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antirez

This is normal, family, doctors, and friends are dangerous:

* Hey, you no longer have enough milk! Try giving some more integration with artificial milk.

* You'll end killing her because of co-sleeping!

* Co-sleeping will increase chances of SIDS!

* Let her cry, otherwise you'll always carry her in your arms!

* <Other bad advices here>

And so forth. My advice is: don't listen to them, they tell you this with good intentions, but the reality is, for a shitload of years since we exist small babyes co-sleeped with their mothers. This is how it's supposed to work.

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For "a shitload" of years infant mortality rate was >15% too. How things used to be is not a good indicator of optimal approaches.

A scientifically-minded person should not prefer random internet commentators to doctors' when the sole argument proferred by the former is that things used to be a certain way, therefore it's ok.

Probably not because of co-sleeping, many researches think that co-sleeping shows a correlation without actual causality.

That's not how it works. That research shows only correlation does not mean research shows ~causality. Correlation does not imply causation, but it definitely suggests it absent other explanations.

It would be hard to study causality in this instance because of medical ethics. You cannot assign a treatment that you believe to be more likely to cause an infant to die, so RCTs are impossible in this domain.

http://www.medpagetoday.com/Pediatrics/GeneralPediatrics/164... -- co-sleeping babies are 21.7 times more likely to die from SIDS than non-co-sleeping babies, according to this study. That definitely doesn't prove causality. But the correlation is certainly waggling its eyebrows suggestively in causality's direction.

From the study you cite: "Much of the elevated risk appeared to be attributable to drug and alcohol use among the parents".

There are parents that co-sleep because they are disorganized, drunk, and so forth, not even able to put the children in their bed. That's the reason why probably there is no causality.

Wait, so a large portion of the risk comes from drugs and alcohol, therefore you are going to ignore whatever risks come directly from co-sleeping? Am I misunderstanding your argument?

I think what he's saying is that co-sleeping provides benefits to his family. While there are risks, it's difficult to discern what the increased risk is in the absence of drugs and alcohol. He feels that there may not be a causal link between SIDS and co-sleeping for families who take co-sleeping seriously and take steps to minimize the known factors in SIDS.

It's not a great argument necessarily, but people accept additional risk of injury to their kids all the time if the benefits outweigh the risks.

A scientifically-minded person realizes that doctors people too, with their own biases, agendas, and misinformation. A scientifically-minded person would seek out research to determine the best course of action.

Of course, I would never deny that people should do their own research. Based on my googling, they would probably find that there's a lot of research to back up the doctors' advice, and plenty of anecdotes to back up co-sleeping advocates.

Certainly the default position should be that medical professionals know what they are talking about for folks who are not inclined to do the actual research.

> Certainly the default position should be that medical professionals know what they are talking about

In general I agree with you. When you're faced with a large amount of literature from many doctors and specialists in the field you should be able to assume that someone has done the research, and that most of the medical profession agree.

It'd be great if more people could read and understand research. But we're stuck with sub-optimal reporting, and people struggling to understand what is really meant by "50% reduction in risk" or "20 times less likely to die".

Having said all that: Here's an off topic rant.

There are very many examples of doctors not using scientific method but relying on their "expertise".[1]

This has caused significant harm to many people.

Doctors tend not to talk about stuff that is obvious nonsense, and a lot of their interventions sound plausible. But that's the sneaky danger! We know woo is woo, and if people want to fund research into it good luck to them. But for things that sound plausible? That's exactly when we need good research, because common sense and expertise is fallible.

This isn't from doctors trying to deceive people. It's from good clinicians who are not aware of their limits.

[1] A great example is "Arthroscopic Knee Surgery No Better Than Placebo Surgery", from about 2000.

A person with common sense would look at the mass of a baby, and the mass of an adult human. They'd consider their tendencies to sleep heavily, and perhaps conclude that the adult could easily roll over on the baby, and kill it. Or knock it off the edge of the bed, and kill it.

Hell, if you do the research there are plenty instances of people punching their sleeping partner in the face during sleep, because they were having a dream (I almost did it once, with my fist landing right next to my girlfriend's head in her pillow. I thought I was having a fist fight, but I was dreaming)

So, could a human kill a baby by sleeping with it? I don't know. Could a swallow carry a coconut?

> A person with common sense would look at the mass of a baby, and the mass of an adult human.

Weight/mass has very little to do with it. The baby is never 'crushed' it is 'smothered'.

Also when you smother a baby (accidentally or intentional) it squirms. So common sense would indicate the key factor is how heavily you sleep, and how easily could you role onto the baby.

If the babies head is the same level as your head, the chances of rolling on top, would require some pretty intense dreaming.

Knocking a baby off the bed is very unlikely to kill a baby (they are in a relaxed state, and have flexible bone structure/skull).

Research indicates co-sleeping is dangerous when the adult has consumed alcohol or drugs (i.e is sleeping very heavily).

I personally would be a horrible co-sleeper.

I can set 5 alarms and hear none. I only wake up at the end of a sleep cycle, no matter what's happening around me.

Incidentally I just read the child rearing chapter of Jared Diamond's latest book about traditional societies. Turns out they all tend to co-sleep, but usually they sleep on the ground or on hard mattresses. As JD points out, it is easier to notice that you have rolled onto your child with a hard mattress.

This is an excellent point.

I just bought a new mattress and I can say for sure, after having slept on a $100 target futon for the past 2 years, that I'd not know if a baby was underneath me on this one...

I appreciate the sentiment, but I don't think you're reading the parent's post very charitably. They aren't saying, "things used to be a certain way, therefore it's OK." The way I read it, they're suggesting that, if the behavior really killed that many infants, it would be weeded out by the biocultural evolutionary process.

If you actually look into the research instead of offloading your opinions to the experts, you'll see that the SIDS research is not well done. As I recall, the work on which this AAP decision was based included sleeping in a couch and sleeping while intoxicated - not exactly best practices. SIDS is basically just a catch-all term for "we don't know what killed the baby".

> if the behavior really killed that many infants, it would be weeded out by the biocultural evolutionary process.

That would also be a terrible argument. To name just one example, shaken baby syndrome still exists.

> If you actually look into the research instead of offloading your opinions to the experts

I've briefly looked into the research, and it seems to mesh pretty well with what the experts are saying. Now you are saying that it "isn't well done". That may be true. But I'm not seeing anything that shows co-sleeping to be equally safe with a crib in the same room. So I have a few possibilities: all the experts are wrong and all the studies that are being done on the issue are defective. Or, SIDS is probably somewhat related to co-sleeping. Unless there is some more evidence that I'm not seeing, I'm going to have to assign the latter a higher probability of being true.

Also, let's face it, part of the reason people offload opinions to experts is that experts are trained in analyzing and processing data in their domain to a greater degree than non-experts. There needs to be some pretty compelling evidence to override their views.

Here's the details from the previously mentioned study on co-sleeping that shows it can be safe or safer than non-co-sleeping: "The proportion of SIDS infants found cosleeping in a bed with parents who had drunk two units or less of alcohol and taken no drugs was no different from that of the random control infants (18% v 16%). If parents who regularly smoked were further excluded, then five of the SIDS infants (6%) were found in this less risky cosleeping environment compared with nine of the random control infants (10%)."

http://www.bmj.com/content/339/bmj.b3666

TLDR: In this study, SIDS was more likely if the co-sleeper had ingested drugs/alcohol, if the sleeping occurred on a couch, or both. Sober co-sleeping on a bed was as safe or safer than not co-sleeping.

> That would also be a terrible argument. To name just one example, shaken baby syndrome still exists.

(Just to play devil's advocate) Yes, but one can surmise an evolutionary reason for that - a colicky child is more likely to be the victim in that scenario; likewise, a colicky child is less likely to be healthy.

A better argument may be that prior to 'modern' medicine, bassinets (or an analog) were spontaneously popularized in various cultures -- (if that's true).

> all the experts are wrong and all the studies that are being done on the issue are defective.

Many doctor's groups positions, when confronted with inconclusive evidence, tend to (rightfully) stand on the side of caution. A great example is caffeiene (as well as many other foods) in pregnancy. Little evidence for harm, but its possible. So its a little less harsh than all experts being dead wrong and studies defective; more likely all experts playing it safe and studies inconclusive (if that is the case).

(/devils advocate)

Doctors are usually learned people who have a lot of helpful (and often lifesaving) advice.

But the fact is, being a doctor doesn't make you an expert in nutrition or diet, and it certainly doesn't make you an expert in things like co-sleeping.

I'm pretty sure the only deaths you'll have these days as a result of co-sleeping is when one of the parents smoked, took drugs or was obese (and usually a combination).

I agree with what you say, but in my experience here in Sicily, I'm sure there is also a good percentage of bad faith. In the hospital where Greta (my daughter) was born, and later in doctors waiting rooms, I saw a lot of mothers actively discouraged to breastfeed their children in a way or the other. Because co-sleeping is a very important factor in the success rate of breastfeeding I wonder if there is also some connection with many doctors discouraging it.

I know this looks odd but I know first-hand people working inside the hospital and I got internal acknowledges about the fact that hospitals received pressurs in the context of breastfeeding once they started to encourage it too broadly. Artificial milk is a 50$/week tax they are able to get from most newborns for months.

Thats surprising, here in US, atleast at Kaiser hopital highly recommend breast feeding, and they offer lots of free support/classes. And surprisingly they don't recommend cosleeping.

Hmm perhaps I'm just a cynic, but if health care providers are coming out with such garbage as discouraging breast feeding, it's got to make you wonder whether they want people to be sicker!

Some of those are so infuriating. Luckily by now there are also some experts who speak out against the "let her cry" theory. Turns out that feeling safe and cared for actually gives kids more confidence and in the long run than being left alone for long stretches of time.

We also had a close shave with the milk thing, but there are also now experts who help with and promote breast feeding. But the "standard docs" are rather quick with "just add artificial food". Even though they should now that it's better for the immune system to be breast fed (there actually is research on that).

The "cry it out" method (or CIO as it's annoying referred to on the baby forums -- acronyms central) does not actually advocate leaving the child for long stretches of time. It is a common misconception based on people not actually reading about the method, or the person who originally advocated it (Ferber).

For us, we had to do it at around 4 months or we would have been in serious trouble. 4 months of averaging 2-3 hours of uninterrupted sleep per week was wreaking havoc on our lives, and no one (including baby) was happy. The only way she would ever sleep is in our bed next to mum, and this was not sustainable, and terrified us every single night.

We read all of the no-cry sleep methods, and ferber. We realized that we were essentially doing all of the no-cry methods already (swaddle, side sleep, white noise, pick-up and soothe immediately, co-sleep, cradle at the side of the bed) and we tried each one for weeks.

None of it worked. At all.

For the Ferber method, you only leave the child for a few minutes at a time and gradually increase it. In our case, she was never left alone for longer than 10 minutes (we couldn't do any longer) and we did it over weeks and as gradually as we could. Now she sleeps in 4+ hours segments regularly which, to us, has been a god send.

To each their own. No one method is foolproof as all babies are different and I've learned through this that I no longer trust "experts" or anecdotal evidence. I will use it as a guideline, but adjust based on my own observations. I don't think any other approach works.

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