. "If you're rocked to sleep, nursed to sleep, fed to sleep at bedtime, you're going to need that every time you wake up."
To counter that dependence, Mindell suggests that parents indulge in a regular goodnight routine, but slip away before the baby drifts off to sleep. "We want bedtime to be this wonderful time for families, we want the cuddling, we want the story reading, we want that to be a really special part of the day," Mindell says. "We just want the literal falling asleep to be independent."