The co-sleeping decision -- "should an infant/toddler sleep in bed with their parents" -- is one that is faced by all parents. I often hear arguments by "experts" against co-sleeping arrangements. Such arguments are supposedly grounded in science. Many of these arguments are addressed to parents who may feel burdened by anxious and temperamentally more demanding children. The desire to reduce the parents' distress by giving them legitimate reasons for shutting out the needs of their child and going on with their lives is understandable.
However, in my work, I see the consequences of such parent-centered advice on the children who have become adults and seek treatment for a variety of psychiatric conditions, most commonly depression, anxiety or difficulty in establishing intimate relationships. There is considerable research evidence showing that babies come equipped with vastly different temperaments. Many children adapt well to sleeping separately from their parents and grow up to be well-adjusted adults. However, many other babies are born with a different temperament best described as "sensitive" (anxiety-prone, shy infants, who do not adapt well to change) and have different needs. These are, of course, also the babies who put more demands on their parents and generate complaints to pediatricians. It is true that their behavior (for example, demands to sleep with parents) can be controlled with "stern," almost inhumane methods such as locking doors and reminding a terrified two year old child about "politeness." However, experts who recommend against co-sleeping in all circumstances do not seem to consider the longer term consequences of such brutality. What do sensitive children learn? They learn that their need for warmth and reassurance is a character flaw; that parents are cold, distant figures; that fear and loneliness are the expected currency of existence. They learn that important figures in one's emotional world cannot be trusted to understand and respond with a caring attitude. Since their need is in-born and cannot be controlled, they often adjust by either withdrawing and removing themselves from their emotions (depressive tendencies as adults) or by learning how to manipulate and control others who won't give freely when it is so needed (oppositional, antisocial tendencies), or by learning later to soothe loneliness and pain, not with people, but with means that, to them, seem more reliable, such as alcohol or drugs.
Arguments against co-sleeping arrangements often center around studies which have shown that a large percentage of children who sleep with parents resist going to bed and awaken several times at night. This is an example of a common flaw in pseudo-scientific studies, known as a "sample bias." Naturally, sensitive children -- who tend to need longer times with their parents to fall asleep and whose sleep is more fragile -- are also the ones that parents are more likely -- and rightly so -- to let into their bed. It is no surprise, therefore, that "studies" would find an association between sleeping in the parents bed and "fussy sleepers." The flaw is in attributing the cause of the problem to the sleeping arrangement rather than to differences in temperament. Other arguments state that children who sleep in bed with parents will not make the decision to start sleeping in their own bed. Where do these self-described "experts" think all the children who were allowed to sleep in their parents' bed and are now adults are sleeping today? Do children who use diapers go directly on to Depends Undergarments and keep them for the rest of their lives? Should babies never be put in a stroller for fear that they may not learn how to walk? Children do, of course, progressively develop the desire to move on and have their own space, including their own sleeping space. Maybe not always on the same schedule as every other child, but on their own schedule, just like they learn to speak, to walk and to control their bodily functions.
What reason tells us as physicians and scientists, is that there are different kinds of children and that sensitive, shy, easily-scared babies need more reassurance than children who are spontaneously out-going, independent and self-reliant early in life. In my mind, there is no doubt that parents' attention to these needs is what allows many sensitive children to grow up to be fully independent and happy adults, when others, who did not receive the care they needed develop the painful psychological ailments that I see so much of.
If there are different kinds of children, how do parents know which ones need to be allowed to sleep in their bed and which ones can be encouraged to sleep separately? Rather than use the blanket cold-shoulder recipe for such an important and delicate relationship, I strongly believe that parents need to rely on their own instinct to make this decision. Parents who care about their children can tell when a child truly needs something and when he or she is only "testing limits." Of course, relying on one's own instinct feels scary in such important matters, but how does it feel to rely on an "expert" who tells every parent to do the same thing for every child?
by David Servan-Schreiber, M.D., Ph.D Reprinted by permission
© David Servan-Schreiber, M.D., Ph.D Clinical Associate Professor of Psychiatry, Univ. of Pittsburgh School of Medicine Chief, Division of Psychiatry, Shadyside Hospital Medical Director, Center for Complementary Medicine Former Co-Director, Clinical Cognitive Neuroscience Laboratory, Carnegie Mellon University and University of Pittsburgh
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