No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Outcome Correlates of Parent-Child Bedsharing: An Eighteen-Year Longitudinal Study
Abstract
We report results of the first longitudinal study of outcome correlates of parent-child bedsharing. Two hundred five families in nonconventional and conventional family lifestyles have been followed since 1975. A target child in each family was followed from the third trimester of mother's pregnancy through age 18 years. Bedsharing in early childhood was found to be significantly associated with increased cognitive competence measured at age 6 years, but the effect size was small. At age 6 years, bedsharing in infancy and early childhood was not associated with sleep problems, sexual pathology, or any other problematic consequences. At age 18 years, bedsharing in infancy and childhood was unrelated to pathology or problematic consequences, nor was it related to beneficial consequences. We discuss these results in light of widespread fears of harm caused by parent-child bedsharing. We suggest that such fears are without warrant if bedsharing is practiced safely as part of a complex of valued and related family practices.
... Finally, bed-sharing varies significantly with child age. Cross-sectional and longitudinal studies from the US and Europe indicate that bed-sharing increases after the first year of life [7,12], remains relatively stable from 1 to 3 years of age [6,9,12] and declines after 4 or 5 years of age [11,12]. ...
... In prospective studies with non-clinical, preschool samples, results are mixed. Several studies have documented longitudinal associations between bed-sharing and sleep problems [6,12,18] whereas only one study [19] out of five [6,8,11,19,20] demonstrated associations with psychopathology, specifically overall psychopathology, anxiety and depression. ...
... Methodological limitations also contribute to the mixed findings. First, most studies have assessed bedsharing using a single questionnaire or interview item [7,8,26], or multiple items without measureing reliability [6,11]. Direct observations of bed-sharing are small and rare and often recruit based on bed-sharing status, thus concurrent validity with other assessment are not available [13,27]. ...
Objective
To advance understanding of early childhood bed-sharing and its clinical significance, we examined reactive bed-sharing rates, sociodemographic correlates, persistence, and concurrent and longitudinal associations with sleep disturbances and psychopathology.
Methods
Data from a representative cohort of 917 children (mean age 3.8 years) recruited from primary pediatric clinics in a Southeastern city for a preschool anxiety study were used. Sociodemographics and diagnostic classifications for sleep disturbances and psychopathology were obtained using the Preschool Age Psychiatric Assessment (PAPA), a structured diagnostic interview administered to caregivers. A subsample of 187 children was re-assessed approximately 24.7 months after the initial PAPA interview.
Results
Reactive bed-sharing was reported by 38.4% of parents, 22.9% nightly and 15.5% weekly, and declined with age. At follow-up, 48.9% of nightly bed-sharers and 88.7% of weekly bed-sharers were no longer bed-sharing. Sociodemographics associated with nightly bed-sharing were Black and (combined) American Indian, Alaska Native and Asian race and ethnicity, low income and parent education less than high school. Concurrently, bed-sharing nightly was associated with separation anxiety and sleep terrors; bed-sharing weekly was associated with sleep terrors and difficulty staying asleep. No longitudinal associations were found between reactive bed-sharing and sleep disturbances or psychopathology after controlling for sociodemographics, baseline status of the outcome and time between interviews.
Conclusions
Reactive bed-sharing is relatively common among preschoolers, varies significantly by sociodemographic factors, declines during the preschool years and is more persistent among nightly than weekly bed-sharers. Reactive bed-sharing may be an indicator of sleep disturbances and/or anxiety but there is no evidence that bed-sharing is an antecedent or consequence of sleep disturbances or psychopathology.
... Owens, 2004 for an overview). Other cultural communities find infants' bedsharing with their caregivers problematic, because they fear that it is related to sudden infant death syndrome (i.e., SIDS, for example Mitchell et al., 1992;Nakamura et al., 1999) or are concerned about the developmental consequences of co-sleeping (see Okami et al., 2002, for a discussion). However, numerous publications also defend co-sleeping, saying that this is the evolved way for children to sleep (McKenna et al., 1993), that it is positively related to breastfeeding (Buswell & Spatz, 2007), parent-child relationship (Ball et al., 2000;Hayes et al., 1996;Mileva-Seitz et al., 2016) and children's development (Okami et al., 2002). ...
... Other cultural communities find infants' bedsharing with their caregivers problematic, because they fear that it is related to sudden infant death syndrome (i.e., SIDS, for example Mitchell et al., 1992;Nakamura et al., 1999) or are concerned about the developmental consequences of co-sleeping (see Okami et al., 2002, for a discussion). However, numerous publications also defend co-sleeping, saying that this is the evolved way for children to sleep (McKenna et al., 1993), that it is positively related to breastfeeding (Buswell & Spatz, 2007), parent-child relationship (Ball et al., 2000;Hayes et al., 1996;Mileva-Seitz et al., 2016) and children's development (Okami et al., 2002). Recent papers have argued that the discussion should not be about sharing a bed per se but about how to make bedsharing or co-sleeping safe for the children, if parents choose it (Barry, 2019;Gettler & McKenna, 2010). ...
... In some societies, co-sleeping prevails even when the culture has changed, causing conflicts between values and practices (Shimizu et al., 2014). However, in other places such as the USA (Okami et al., 2002) or Italy (Cortesi, Giannotti, Sebastiani, & Vagnoni, 2004) co-sleeping (re)emerges as "a lifestyle choice" (Dollberg, Shalev, & Chen, 2010). We would argue that lifestyle choices are driven by parents' values nevertheless, as is illustrated by the general differences in childrearing agendas between solitary and co-sleeping families (Okami et al., 2002). ...
This study addresses Norwegian infants’ sleeping places during the day and night. In the first part we asked the general public to indicate where they think infants should sleep by placing stickers on a depiction of different sleeping places. This revealed that infants were expected to predominantly sleep outside in a stroller during the day and either bedshare, room share or sleep independently from their parents at night. Interviews with Norwegian mothers confirmed these patterns and revealed that mothers emphasized the benefits of fresh air and being out in nature. They expressed valuing independence, though their opinions on how this could be achieved diverged, some proposing independent, other co-sleeping. Other outcomes of sleeping arrangements were rarely mentioned. Some, particularly mothers whose children bedshared or had different sleeping places from one night to the other or throughout the night, emphasized the infants’ right to choose how to sleep. None of the mothers endorsed letting infants cry themselves to sleep but many mentioned the importance of the child feeling secure. We argue that the seemingly contradictory sleeping patterns is in line with cultural values for independence, social cohesion and a love of nature.
... Across later toddlerhood and childhood specifically, research findings on bedsharing and its effects have been inconsistent (Cortesi, Giannotti, Sebastiani, Vagnoni, & Marioni, 2008;Hayes, Parker, Sallinen, & Davare, 2001;Jenni, Fuhrer, Iglowstein, Molinari, & Largo, 2005;Kim, Lee, & Cain, 2017;Latz, Wolf, & Lozoff, 1999;Liu, Liu, & Wang, 2003;Lozoff, Wolf, & Davis, 1984;Mindell, Sadeh, Kwon, & Goh, 2013;Okami, Weisner, & Olmstead, 2002). While some work indicates greater sleep disturbances in bedsharing children (e.g., Cortesi et al., 2008;Hayes et al., 2001;Kim et al., 2017), other studies indicate no detrimental effects (e.g., Okami et al., 2002). ...
... Across later toddlerhood and childhood specifically, research findings on bedsharing and its effects have been inconsistent (Cortesi, Giannotti, Sebastiani, Vagnoni, & Marioni, 2008;Hayes, Parker, Sallinen, & Davare, 2001;Jenni, Fuhrer, Iglowstein, Molinari, & Largo, 2005;Kim, Lee, & Cain, 2017;Latz, Wolf, & Lozoff, 1999;Liu, Liu, & Wang, 2003;Lozoff, Wolf, & Davis, 1984;Mindell, Sadeh, Kwon, & Goh, 2013;Okami, Weisner, & Olmstead, 2002). While some work indicates greater sleep disturbances in bedsharing children (e.g., Cortesi et al., 2008;Hayes et al., 2001;Kim et al., 2017), other studies indicate no detrimental effects (e.g., Okami et al., 2002). In part, this discrepancy in findings may reflect a lack of objective sleep assessments, as most published work has used parent-reported questionnaires or interviews (Cortesi et al., 2008;Jenni et al., 2005;Kim et al., 2017;Liu et al., 2003;Mindell et al., 2013; for a review, see also Mileva-Seitz et al., 2017). ...
... In contrast, additional longitudinal and cross-sectional analyses have indicated either that parent-child bedsharing does not predict child sleep (Okami et al., 2002), or that bedsharing is associated with child sleep disturbances only in certain demographic groups (Latz et al., 1999;Lozoff et al., 1984). For instance, one U.S. study indicated that for children 6 months old to 4 years old, bedsharing was associated with greater disruptive sleep problems (consistent night wakings, struggles surrounding bedtime) in White children but not in Black children (Lozoff et al., 1984). ...
Bedsharing (sharing a bed with others during sleep) in early childhood (3–5 years old) is common across Western and non-Western societies alike. Though prior work indicates that bedsharing may relate to impairments in child sleep quantity or quality, the majority of studies conducted in young children are limited to parent-child bedsharing and rely almost exclusively on caregiver reports to measure child sleep. Here, the authors endeavored to gain further insights into the diversity of bedsharing practices among children in the United States, including how different bedsharing partners (caregivers, siblings) might impact actigraphy-derived measures of children’s sleep. Using a sample of 631 children ages 2:9 to 5:11 years, we found that over 36% of children bedshared in some form overnight, with approximately 22% bedsharing habitually. In a subset of children for whom actigraphy measures were collected (n = 337), children who bedshared habitually (n = 80) had significantly shorter overnight sleep, later sleep and wake times, and longer naps than solitary sleepers (n = 257), even when controlling for socioeconomic status. Despite supplementing their shorter overnight sleep with longer naps, habitually bedsharing children had significantly shorter 24-hr sleep time than did solitary sleepers, though differences in sleep efficiency were nonsignificant for all sleep periods. Additionally, sleep efficiency, onset latency, and duration did not differ between children who habitually bedshared with siblings versus those who habitually bedshared with parents. The present results add to prior work examining family contextual correlates of sleep differences in early childhood and provide a more objective account of relations between bedsharing and child sleep.
... (Horsley et al., 2007) The findings from two large casecontrol studies showed that bed-sharing is inappropriate if parents consume alcohol, take drugs or smoke, or if the infant is pre-term. (Blair et al., 2014) Studies reporting other harms or benefits of bed-sharing, like the risk of hospitalizations, (Ngale et al., 2013) cognitive and behavioural problems, (Barajas et al., 2011, Okami et al., 2002, Madansky and Edelbrock, 1990) psychiatric symptoms, (Kaymaz et al., 2014) and psychosexual development (Jain et al., 2011) in offspring are scarce at the literature. This study aimed to describe bed-sharing trajectories from 3 months to 6 years of age and to investigate the association between bed-sharing trajectories and mental health at the age of 6 years among children from a population-based birth cohort. ...
... Other studies exploring the effect of bed-sharing on the child behavior and mental health were found at the literature. (Madansky and Edelbrock, 1990, Okami et al., 2002, Barajas et al., 2011, Kaymaz et al., 2014 In a randomly selected community sample of 2 year-old children (n = 199) and followed-up within 2 weeks of the 3 rd anniversary, the majority of parents reported that their child had slept in their bed with them at least once during the previous two months (11% reported that the child always co-slept). (Madansky and Edelbrock, 1990) Bed-sharing was moderately stable over a year with 65% of the initial co-sleepers still co-sleeping one year later. ...
... A cohort of 205 children was followed at birth in 1975 and at the age of 6 years and again at adolescence in 1994. (Okami et al., 2002) Bed-sharing was measured with mothers at the child age of 5 months, 3, 4 and 6 years old (asking about ages 5 and 6 years). Children were then classified in a 5-point continuum from zero (no exposure to bed-sharing) to 4 (frequent exposure): 9% of the parents reported regularly sharing their beds with their 5-month-old infants, 6% at 3, 4 and 5 years, and 3% at age 6 years. ...
Background:
Little is known about the effect of bed-sharing with the mother over the child mental health.
Methods:
Population-based birth cohort conducted in Pelotas, Brazil. Children were enrolled at birth (n=4231) and followed-up at 3 months and at 1, 2, 4, and 6 years of age. Bed-sharing was defined as "habitual sharing of the bed between the child and the mother, for sleeping, for part of the night or the whole night". Trajectories of bed sharing between 3 months and 6 years of age were calculated. Mental health was assessed at the age of 6 years using the Development and Well-Being Assessment instrument that generates psychiatric diagnosis according to ICD-10 and DSM-IV criteria. Odds ratios (OR) with 95% confidence intervals were obtained by multivariate logistic regression.
Results:
3583 children were analyzed. Four trajectories were identified: non bed-sharers (44.4%), early-only (36.2%), late-onset (12.0%), and persistent bed-sharers (7.4%). In the adjusted analyses persistent bed-sharers were at increased odds of presenting any psychiatric disorder (OR=1.7; 1.2-2.5) and internalizing problems (OR=2.1; 1.4-3.1), as compared to non bed-sharers. Among the early-only bed-sharers OR for any psychiatric disorder was 1.4 (1.1-1.8) and for internalizing problems 1.6 (1.2-2.1).
Limitations:
Although the effect of bed-sharing was adjusted for several covariates including the family socio-economic status, maternal mental health and excessive crying, there was no information on maternal personal reasons for bed-sharing. Mothers that bed-share intentionally and those that bed-share in reaction to a child sleep problem may have a different interpretation of their children behavior that may bias the study results.
Conclusion:
Bed-sharing is a common practice in our setting and is associated with impaired child mental health at the age of six years.
... Parents commonly choose their children's sleep arrangements on the basis of cultural beliefs or values, and professional advice [3]. However, across cultures much controversy exists regarding the potential benefits and risks associated with bed-sharing [5][6][7][8]. For instance, in Western countries children's development of independence and individualism is cardinal, and thus especially the hazards of bed-sharing might be stressed. ...
... Bedsharing has further been associated with child and parent anxiety, and issues of separation and sleep management [22]. However, studies investigating the association between sleep problems and bed-sharing in infants and younger children yielded inconsistent findings [8,10,11,13,21,23]. Furthermore, one longitudinal study indicated that bed-sharing in infancy and early childhood was not related to either sleep problems, pathology nor to problematic consequences, nor was it related to beneficial consequences at ages 6 and 18 years [8]. ...
... However, studies investigating the association between sleep problems and bed-sharing in infants and younger children yielded inconsistent findings [8,10,11,13,21,23]. Furthermore, one longitudinal study indicated that bed-sharing in infancy and early childhood was not related to either sleep problems, pathology nor to problematic consequences, nor was it related to beneficial consequences at ages 6 and 18 years [8]. ...
... To fill this gap in the literature, the present study examined the association between the physical home environment and sleep in early childhood, identifying which aspects of the physical home environment are the most predictive of various aspects of child sleep. estimated to occur in between 4% and 26% of American families with young children (Barajas et al., 2011;Okami et al., 2002). However, bedsharing research has often focused on infancy/toddlerhood, with substantially less research devoted to examining the effects of bedsharing in older children (Andre et al., 2021). ...
... However, bedsharing research has often focused on infancy/toddlerhood, with substantially less research devoted to examining the effects of bedsharing in older children (Andre et al., 2021). This is likely due, in part, to the fact that bedsharing decreases substantially after infancy (Okami et al., 2002). However, bedsharing with a parent that does persist past infancy/toddlerhood has been associated with heightened, parent-reported sleep disturbances in preschoolers and school-aged children (Kim et al., 2017;Lee et al., 2018), as well as increased internalizing and externalizing problems both concurrently and in preadolescence (Chen et al., 2021). ...
The physical home environment is thought to play a crucial role in facilitating healthy sleep in young children. However, relatively little is known about how various features of the physical home environment are associated with sleep in early childhood, and some of the recommendations clinicians make for improving child sleep environments are based on limited research evidence. The present study examined how observer and parent descriptions of the child's physical home environment were associated with child sleep, measured using actigraphy and parent's reports, across a year in early childhood. The study used a machine learning approach (elastic net regression) to specify which aspects of the physical home environment were most important for predicting five aspects of child sleep, sleep duration, sleep variability, sleep timing, sleep activity, and latency to fall asleep. The study included 546 toddlers (265 females) recruited at 30 months of age and reassessed at 36 and 42 months of age. Poorer quality physical home environments were associated with later sleep schedules, more variable sleep schedules, shorter sleep durations, and more parent-reported sleep problems in young children. The most important environmental predictors of sleep were room sharing with an adult, bed sharing, and quality of both the child's sleep space and the wider home environment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
... Few studies have explored the long-term consequences of cosleeping on childhood and adolescent behavior. To our knowledge, only four international longitudinal studies have examined the influence of early co-sleeping on delayed manifestation of behavior problems (Barajas et al., 2011;Okami et al., 2002;Santos et al., 2016;Volkovich et al., 2015). The association between co-sleeping and children's behavior problems remains inconsistent in these studies. ...
... Yet a more recent longitudinal study conducted in Brazil with a larger sample size (n = 3583) found that bed-sharing is associated with increased odds of presenting internalizing behavior and DSM-IV diagnosed mental health issues at the age of six (Santos et al., 2016). The inconsistencies between different cohort studies may be due to potentially insufficient statistical power from small sample sizes or different assessment instruments (Barajas et al., 2011;Okami et al., 2002;Volkovich et al., 2015). However, with a much larger sample, we found that early childhood co-sleeping is associated with multiple pre-adolescent behavior problems across internalizing and externalizing behavior, and DSM-oriented mental health problems. ...
Objective/background:
Co-sleeping is common practice around the globe. The relationship between early childhood co-sleeping and adolescent behavior problems remains uncertain. We aim to identify whether early childhood co-sleeping can predict behavior problems in preadolescence.
Participants:
A cohort of 1,656 Chinese preschool children were followed up in adolescence.
Methods:
Prospective cohort study design involving two waves of data collection from the China Jintan Cohort (1,656 children aged 3-5 years). Co-sleeping history was collected at 3-5-years-old via parent-reported questionnaire at wave Ⅰ data collection. Behavior problems were measured twice in childhood and preadolescence, respectively. Adolescent behavior problems were measured by integrating data from self-report, parent-report and teacher-report using the Achenbach System of Empirically Based Assessment. Predictions were assessed using the general linear model with mixed effects on the inverse probability weight propensity-matched sample.
Results:
1,656 children comprising 55.6% boys aged 4.9 ± 0.6 were initially enrolled in the first wave of data collection. In the second wave of data collection, 1,274 children were 10.99 ± 0.74 (76.9%) aged 10-13 years were retained. Early childhood co-sleeping is significantly associated with increased behavior problems in childhood (Odds Ratio [OR] 1.22-2.06, ps<0.03) and preadolescence (OR 1.40-2.27, ps<0.02). Moreover, co-sleeping history significantly predicted multiscale increase in internal (OR 1.63-2.61, ps<0.02) and external behavior problems in adolescence.
Conclusions:
Early childhood co-sleeping is associated with multiple behavioral problems reported by parents, teachers, and children themselves. Early childhood co-sleeping predicts preadolescent internalizing and externalizing behavior after controlling for baseline behavior problems.
... However, the number of longitudinal studies testing cosleeping and sleep problems was very limited to date, which is very difficult to conduct a meta-analysis. We described the longitudinal studies [61][62][63][64][65] in Table 3 according to what we could retrieve. In general, the results of longitudinal studies were inconsistent. ...
... First, we fail to test the causal relationship between cosleeping and sleep disturbances, because all studies included are cross-sectional design. However, according to what we can retrieve, there are little longitudinal studies at present for carrying out a good meta-analysis [61][62][63][64][65]. In addition, their findings of the relationship between cosleeping and sleep problems are inconsistent, which may be attributed to the differences in origin of country, age at baseline and retest, assessment tool, and adjusted variables and so on. ...
There exist inconsistent findings about the relation between cosleeping and sleep problems in children. We conducted a metaanalysis
to assess these relations and compared their cross-cultural differences. We searched the EMBASE, PsycARTICLES,
PsycINFO, PubMed, ScienceDirect, and Web of Science databases. A random effect model was used, and subgroup analysis
by culture group was performed. By including fifteen qualified studies, this meta-analysis revealed that increased bedtime
resistance, sleep anxiety, night waking, and parasomnia were shown from children cosleeping with others. Cosleeping children
from the West performed more bedtime resistance and night waking, while those children from the East showed more
parasomnia. In general, cosleeping is associated with several sleep disturbances for children, including bedtime resistance,
sleep anxiety, night waking, and parasomnia, and the cultural differences do exist between the West and East. The findings
provide initial evidence of the influence of cosleeping on children’s sleep problems. More studies on the related topic are
needed from diverse cultures in the future.
... In a study of extended parental absence during employment rotation-with one partner in the military-children who co-slept, including older boys (≥3 years) who shared a bed with their mothers, exhibited few emotional or behavioral problems and were even underrepresented in corresponding base psychiatric populations (Forbes et al. 1992). A longitudinal examination of bed-sharing effects on life cycle stages from infancy to 18 years of age concluded that sharing a bed in infancy and early childhood displayed no association with sleep problems, sexual pathologies, or any other problematic consequences (Okami et al. 2002). The authors concluded that when bed sharing is practiced safely, and as a part of valued family relational dynamics, the likelihood of harm was minimal (Okami et al. 2002). ...
... A longitudinal examination of bed-sharing effects on life cycle stages from infancy to 18 years of age concluded that sharing a bed in infancy and early childhood displayed no association with sleep problems, sexual pathologies, or any other problematic consequences (Okami et al. 2002). The authors concluded that when bed sharing is practiced safely, and as a part of valued family relational dynamics, the likelihood of harm was minimal (Okami et al. 2002). ...
Human sleeping arrangements have evolved over time and differ across cultures. The majority of adults share their bed at one time or another with a partner or child, and many also sleep with pets. In fact, around half of dog and cat owners report sharing a bed or bedroom with their pet(s). However, interspecies co-sleeping has been trivialized in the literature relative to interpersonal or human-human co-sleeping, receiving little attention from an interdisciplinary psychological perspective. In this paper, we provide a historical outline of the “civilizing process” that has led to current sociocultural conceptions of sleep as an individual, private function crucial for the functioning of society and the health of individuals. We identify similar historical processes at work in the formation of contemporary constructions of socially normative sleeping arrangements for humans and animals. Importantly, since previous examinations of co-sleeping practices have anthropocentrically framed this topic, the result is an incomplete understanding of co-sleeping practices. By using dogs as an exemplar of human-animal co-sleeping, and comparing human-canine sleeping with adult-child co-sleeping, we determine that both forms of co-sleeping share common factors for establishment and maintenance, and often result in similar benefits and drawbacks. We propose that human-animal and adult-child co-sleeping should be approached as legitimate and socially relevant forms of co-sleeping, and we recommend that co-sleeping be approached broadly as a social practice involving relations with humans and other animals. Because our proposition is speculative and derived from canine-centric data, we recommend ongoing theoretical refinement grounded in empirical research addressing co-sleeping between humans and multiple animal species.
... In a study of low-income families in the US, bed-sharing was not related to cognitive outcomes (letterword identification, applied problems) after controlling for maternal and child characteristics [95]. A longitudinal sample of American families (including some 'counterculture' families who chose intentional bed-sharing from infancy) suggested a positive effect of early bed-sharing on cognitive competence at six years of age [244]. ...
... In the one of the few longitudinal studies, bed-sharing was assessed at ages five months, three, four and six years; no positive or negative effects were found at age six on measures of behavioral and emotional maturity, including mood and affect, school adjustment, interpersonal relationships, self-acceptance, vandalism, crimes, and substance use [244]. This study did, however, find a small positive association of bed-sharing with cognitive competence in 6-year-olds [244]. ...
The practice of parent and child sharing a sleeping surface, or ‘bed-sharing’, is one of the most controversial topics in parenting research. The lay literature has popularized and polarized this debate, offering on one hand claims of dangers, and on the other, of benefits - both physical and psychological - associated with bed-sharing. To address the scientific evidence behind such claims, we systematically reviewed k=659 published papers (peer-reviewed, editorial pieces, and commentaries) on the topic of parent-child bed-sharing. Our review offers a narrative walkthrough of the many subdomains of bed-sharing research, including its many correlates (e.g., socioeconomic and cultural factors) and purported risks or outcomes (e.g., sudden infant death syndrome, sleep problems). We found general design limitations and a lack of convincing evidence in the literature, which preclude making strong generalizations. A heat-map based on k=98 eligible studies aids the reader to visualize world-wide prevalence in bed-sharing and highlights the need for further research in societies where bed-sharing is the norm. We urge for multiple subfields - Anthropology, Psychology/Psychiatry, and Pediatrics - to come together with the aim of understanding infant sleep and how nightly proximity to the parents influences children’s social, emotional, and physical development.
... The combination of qualitative and quantitative evidence provides both prevalence estimates and information on culturally based goals and beliefs: We know from the combination of these forms of data and analysis that worldwide, parents sleep with infants and toddlers to insure their health and to facilitate breastfeeding; older children and parents sleep together for shared comfort and familiarity. These practices do not lead to excessive dependency or other outcomes that often worry U.S. parents (Morelli, Oppenheim, Rogoff, & Gold-smith, 1992;Okami, Weisner, & Olmstead, 2002). Shweder et al. (2006) note that the study of culture in human development benefits from the integration of symbolic (e.g., beliefs, goals, and rules) and behavioral (e.g., customs and behaviors) aspects of cultural communities. ...
Multiple methods are vital to understanding development as a dynamic, transactional process. This article focuses on the ways in which quantitative and qualitative methodologies can be combined to enrich developmental science and the study of human development, focusing on the practical questions of “when” and “how.” Research situations that may be especially suited to mixing qualitative and quantitative approaches are described. The authors also discuss potential choices for using mixed quantitative–qualitative approaches in study design, sampling, construction of measures or interview protocols, collaborations, and data analysis relevant to developmental science. Finally, they discuss some common pitfalls that occur in mixing these methods and include suggestions for surmounting them.
... In long-term studies that monitored babies sleeping with their parents or alone, it was observed that co-sleeping children were happier and less worried, and had greater self-respect, less fear of sleep and fewer behavioural problems, and tended to be more comfortable with intimacy (Beijers, et al., 2019). In a longitudinal study begun by Okami, Weisner & Olmstead (2002), in 1975, interesting data were obtained regarding parent-child bed sharing. In the study, bed sharing in infancy was found to be significantly correlated with increased cognitive competence measured at the age of 6, although the effect size was small. ...
The aim of this study was to assess preschool children’s sleep habits and sleep problems and to examine their relationship with emotion regulation. The teachers and mothers of 308 preschool children participated in the study. A Child Information Form and Sleep Habits Questionnaire were applied to the mothers. In this way, the children’s age and gender information, co-sleeping habits, bedtime resistance, sleep onset delay, sleep duration, sleep anxiety, night wakings, parasomnias, sleep-disordered breathing, and daytime sleepiness were evaluated. The teachers were requested to fill in an Emotion Regulation Questionnaire. The research findings revealed that scores in the lability/negativity subdimension of the emotion regulation scale were statistically higher in boys. Similarly, scores of 5-year-old children were higher in the emotion regulation negativity dimension. According to the research findings, it was determined that sleep problems did not affect the children’s emotion regulation skills.
... Hence suggested that co-sleeping can be practiced as a part of cultural practices. 30 ...
... The rise of industrialization, which brought about permanent dwellings, cribs, and alternative feeding options, was accompanied by shifting societal values (Mileva-Seitz et al., 2017). Shaped by medical recommendations (e.g., correlational links between bed-sharing and sudden infant death syndrome) (Vennemann et al., 2012) and parental and professional beliefs (e.g., interference with partner intimacy, decreases child autonomy) (McKenna et al., 2007;Okami et al., 2002;Owens, 2002), bed-sharing was no longer essential for infant survival and Western nations transitioned toward separate sleep surfaces for infants (McKenna et al., 2007). ...
Over the past two decades, there has been heightened interest and awareness of the impact that sleep has on children's development, learning, mood, and behavior. Clinical services for pediatric sleep disorders are increasingly available and there has been a proliferation of research related to sleep disturbances in children. This article was designed to provide a broad overview of common sleep problems and their treatments in youth. Pediatric sleep medicine is a rapidly developing field with abundant opportunities for expanding our scientific understanding of sleep disorders and creating novel interventions for children and adolescents with disturbed sleep.
... 31 However, only 9% of mothers in North America regularly bed share with their infants, and only 3% do so at age 6 years. 32 Lower co-sleep rates in the United States may reflect recommendations from organizations such as the American Academy of Pediatrics, which dissuade parents from co-sleeping with their children based on safety concerns, including correlations between bed sharing and Sudden Infant Death Syndrome. 8,[33][34][35]36 Although parent-child bed sharing is low overall in the United States, it is a more common practice in US Black and Hispanic populations compared to non-Hispanic White populations. ...
Background
Bed sharing is common practice across the global population. However, the vast majority of research on bed sharing has focused solely on mother-infant bed sharing.
Methods
Here, we provide a holistic review of research on bed sharing. Articles investigating the relationship between bed sharing and sleep were identified in 4 dyad categories: (1) parent and child, (2) couples, (3) siblings, and (4) pet owners and pets. Of interest was whether sleep-promoting factors such as psychological comfort were generalizable across bed-sharing dyads; alternatively, sleep-demoting factors such as movement or heat may be commonalities.
Results
We found that, across dyad types, in general, subjective reports of sleep quality were better when bed sharing despite generally worse objective measures of sleep.
Conclusions
Understanding bed sharing is important to treating sleep disturbances, given the prevalence of shared beds. This scoping review points to critical gaps in our understanding of bed sharing that motivate future research.
... Furthermore, several aspects need to be better empirically addressed. Some authors, for example, suggested that for those families in which parents practice voluntary co-sleeping as a choice, cosleeping seems not to be associated with increased risk for sleep problems, but may reflect lifestyle attitudes [64]. Age, gender, parenting agreement, and other intervening variables should be further considered. ...
Background
Improving maternal’s health is a worldwide priority. Sleep is a fundamental operating state of the central nervous system and it may be one of the most important psychophysiological processes for brain function and mental health. The study of maternal sleep problem including insomnia, however, implies deepening our understanding of family context. Family systems are dynamic and involve reciprocal interactions among members during day and night. So far, however, maternal and children’s sleep has been rarely studied in a family perspective, and paternal sleep has often been neglected.
Methods
The present work summarizes in a narrative review the state of the art of our current knowledge on the role of insomnia and poor quality of sleep for mental health in all family members in the peripartum period. The mother, the father, the child and the family interactive perspectives are considered.
Results
Insomnia and poor sleep problems are frequent in all family members during peripartum. Poor sleep and insomnia symptoms are recognized as important risk factors for mental health in adults and children. Despite this alarming evidence, sleep is rarely assessed in clinical contexts
Conclusions
Clinical implications include the utmost relevance of assessing sleep problems during pregnancy and early post-partum. Insomnia and poor sleep quality should be evaluated and treated in the clinical practice by using a “family perspective.”
... Une pré dominance masculine a é té constaté e dans notre é tude avec un sex-ratio de 1,69. Ce constat non retrouvé dans la litté rature [9,25] peut être expliqué par la surrepré sentation du sexe masculin en consultation de pé dopsychiatrie en Tunisie [8,26]. Une autre spé cificité de notre population est la pré dominance des benjamins dans notre é chantillon ; ceci peut être expliqué par le fait que les benjamins seraient les plus emmené s en consultation de pé dopsychiatrie par rapport aux autres membres de leur fratrie [6]. ...
Résumé
Objectif
L’objectif de notre étude était de déterminer les particularités sociodémographiques et cliniques des enfants et de leurs parents pratiquant un cosleeping au cours du sommeil.
Méthode
Il s’agit d’une étude prospective descriptive qui s’est déroulée dans un service universitaire de pédopsychiatrie à Tunis (Tunisie) de juillet à novembre 2017. Elle a porté sur tous les nouveaux consultants âgés entre 2 et 18 ans, qui (a) ou dont les parents ont rapporté l’existence d’un cosleeping. Les données sociodémographiques et cliniques ont été relevées à partir des dossiers. Le(s) parent(s) a (ont) répondu à un hétéro-questionnaire, étudiant les modalités du cosleeping.
Résultats
La population était constituée de 70 patients. La moyenne d’âge était de 6,82 ans. Le sex-ratio était de 1,69. Les enfants étaient des benjamins dans 49 % et des enfants uniques dans 14 %. Un antécédent somatique pathologique a été noté chez 37 enfants. Aucun antécédent médical n’a été noté chez la mère dans 74 % et chez le père dans 80 %. Le trouble du spectre de l’autisme et l’anxiété de séparation étaient les deux diagnostics les plus fréquemment répertoriés chez les patients. Le cosleeping consistait en un partage du même lit dans 87 % des cas. L’enfant dormait avec sa mère seule dans 63 % et avec ses deux parents dans 22 % des cas.
Conclusion
Le cosleeping, en consultation de pédopsychiatrie, ne représente certes pas un trouble du sommeil, mais peut traduire une situation particulière nécessitant une exploration minutieuse.
... A decreased arousability to hypoxia from fetal exposure to passive smoking may well be the mechanism that leads to this increased risk [17][18][19]. To add to the complexity, bedsharing is also a common and valued childcare practice in many cultures, including Māori and Pacific families in New Zealand [20] and is seen in many cultures as developing and maintaining a sense of ongoing connection to the infant [21,22] as well as facilitating breast feeding [23][24][25]. Māori women however, have high rates of smoking and Māori women from communities of high deprivation in Auckland, New Zealand's biggest city, have a prevalence of cigarette smoking in pregnancy of 53% [26]. ...
Background: Sudden Unexpected Death in Infancy (SUDI) has persistent high rates in deprived indigenous communities and much of this mortality is attributable to unsafe sleep environments. Whilst health promotion worldwide has concentrated on avoidance of bedsharing, the indigenous Māori community in New Zealand has reproduced a traditional flax bassinet (wahakura) designed to be used in ways that include bedsharing. To date there has been no assessment of the safety of this traditional sleeping device. Methods/Design: This two arm randomised controlled trial is being conducted with 200 mother-baby dyads recruited from Māori communities in areas of high deprivation in the Hawkes Bay, New Zealand. They are randomised to wahakura or bassinet use and investigation includes questionnaires at baseline (pregnancy), when baby is 1, 3, and 6 months, and an overnight video sleep study at 1 month with monitoring of baby temperature and oxygen saturation, and measurement of baby urinary cotinine and maternal salivary oxytocin. Outcome measures are amount of time head covered, amount of time in thermal comfort zone, number of hypoxic events, amount of time in the assigned sleep device, amount of time breastfeeding, number of parental (non-feed related) touching infant events, amount of time in the prone sleep position, the number of behavioural arousals and the amount of time infant is awake overnight. Survey data will compare breastfeeding patterns at 1, 3, and 6 months as well as data on maternal mind-mindedness, maternal wellbeing, attachment to baby, and maternal sleep patterns. Discussion: Indigenous communities require creative SUDI interventions that fit within their prevailing world view. This trial, and its assessment of the safety of a wahakura relative to a standard bassinet, is an important contribution to the range of SUDI prevention research being undertaken worldwide.
... We now know that many behaviors that were thought to be harmful to children have been shown not to harm when they were studied prospectively in families that believed that the behaviors were normal (Okami & Olmstead, 2002;Okami, Olmstead, & Abramson, 1997;Okami, Olmstead, Abramson, & Pendleton, 1998). Specifically, Okami et al. (1997) found that 77% of mothers reported that their child had engaged in sex play before six years of age and even when masturbation-only was removed from the statistic, 47.6 had engaged in sex play of other sorts. ...
Treatment of father daughter incest (FDI) survivors using the victim advocacy/child welfare approach to FDI that predominates today in the US has never been compared to results in untreated control subjects in any published report. In the present study, thirty-two survivors of FDI who received treatment based on the victim advocacy/child welfare approach to FDI were compared to 32 control subjects who did not receive treatment. No significant differences were found using analysis of variance on 21 scales and subscales. Statistical analysis of the data from all 64 of the FDI survivors showed that items reflecting a poor self-image and a history of maternal depression predicted more problematic scores on the depression scale. Those who scored higher on religiosity were less likely to be depressed. Redesigned therapy for FDI aimed, first and foremost, at healing the survivors and validated by prospective randomized trials is needed.
... In studies of college-aged populations, individuals who reported cosleeping with their parents in childhood (between the ages of 2 and 13) had higher self-esteem, increased comfort with sexuality, and greater overall life satisfaction. It appears that cosleeping has no lasting negative repercussions [42] and may have significant long-lasting benefits. For many families, solitary sleeping has replaced cosleeping, and is often accomplished through the practice of sleep training. ...
Night terrors, also known as sleep terrors, are an early childhood parasomnia characterized by screams or cries, behavioral manifestations of extreme fear, difficulty waking and inconsolability upon awakening. The mechanism causing night terrors is unknown, and a consistently successful treatment has yet to be documented. Here, we argue that cultural practices have moved us away from an ultimate solution: cosleeping. Cosleeping is the norm for closely related primates and for humans in non-Western cultures. In recent years, however, cosleeping has been discouraged by the Western medical community. From an evolutionary perspective, cosleeping provides health and safety benefits for developing children. We discuss night terrors, and immediate and long-term health features, with respect to cosleeping, room-sharing and solitary sleeping. We suggest that cosleeping with children (≥1-year-old) may prevent night terrors and that, under certain circumstances, cosleeping with infants (≤11-months-old) is preferable to room-sharing, and both are preferable to solitary sleeping.
... Ethnographic fieldwork provides "existence proofs" for previously unknown family practices that challenge assumptions based only on contemporary Euro-American or Western contexts. For example, the majority of infants and young children around the world co-sleep with parents or others, and the associations of various parenting practices and developmental outcomes with co-sleeping appear quite positive (McKenna and McDade 2005;Morelli et al. 1992;Okami et al. 2002). Older siblings routinely and successfully are asked to care for younger siblings and cousins at ages (typically before 13) when it is thought impossible or dangerous according to US law and Western research (Weisner 1997). ...
Qualitative and ethnographic methods for measuring and understanding family daily life are essential to family research. These methods offer depth, breadth, veridicality, holism, and understanding of the meanings and experiences of family life. The cultural and social context is bracketed in, not bracketed out by using these methods. Family activities and how they matter are described using the narrative of those involved. The moral directions for life valued by family members are better understood. The value of such methods is even greater when we can combine them with quantitative and other assessment measures to provide an integrated suite of evidence. Qualitative interviews and observations of families, including photos and video, can be reliably coded for quantitative analyses or indexed for thematic and pattern analysis. Interventions also benefit from a richer understanding of what goes on inside the program when qualitative methods are applied. Qualitative methods and analyses are particularly strong for gaining trust and rapport, unpacking conventional analytic categories, understanding family processes over time, describing everyday scripts and narratives that drive family behavior and family routines, and discovering the diverse and pluralistic family forms and beliefs in cultures around the world.
... Bed-sharing also has been suggested to promote confidence, self-esteem, and intimacy in adulthood, possibly by reflecting an attitude of parental acceptance (Crawford, 1994). Similarly, an 18-year longitudinal study found evidence for small, positive effects of bed-sharing on cognitive competence in childhood and psychosexual adjustment in adulthood (Okami, Weisner, & Olmstead, 2002). It therefore is surprising that the relationship between bed-sharing and infant secure attachment has never been empirically tested. ...
We tested whether mother-infant bed-sharing is associated with increased secure infant-mother attachment, a previously unexplored association. Frequency of bed-sharing and mothers' nighttime comforting measures at 2 months were assessed with questionnaires in 550 Caucasian mothers from a population-based cohort. Attachment security was assessed with the Strange Situation Procedure (M.D.S. Ainsworth, M.C. Blehar, E. Waters, & S. Wall, 1978) at 14 months. When using a dichotomous variable, "never bed-sharing" (solitary sleepers) versus "any bed-sharing," the relative risk of being classified as insecurely attached for solitary-sleeping infants (vs. bed-sharers) was 1.21 (95% confidence interval: 1.05-1.40). In multivariate models, solitary sleeping was associated with greater odds of insecure attachment, adjusted odds ratio (OR): 1.50, 95% CI = 1.02-2.20) and, in particular, with greater odds of resistant attachment, adjusted OR = 1.74, 95% CI = 1.10-2.76); and with a lower attachment security score, β = -0.12, t(495) = -2.61, p = .009. However, we found no evidence of a dose-response association between bed-sharing and secure attachment when using a trichotomous bed-sharing variable based on frequency of bed-sharing. Our findings demonstrate some evidence that solitary sleeping is associated with insecure attachment. However, the lack of a dose-response association suggests that further experimental study is necessary before accepting common notions that sharing a bed leads to children who are better or not better adjusted.
... 2 have also questioned the existence of a latency period whereby sexual drives, according to Freud, go underground (Friedrich, Grambsch, Broughton, Kuiper, & Beilke, 1991; Lamb, 2002 Lamb, , 2006 Okami, Weisner, & Olmstead, 2002). These theorists have suggested that these sexual impulses and behaviors go underground to the extent that they are hidden from parents and the culture but that they continue. ...
Building on research about sexualization in media, body image, and its impact on the development of girls of color, we present a discourse analysis of what the members of three focus groups of teen girls of color, primarily daughters of immigrants, said when asked to talk about what it means to them to be sexy, and about their perceptions of media influence. We focus on interpretive repertoires, contradictions, and discursive strategies regarding race, body image, and perceptions about sexiness.
... 80 Studies from England, the United States, and New Zealand have all reported a longer duration of breast feeding in infants who shared a bed. [81][82][83][84][85] In one US study, the reasons why African-American women chose to share a bed with their infants were no room for, or no money to buy, a cot, convenience of feeding (formula or breast milk), and ease of monitoring. 86 ...
Sudden infant death syndrome (SIDS) remains the leading cause of death between 1 month and 1 year of agePlacing infants in the prone position (on their stomach) to sleep and exposure to maternal smoking are major risk factors for SIDSInfants born preterm are at four times the risk compared with infants born at termThe safest place for infants to sleep is in the parental bedroom in their own cot and in close proximity to parents to allow for feeding and comforting; sleeping on a sofa or couch with an infant is extremely dangerousBed sharing with infants is a risk factor for SIDS—infants are at highest risk if younger than 3 months or if the parents smoke, use illicit drugs, or consume alcoholBreast feeding decreases the risk of SIDS and therefore mothers should be encouraged to breast feed for this reason and other health benefits
... Especially, such conditions as smoking or fatigued mothers may increase the risk for sudden infant death syndrome (SIDS) (10). In some studies evaluating the potential developmental consequences of bed-sharing, an association has been found between bed-sharing in the early childhood period and cognitive/ behavioral problems in later period (11)(12)(13). We did not find any study that investigated the relationship between bed-sharing in the early childhood period and generalized anxiety disorder (GAD) in the adolescent period. ...
This study aims to investigate whether anxiety disorders in adolescents have a link with the separation time of bed/bedroom sharing with parents. It also aims to raise awareness in society about the issue of minimizing anxiety disorders in childhood.
A case-control study was conducted in Şevket Yılmaz Training and Research Hospital between June 2013 and May 2014. The participants included 51 adolescents who were diagnosed as generalized anxiety disorder (GAD) with no-comorbidity and 71 healthy adolescents as the control group, who were chosen randomly. Diagnosis of GAD was based on the criteria from the Diagnostic and Statistical Manual of Mental Disorders (4th ed) by child and adolescent psychiatry doctors. The Turkish version of the State-Trait Anxiety Inventory (STAI) was used for the control group. A special survey about demographics and bed-sharing statements was constructed for the purpose of the study. The groups were analyzed in terms of duration of co-sleeping (bed-sharing) and rooming-in (keeping the mother and the baby in same room) with parents during infancy and the development of anxiety disorders in later period.
Mean duration of rooming-in was significantly longer in the case group than in the control group (p=0.009). Similarly, mean duration of co-sleeping in the case group was longer than that of the control group. However, this difference was not statistically significant (p=0.529).
Sleeping in the same room with children for a long time may result in anxiety disorders in later period due to possible difficulties in bonding and/or less self-confidence.
... A decreased arousability to hypoxia from fetal exposure to passive smoking may well be the mechanism that leads to this increased risk [17][18][19]. To add to the complexity, bedsharing is also a common and valued childcare practice in many cultures, including Māori and Pacific families in New Zealand [20] and is seen in many cultures as developing and maintaining a sense of ongoing connection to the infant [21,22] as well as facilitating breast feeding [23][24][25]. Māori women however, have high rates of smoking and Māori women from communities of high deprivation in Auckland, New Zealand's biggest city, have a prevalence of cigarette smoking in pregnancy of 53% [26]. ...
Background:
Sudden Unexpected Death in Infancy (SUDI) has persistent high rates in deprived indigenous communities and much of this mortality is attributable to unsafe sleep environments. Whilst health promotion worldwide has concentrated on avoidance of bedsharing, the indigenous Māori community in New Zealand has reproduced a traditional flax bassinet (wahakura) designed to be used in ways that include bedsharing. To date there has been no assessment of the safety of this traditional sleeping device.
Methods/design:
This two arm randomised controlled trial is being conducted with 200 mother-baby dyads recruited from Māori communities in areas of high deprivation in the Hawkes Bay, New Zealand. They are randomised to wahakura or bassinet use and investigation includes questionnaires at baseline (pregnancy), when baby is 1, 3, and 6 months, and an overnight video sleep study at 1 month with monitoring of baby temperature and oxygen saturation, and measurement of baby urinary cotinine and maternal salivary oxytocin. Outcome measures are amount of time head covered, amount of time in thermal comfort zone, number of hypoxic events, amount of time in the assigned sleep device, amount of time breastfeeding, number of parental (non-feed related) touching infant events, amount of time in the prone sleep position, the number of behavioural arousals and the amount of time infant is awake overnight. Survey data will compare breastfeeding patterns at 1, 3, and 6 months as well as data on maternal mind-mindedness, maternal wellbeing, attachment to baby, and maternal sleep patterns.
Discussion:
Indigenous communities require creative SUDI interventions that fit within their prevailing world view. This trial, and its assessment of the safety of a wahakura relative to a standard bassinet, is an important contribution to the range of SUDI prevention research being undertaken worldwide.
Trials registration:
Australian New Zealand Clinical Trials Registry: ACTRN12610000993099 Registered 16th November 2010.
... In one longitudinal study of sleeping arrangements and sleep problems, bed sharing and night-wakings during early infancy were not predictive of bed sharing and night-wakings in childhood (Jenni et al., 2005). Furthermore, in an 18-year longitudinal study on bed sharing, bed sharing in infancy and early childhood was unrelated to any sleep disorder, pathologies, or problematic behaviors at age 6 and at age 18 (Okami, Weisner, & Olmstead, 2002). Therefore, any attempt by clinicians to treat behavioral problems via a change in sleeping arrangements must be cognizant of the reasons behind the sleeping arrangement, the cultural considerations, and whether there is a likelihood that that arrangement will help modify both sleeping and externalizing behaviors. ...
Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most common childhood disorders (American Psychiatric Association, 2000); however, recent research suggests that there is a potential for faux-ADHD diagnoses (Pressman & Imber, 2011) which may be due to externalizing problems with a different etiology. One etiology that has received attention is sleep-related behaviors, in so far as they have been correlated with behavioral problems (Presman & Imber, 2011; and see Thunström, 2002 for research on severe infant sleep problems predicting later ADHD diagnoses). This paper adds to the research in suggesting further factors that should be considered by researchers and clinicians.
... Cosleeping is also recognised as a possible risk factor for SIDS particularly amongst infants of parents who smoke or are under the influence of alcohol or drugs 10 . A recent followup study looking at long term outcomes relating to bedsharing found that it had neither adverse nor beneficial consequences 11 . ...
51 deaths were attributed to
non-drowning asphyxia in children
aged less than five in
Queensland during 1994-2000.
4 Two thirds of these deaths
involved infants aged under
one year.
4 Sleep related deaths were the
most frequent cause amongst
infants.
4 Amongst toddlers 41% involved
rope, cord or strap, 29%
foreign body and 29% were
sleep related.
4 192 children aged less than
five presented to QISU hospital
EDs with asphyxia related injuries.
4 Almost half of the children presenting
were aged less than
one year.
4 Food, coins and toys were the
most frequently identified items
involved in these presentations.
4 42% of the presentations
resulted in hospital admission.
4 80% of the infant sleep related
deaths were either co-sleeping
or not sleeping in an appropriate
infant sleeping container.
... Environmental characteristics can influence preschool children's sleep such as cosleeping, bed sharing, and number of bedrooms (Okami, Weisner, & Olmstead, 2002). In a study of inner-city minority families with children under 5 years of age, 88% of the respondents indicated that cosleeping was common and most caregivers (83%) reported that they had slept with their child the last night previous to the study. ...
Minority women living in inner city environments may be at more risk for psychological distress. Maternal stress, anxiety, depression, and psychological trauma can influence the preschool child's behavior and may have a negative impact on the preschool child's sleep patterns. The purpose of the study was to: (a) examine objective and subjective preschool children sleep patterns and (b) explore the relationship between objective and subjective sleep patterns in preschool children and maternal psychological status.
A cross-sectional observational design was used. Descriptive analyses and correlations were conducted to examine the data. Twenty-one minority women were recruited from the Special Supplemental Nutrition Program for Women, Infants, and Children Program.
Preschool children wore wrist actigraphs, and their sleep efficiency, time in bed, and sleep periods were analyzed. Mothers completed measures on depression, anxiety, stress, and psychological trauma.
Mothers' self-report of their children's sleep habits indicated at risk scores for sleep problems. Life stress in the mothers was statistically significant and negatively related to preschool child's sleep duration. Mild to severe symptoms of depression and mild anxiety were reported and criteria for Post Traumatic Stress Disorder were found in 12 of the 21 mothers. The results of the study indicate that parent education on sleep and the minority preschool child should be part of community interventions and screening preschool parents for psychological distress should be considered with referrals for support services.
The Child Sleep Hygiene Questionnaire (CSHQ) and its adapted version for autistic children, known as CSHQ-Autism, have gained recognition as essential tools for studying pediatric sleep patterns. 67 autistic children were evaluated using these questionnaires. 52 children screened positive on the CSHQ while 18 were screened positive on the CSHQ-Autism. Notably, both tools showed elevated ratings in the domains of sleep anxiety and co-sleeping, which may hinder their ability to accurately distinguish sleep disturbances. However, the prevalence of sleep anxiety/co-sleeping in Indian culture was found to be linked to more severe sleep disorders, while also serving as a protective factor against separation anxiety and sudden infant death syndrome (SIDS). Therefore, while the CSHQ and CSHQ-Autism serve as valuable assessment tools, their scores may be inflated by ingrained cultural norms in the Indian context.
Sleep plays a crucial role in healthy human development. Nevertheless, burgeoning societal data from many countries indicates that significant proportions of children and adolescents do not regularly achieve the recommended sleep duration outlined in clinical guidance. Furthermore, there is a high prevalence of sleep initiation and maintenance disorders in paediatric populations. These disorders are strongly associated with behavioural and emotional problems, which in turn impact educational progress and social development. Despite their widespread prevalence and the deleterious impact they have on the health and quality of life of both children and their families, paediatric sleep disorders are generally poorly understood and remain undertreated in many clinical settings. Improving clinical education on the cognitive‐behavioural management of paediatric insomnia for clinicians at all levels of paediatric care is, therefore, of great importance. This chapter is intended to be used as a primer for clinicians undertaking the assessment and cognitive‐behavioural treatment of sleep problems in paediatric patients in the childhood and adolescent years. It will focus on presenting cognitive‐behavioural protocols for problems initiating and/or maintaining sleep, as well as discussion of issues surrounding assessment and diagnosis.
Every year in the United States, approimately 3500 infants die of sleep-related infant deaths, including sudden infant death syndrome (SIDS) (International Statistical Classification of Diseases and Related Health Problems 10th Revision [ICD-10] R95), ill-defined deaths (ICD-10 R99), and accidental suffocation and strangulation in bed (ICD-10 W75). After a substantial decline in sleep-related deaths in the 1990s, the overall death rate attributable to sleep-related infant deaths have remained stagnant since 2000, and disparities persist. The triple risk model proposes that SIDS occurs when an infant with intrinsic vulnerability (often manifested by impaired arousal, cardiorespiratory, and/or autonomic responses) undergoes an exogenous trigger event (eg, exposure to an unsafe sleeping environment) during a critical developmental period. The American Academy of Pediatrics recommends a safe sleep environment to reduce the risk of all sleep-related deaths. This includes supine positioning; use of a firm, noninclined sleep surface; room sharing without bed sharing; and avoidance of soft bedding and overheating. Additional recommendations for SIDS risk reduction include human milk feeding; avoidance of exposure to nicotine, alcohol, marijuana, opioids, and illicit drugs; routine immunization; and use of a pacifier. New recommendations are presented regarding noninclined sleep surfaces, short-term emergency sleep locations, use of cardboard boxes as a sleep location, bed sharing, substance use, home cardiorespiratory monitors, and tummy time. In addition, additional information to assist parents, physicians, and nonphysician clinicians in assessing the risk of specific bed-sharing situations is included. The recommendations and strength of evidence for each recommendation are published in the accompanying policy statement, which is included in this issue.
Human infants spend most of their time sleeping, but over the first few years of life their sleep becomes regulated to coincide more closely with adult sleep (Galland et al., 2012; Paavonen et al., 2020). Evidence shows that co-sleeping played a role in the evolution of infant sleep regulation, as it is part of an ancient behavioral complex representing the biopsychosocial microenvironment in which human infants co-evolved with their mothers through millions of years of human history (Ball, 2003; McKenna 1986, 1990). This paper is a conceptual, interdisciplinary, integration of the literature on mother-infant co-sleeping and other mother-infant co-regulatory processes from an evolutionary (biological) perspective, using complexity science. Viewing the mother-infant dyad as a “complex adaptive system” (CAS) shows how the CAS fits assumptions of regulatory processes and reveals the role of the CAS in the ontogeny of mother-infant co-regulation of physiological (thermoregulation, breathing, circadian rhythm coordination, nighttime synchrony, and heart rate variability) and socioemotional (attachment and cortisol activity) development.
Child well-being is an indispensable and often a complex part of most parents’ daily concerns. In addition to the parenting styles and social interactions inside or outside one’s primary environment, urbanized living and contemporary lifestyle habits have brought into focus the attitudes and behaviors displayed by parents or caregivers with subtle to pronounced impact on children sharing the same household. As we transition through these changes, a shift in focus from mere survival to physical and psychological well-being is imperative. Driven by the complexities of the new-age social and economic trends, the chapter illustrates a socio-ecological approach to assay the transactional individual orientations, life choices, and community-based indicators of child health. Agents of consumerism showcase conspicuous consumer socialization and materialism, including dietary habits and brand imaging which impinges upon child health, identity, and self-esteem. Parents’ work–life choices and an apparent insufficiency of resources to cope with the work–life conflict, stress, and burnout, create an unhealthy environment for the children where they can be exposed to adult behaviors ranging from substance abuse to violence. Finally, lifestyle choices including sedentary living, poor sleep hygiene, and a surge in screen time and digital dependence are leaving an indelible mark on the child’s own life choices and future health. We purport to unravel the modern connotations of child empowerment and autonomy alongside their diverse child well-being outcomes in our pursuit of desirable nurturing.
Bedsharing is controversial for nighttime caregiving in the U.S. today, as in most of the West. However, from the standpoint of evolutionary pediatrics, anthropology, and cultural psychology, bedsharing is not controversial at all, representing the context for human infant evolution and conferring a host of physiological benefits to the infant as well as the mother. In an effort to understand the rise in Western bedsharing in recent decades (and following Ball, 2002; McKenna & Volpe, 2007), Salm Ward (2015) systematically reviewed the literature on mother-infant bedsharing and identified ten reasons why mothers choose to bedshare: (1) breastfeeding, (2) comforting for mother or infant, (3) better/more sleep for infant or parent, (4) monitoring, (5) bonding/ attachment, (6) environmental reasons, (7) crying, (8) cultural or familial traditions, (9) disagree with danger, and (10) maternal instinct. The current paper offers the “review behind the review,” highlighting the scientific evidence behind the reasons mothers give for their decision to bedshare, focusing on how mothers’ decisions about infant sleep location influence infant behavior and development.
The reference of choice for pediatricians, residents, and medical students, this revised and expanded sixth edition provides clear, practice-oriented guidance on the core knowledge in pediatrics. Edited by a leading primary care authority with more than 100 contributors, this edition provides comprehensive coverage of hundreds of topics ranging from asthma and urinary tract infections to toilet training and adolescent depression. View a message from Dr Berkowitz. Available for purchase at https://shop.aap.org/berkowitzs-pediatrics-6th-edition-paperback/ (NOTE: This book features a full text reading experience. Click a chapter title to access content.)
It is now widely recognised that culture plays an important role in shaping ideas about child development and parenting (e.g. Harkness, Raeff and Super, 2000). Numerous studies have shown cross-cultural differences in the types of competencies parents encourage in children, the age at which parents expect developmental skills to be acquired and the methods parents use to promote these skills. Cross-cultural differences have also emerged in relation to parents' ideas about developmental delay, their beliefs about intervention, and support seeking behaviours (e.g. Danesco, 1997). Within the UK, where referrals to child development and learning disability services are Increasingly culturally diverse, it is important for professionals to develop an awareness of cultural practices and beliefs in order to provide services which are culturally sensitive. This point is soon to be echoed in the new National Service Framework for Children (Department of Health, forthcoming). Despite the recent emphasis on delivery of culturally sensitive services, previous researchers have consistently highlighted the shortcomings of health and social care services for ethnic minority groups. Inequalities faced by parents from South Asian communities who have a child with a learning difficulty, have been a particular cause for concern. This group have been shown to experience substantial discrimination and inequality in their access to health, social, education and welfare services (e.g. Mir et at. 2001), a factor which Is often partly linked to poor professional knowledge and sensitivity to cultural and religious belief systems. Very little is currently known about South Asian parents' beliefs about child development, parenting and developmental delay despite the relevance of these areas to clinical practice. Therefore, 10 South Asian mothers and 10 white British mothers of a child with global developmental delay were interviewed about their beliefs about typical child development, their child rearing practices and the factors influencing their ideas about child development and parenting. Beliefs about developmental delay and support seeking behaviour were also investigated. The data were analysed using thematic content analysis and quantitative methods. In relation to typical child development, results indicated that South Asian mothers and white British mothers held similar beliefs about the age at which children achieve different developmental skills. However, differences emerged in terms of the importance attached to the development of different skills. South Asian mothers were significantly less likely to highlight the importance of self-help skills compared to white British mothers. South Asian mothers were also significantly less likely to expect gender differences in children's acquisition of skills. Factors influencing mothers' ideas about child development and parenting differed cross-culturally. Significantly more white British mothers than South Asian mothers were influenced by friends, professionals and books and media, whilst significantly more South Asian mothers were influenced by their religious beliefs. Parenting practices, such as toilet training, also differed between the two groups. In relation to developmental delay, the groups differed in terms of their understanding and explanations of developmental delay. South Asian mothers were less likely to use medical and biological explanations of their child's difficulties than white British mothers. Help-seeking behaviours also differed cross-culturally, with South Asian mother more likely to turn to religious persons for support and less likely to turn to professionals for support than white British mothers. In relation to experiences of support services offered, mothers identified similar shortfalls in service provision. These included "being kept in the dark" about their child's difficulties, being confused about the organisation of the support system, having to "battle" to receive support, feeling that resources were either too few or inappropriate, and feeling that professionals failed to hold in mind a complete picture of their child's difficulties. These results are discussed in the context of existing literature together with suggestions for future research and the clinical implications of the study.
Introduction
Bed sharing during childhood is not uncommon; however, it is unclear how different bed-sharing practices affect children’s sleep. While studies have explored relations between habitual parent-child bed sharing and sleep, less is known about how differences in the consistency of bed sharing, as well as diverse co-sleep partners, might influence sleep. Thus, the present study investigated how different bed-sharing frequencies and partners might impact the effects of co-sleeping on child sleep.
Methods
Parents of 521 preschool-aged children (235 female, M=51.6 months) completed child sleep diaries over 16 days. Diaries included co-sleeping questions (presence/frequency of bed sharing, who children shared with), along with sleep duration and timing entries. From parents’ reports, children were identified as habitual bed-sharers, inconsistent/occasional bed-sharers, solitary sleepers, or “other” (children who routinely woke to change sleeping spaces; this category was excluded). Bed-sharers were further classified as sleeping alongside parents, siblings, or other (e.g. pets). Actigraphy was collected for a subset of children (n=338), and researchers compared actigraphy-derived measures (sleep durations, WASO) among different co-sleep groups.
Results
Across the full sample, 21.3% of children were habitual bed-sharers; 10.9% were occasional; and, 63.5% were solitary sleepers. Bed-sharers most often shared with parents only (47.7% of habitual, 54.4% of occasional), though sibling-only sharing was also prominent among habitual bed-sharers (27.0%). Regarding sleep quality, co-sleeping frequency marginally predicted overnight sleep durations (F(2,318)=3.03, p=.050), with habitual bed-sharers sleeping less than solitary sleepers. Co-sleeping significantly predicted nap durations (F(2,293)=3.22, p=.042), with habitual bed-sharers napping longer than solitary sleepers and occasional bed-sharers (ps<.05). In contrast, occasional bed-sharers had greater overnight WASO compared to habitual bed-sharers and solitary sleepers (main effect: F(2,318)=3.73, p=.025; pairwise ps<.05). No sleep differences were found between children who habitually shared beds with parents vs. siblings (ps>.10).
Conclusion
Our findings suggest that different co-sleeping patterns relate differentially to sleep quality. Further analyses will explore whether napping and overnight sleep interact to alter overall sleep efficiency among co-sleepers, and future studies should determine how experimental manipulations of co-sleeping influence sleep quality.
Support (If Any)
NIH R01 HL111695.
Pseudoscience in Child and Adolescent Psychotherapy - edited by Stephen Hupp March 2019
Cambridge Core - Health and Clinical Psychology - Pseudoscience in Child and Adolescent Psychotherapy - edited by Stephen Hupp
Background
The objective of this study was to evaluate a possible correlation between parent-child bed-sharing and growing pains.
Methods
A questionnaire inquiring about bed-sharing habits of children and parents and the location, duration, intensity, and treatment of the child’s growing pain was completed by a consecutive series of families whose child (ages 3-10 yr) presented for evaluation of pain ultimately diagnosed as growing pains. A consecutive series of children (ages 3-10 yr) with a distal radial buckle fracture served as the control group.
Results
Twenty-two of 44 (50%) families in the growing pain group answered “yes” to the bed-sharing question. Only 16 of 54 (29%) in the control group answered “yes.” Bed-sharing rates were significantly different between groups ( P = 0.048). However, the mean age between the groups was also significantly different (growing pains group = 6.9 yr, control group = 5.5 yr, P = 0.002). To control for age, all patients over 7 yr from both groups were eliminated for analysis. Results revealed that the mean age was similar ( P = 0.15) in both groups, but the rate of bed-sharing was no longer significantly different (growing pains group [50%], control group group [38%], P = 0.123).
Conclusions
Despite finding that the rate of parent-child bed-sharing was 50% in our growing pains population, when we controlled for age, there was no difference from our control. Parent-child bed-sharing does not seem to be a significant component of growing pains. Bed-sharing could be a possible mechanism to manage a child’s growing pains.
Aim:
We studied sleep patterns, sleep problems and associated socio-demographic factors among children aged 1-12 years in Lagos, Nigeria.
Methods:
This prospective hospital-based study involved 432 children (55% males) who came for routine paediatric care at the Lagos State University Teaching Hospital. Information on socio-demographics, sleeping patterns and specific sleep disorders were obtained.
Results:
The mean age of the subjects was 5.4 ±3.3 years. Night sleep duration decreased significantly with age from 9.6 ±1.3 hours at 1-4 years to 8.7 ±1.0 hours at 9-12 years (p < 0.001). There was no significant gender difference in bed times (p=0.057), rise times (p=0.095) and night sleep duration (p=0.191). Most (70%) napped during the day and 26% of these did so on a regular basis. The most common sleep problems were enuresis (42%), afraid of sleeping alone (38%), snoring (28%) and sleep talking (24%). There was no significant association between sleep duration (p>0.05), sleep problems (p>0.05) and socio-demographic characteristics. Comparisons with other studies showed that the children had shorter sleep duration than peers in other countries and regions and a higher prevalence of sleep disorders.
Conclusions:
Children in Nigeria had shorter sleep duration and more sleep problems than children in other international studies. This article is protected by copyright. All rights reserved.
Study objectives
Previous studies have performed cross-cultural comparisons of differences in childhood sleep problems between Asian and Western countries. However, whether such differences can be observed among Asian countries remains unclear. The present study aimed to investigate differences in the pattern of sleep problems between Japanese and Chinese preschoolers.
Methods
Data were collected from one city in Japan and 10 cities in China. The present study recruited 438 Japanese and 1,020 Chinese preschoolers aged 4 and 5 years. Sleep problems and patterns were assessed based on parental reports using the Children’s Sleep Habits Questionnaire (CSHQ).
Results
Analysis of covariance revealed no significant difference in total CSHQ scores between Japanese and Chinese preschoolers, indicating that the total severity of sleep problems did not differ between the groups. Japanese preschoolers exhibited higher scores on the bedtime resistance subscale of the CSHQ than Chinese preschoolers. Conversely, Chinese preschoolers exhibited higher subscale scores for night wakings and sleep-disordered breathing. In addition, Japanese preschoolers exhibited earlier bedtimes and wake times, and shorter total sleep times than Chinese preschoolers.
Conclusions
Our findings indicate that the patterns of sleep problems in preschoolers differ between Japan and China, and that such differences may be due to differences in co-sleeping practices, bedtime routines, and/or environmental conditions. Thus, investigators studying sleep in preschoolers should consider regional differences in the pattern of sleep problems, even among Asian countries.
The purpose of this study was to compare sleep disturbances of children and their mothers, children's behavioral problems, and parenting self-efficacy between Korean American families who coslept and those who did not cosleep. Forty-eight mothers of children between 3 and 8 years of age completed the following surveys: Children's Sleep Habits Questionnaire, Pediatric Symptom Checklist, Pittsburgh Sleep Quality Index, Parenting Self-Efficacy Questionnaire, and Acculturation Rating Scale for Mexican Americans II. Overall, 48% (n = 23) of families coslept, and families with younger children coslept more than families with older children (x2=12.48,p.05). When the families were divided into non-cosleeping (i.e., rarely) and cosleeping (i.e., sometimes and usually) groups, 100% of the cosleeping children had sleep disturbances compared to 56% of the non-cosleeping children (x2=8.67,p.01). For mothers, 28% (n = 7) of the non-cosleeping mothers reported sleep disturbances, compared to 52% (n = 12) of the cosleeping mothers (x2=2.93,p=.08). Children's behavioral problems were not different between the two groups (F = 1.78, p = NS). Cosleeping mothers reported lower parenting self-efficacy than non-cosleeping mothers (F = 6.26, p < .05). When providing care to Korean American families with young children, their cosleeping, sleep disturbances, and parenting self-efficacy need to be addressed.
A comparison of 74 victims of father-daughter incest (FDI) to 355 controls who were victims of child-sexual abuse (CSA) by an adult male other than their father identified multiple significant differences between the two groups attributable to effects unique to FDI. For example, FDI victims had more problematic scores on the depression scale, and they preferred to have partner sex less frequently than the victims of CSA-AM. Problematic relationships between parents, higher family-tolerated father-daughter nudity, and a new partner in the home all increased the likelihood of FDI. Hypersexual and risky sexual behaviors increased the likelihood of endorsing being sexually addicted.
The practice of infant bed-sharing remains controversial in countries such as the UK and the US, despite its prevalence, and healthcare professionals are often faced with the task of advising parents on bed-sharing without the support of consistent or up-to-date guidelines. This article explores UK and US recommendations on infant bed-sharing, considering the existing evidence. The possible relationship between infant bed-sharing and sudden infant death syndrome (SIDS) is explored, alongside other factors that may be linked to SIDS. Areas where further research is required are identified and appropriate resources are provided, with a view to empowering healthcare professionals to support parents in making an informed and proactive decision about infant bed-sharing.
On October 10, 2005, the American Academy of Pediatrics Task Force on Sudden Infant Death Syndrome made the recommendation that babies should not sleep in the same bed as adults. The purpose of this article is to present a more holistic approach to bedsharing based on the current research.
In this article I compare clinical opinion with empirical evidence of psychological harm associated with childhood exposure to parental nudity, parent‐child co‐sleeping, and scenes of parental sexuality (“primal scenes”). Exceedingly scant empirical data could be located. Only in the case of parent‐child co‐sleeping is there any suggestion in the empirical literature of associated harm, and this harm—sleep disturbance—may be an antecedent rather than a consequence of co‐sleeping. A unique in‐progress 18‐year longitudinal study of adjustment is also described.
In this study, nested latent-variable causal models were contrasted to compare the direct and indirect relationships of distal family and child and proximal adolescent factors to dropping out of high school. The sample included 194 Euro-American conventional and nonconventional families in a 19-year longitudinal study. The findings showed that dropping out of high school is a multiply-determined process, with early influences beginning in childhood, that involves family as well as child and adolescent factors. Early family nonconventionality with higher commitment to lifestyle values was associated with a lower probability of dropping out; cumulative family stress, lower high school achievement and motivation, lower sixth-grade school performance, and adolescent drug use were associated with a higher probability of dropping out. Family lifestyles and values are related to children's developmental pathways through childhood exposure to drug use, child ability prior to school entry, and early school performance. Nonconventional lifestyles with a higher commitment to lifestyle values may offer long-term protection for children from school failure.
Using confirmatory methods, a direct modeling theory was contrasted with a cognitive mediational position in regard to the influence of mothers on their children's use of alcohol, marihuana, and pills. Mothers completed questionnaires assessing their personality and drug use, and their daughters (
n = 481) and sons (
n = 244) independently responded to self-report questionnaires measuring their own drug use and perceived adult drug use. Data support a cognitive mediational linkage between mother and child for alcohol and pill use. A direct modeling explanation seemed to account most accurately for marihuana use. In all analyses, sex of the child was retained as an independent variable, and for all substances there was no differential effect by sex. (32 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Examines the decisions of middle-class US and Highland Mayan parents regarding sleeping arrangements during their child's 1st 2 yrs and their explanations for their differing practices. All 14 Mayan children slept in their mothers' beds into toddlerhood. None of the 18 US infants slept in bed with their mothers on a regular basis as newborns, although 15 slept near their mothers until age 3–6 mo, when most were moved to a separate room. The Mayan parents explained their practices in terms of the value of closeness with infants; US parents explained their practices in terms of the value of independence for infants. US families, but not Mayan families, used bedtime routines and objects to facilitate the transition to sleep. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Objective: To investigate the risks of the sudden infant death syndrome and factors that may contribute to unsafe sleeping environments.Design: Three year, population based case-control study. Parental interviews were conducted for each sudden infant death and for four controls matched for age, locality, and time of sleep.Setting: Five regions in England with a total population of over 17 million people.Subjects: 325 babies who died and 1300 control infants.Results: In the multivariate analysis infants who shared their parents' bed and were then put back in their own cot had no increased risk (odds ratio 0.67; 95% confidence interval 0.22 to 2.00). There was an increased risk for infants who shared the bed for the whole sleep or were taken to and found in the parental bed (9.78; 4.02 to 23.83), infants who slept in a separate room from their parents (10.49; 4.26 to 25.81), and infants who shared a sofa (48.99; 5.04 to 475.60) The risk associated with being found in the parental bed was not significant for older infants (>14 weeks) or for infants of parents who did not smoke and became non-significant after adjustment for recent maternal alcohol consumption (>2 units), use of duvets (>4 togs), parental tiredness (infant slept ≤4 hours for longest sleep in previous 24 hours), and overcrowded housing conditions (>2 people per room of the house).Conclusions: There are certain circumstances when bed sharing should be avoided, particularly for infants under four months old. Parents sleeping on a sofa with infants should always be avoided. There is no evidence that bed sharing is hazardous for infants of parents who do not smoke.Key messsagesCosleeping with an infant on a sofa was associated with a particularly high risk of sudden infant death syndromeSharing a room with the parents was associated with a lower riskThere was no increased risk associated with bed sharing when the infant was placed back in his or her cotAmong parents who do not smoke or infants older than 14 weeks there was no association between infants being found in the parental bed and an increased risk of sudden infant death syndromeThe risk linked with bed sharing among younger infants seems to be associated with recent parental consumption of alcohol, overcrowded housing conditions, extreme parental tiredness, and the infant being under a duvet
Objective - To investigate the role of sleeping arrangements as risk factors for the sudden infant death syndrome after a national risk reduction campaign. Design - Two year population based case-control study. Parental interviews were conducted for each infant who died and for four controls matched for age and date of interview. Setting - Three regions in England with a total population of 17 million people. Subjects - 195 babies who died and 780 matched controls. Results - Prone and side sleeping positions both carried increased risks of death compared with supine when adjusted for maternal age, parity, gestation, birth weight, exposure to smoke, and other relevant factors in the sleeping environment (multivariate odds ratio = 9.00 (95% confidence interval 2.84 to 28.47) and 1.84 (1.02 to 3.31), respectively). The higher incidence of side rather than prone sleeping led to a higher population attributable risk (side 18.4%, prone 14.2%). More of the infants who died were found with bed covers over their heads (21.58; 6.21 to 74.99). The use of a dummy had an apparent protective effect (0.38; 0.21 to 0.70). Bed sharing for the whole night was a significant risk factor for infants whose mothers smoked (9.25; 2.31 to 34.02). No protective effect of breast feeding could be identified on multivariate analysis. Conclusions - This study confirms the importance of certain risk factors for the sudden infant death syndrome and identifies others - for example, covers over the head, side sleeping position - which may be amenable to change by educating and informing parents and health care professionals.
The incidence of transitional objects was studied in 285 children in two pediatric populations differing in race and socioeconomic status. Significant differences were found between groups in incidence and age of onset of attachment, and in specific behavior associated with use of the objects. Child-rearing practices and maternal attitudes were also related to development of attachments. Theoretical implications and directions for continued study are considered.
To determine whether infants who died of the sudden infant death syndrome routinely shared their parents' bed more commonly than control infants.
Case-control study.
Southern California.
200 white, African-American, Latin American, and Asian infants who died and 200 living controls, matched by birth hospital, date of birth, sex, and race.
Routine bedding (for example, crib, cradle), day and night time sleeping arrangement (for example, alone or sharing a bed); for cases only, sleeping arrangement at death. Differences in bed sharing practices among races.
Of the infants who died of the syndrome, 45 (22.4%) were sharing a bed. Daytime bed sharing was more common in African-American (P < 0.001) and Latin American families (P < 0.001) than in white families. The overall adjusted odds ratio for the syndrome and routine bed sharing in the daytime was 1.38 (95% confidence interval 0.59 to 3.22) and for night was 1.21 (0.59 to 2.48). These odds ratios were adjusted for routine sleep position, passive smoking, breast feeding, intercom use, infant birth weight, medical conditions at birth, and maternal age and education. There was no interaction between bed sharing and passive smoking or alcohol use by either parent.
Although there was a significant difference between bed sharing among African-American and Latin American parents compared with white parents, there was no significant relation between routine bed sharing and the sudden infant death syndrome.
We try to keep in mind cultural influences on the advice we give. We remind ourselves that much of what comes to the pediatrician’s attention, as problematic sleep behavior- children who have difficulty falling asleep alone at bedtime, who wake at night and ask for parental attention, or who continue to nurse at night-is problematic only in relation to our society’s expectations, rather than to some more general standard of what con- stitutes difficult behavior in the young child. Our pediatric advice on transitional objects, breast feeding, cosleeping may be unknowingly biased toward traditional Euro Amer- icanviews of childrearing, especially those about bedtime and nighttime behavior. Thus, in giving advice about sleep, pediatric health professionals might dowell to be aware of their own cultural values, to examine closely their patients cultural and family contexts, and to assess parental reactions to children’s sleep behaviors. (1) Who sleeps by whom is not merely a personal or private activity. Instead it is social practice, like burying the dead or expressing gratitude for gifts or eating meals with your family, or honoring the practice of a monogamous marriage, which (for those engaged in the practice) is invested with moral and social meaning for a person’s reputation and good standing in the community. (2) Inclinical pediatrics, cosleeping is thepolitical third rail. If you touch it, youdie. (3) In this chapter, we have contributed a new conclusion to the first version pub- lished in the earlier edition, slightly modified and updated recent developments as regards research into mother-infant cosleeping in the form of bedsharing, and have contributed a new last section that critiques recommendations against any and all bedsharing. But mostly, we provide here (without modification) a cultural background to our thinking about what constitutes “normal, healthy, and desirable” infant sleep and show the interconnectedness between scientific research, cultural values, concerns for morality, and sleeping arrangements that are characteristic of Western society. Specific biological and psychological evidence is put forth supporting the views of Sadeh and Anders (4,5) and Anders (6) on the importance of understanding what is “appropriate” infant sleep on the basis of the overall social and physical context within which it occurs.
This paper reviews the evolutionary history of human birth and infancy, using as data the cross-species, cross-cultural, and fossil records. We argue that studies of other cultures, other species, and other, more ancient times are necessary for fully understanding social, psychological, and physiological processes underlying birth and infant development. Indeed, knowledge of the differences in the ancient and recent environments of birth and infancy is necessary for understanding and solving some of the problems and dissatisfactions with the ways in which childbirth and infancy are experienced in modern life. The most dramatic differences to emerge in this review are in the social environments of childbirth and the sleeping environments of infants.
This paper extends the evolutionary and developmental research model for SIDS presented in previous articles (McKenna 1990a, 1990b). Data from variety of fields were used to show why we should expect human infants to be physiologically responsive in a beneficial way to parental contact, one form of which is parent-infant co-sleeping. It was suggested that on-going sensory exchanges (touch, movement, smell, temperature, etc.) between co-sleeping parent-infant pairs might diminish the chances of an infantile cardiac-respiratory crisis (such as those suspected to occur in some SIDS cases).In this article we review recent epidemiological data and sleep research findings on SIDS to show how they relate to evolutionary and cross-cultural perspectives. Results of a preliminary study of the co-sleeping behavior of mother-infant pairs indicate that, with respect to sleep, arousal, and respiratory patterns, co-sleeping mother-infant pairs affect each other in potentially important ways. We suggest specifically that co-sleeping may shorten periods of consolidated sleep among young infants by causing them to arouse more frequently. Moreover, we suggest that partner-induced arousals might help the infant to confront sleep crises more competently. In the long run, these arousals might prevent the premature emergence of prolonged (adultlike) sleep bouts from which some infants have difficulty arousing-especially during a breathing pause or apnea.
Psychologists in both family practice and developmental research may be puzzled about the scientific status of research on child care as it affects children, parents, and caregivers. What conclusions can be reached about mothers in the labor force, about the advisability of various child care arrangements, about their short and long-term consequences, and what advice do we as psychologists have to offer in the public interest to parents of infants and young children? In this article, we review research on child care, and discuss its implications for the nation and for psychology as a research enterprise and a helping profession.
The life-styles of countercultural, nonconventional families have potential risks as well as benefits for children's school achievement. The effects on children's school achievement of nonconventional family organization, parents' values and commitment to their family life-style, and family stability were examined in a 12-year longitudinal study of 146 nonconventional families and a comparison group of 43 stable, two-parent conventional families. In spite of considerable instability and other potential risk conditions in nonconventional families' lives (single parent or unmarried couple status, frequent change, stigma, low incomes, and others), most of their children do as well or better in school than a comparison group of conventional families. These effects were still present after adjusting for child WISC-R, gender, and family SES. Those children doing best in school come from families who have a stronger commitment to their nonconventional family life-style while those doing less well have families with a lower commitment. Children in single parent families had grades similar to those of children in two-parent families. Family stability-regardless of the form of the family (single parent or couple)- also was associated with higher grades. Strong commitment to meaningful values regarding the importance of one's family life-style can protect children against some of the risks that were a part of many countercultural family's lives.
The influence of family values on adolescent problem behaviors is explored in an 18-year study of 199 families. Factor analyses revealed two value dimensions: traditional/achievement and humanistic/egalitarian. Problem behavior was indicated by drug use, delinquency, dropout, and sexual behavior. Maternal values predicted similar adolescent values. Traditional values generally protected adolescents against problem behaviors. Humanistic/egalitarian values protected against delinquency but increased drug use risk. Maternal countercultural identity protected adolescents against hard drug use.
This cross-cultural survey of sex customs treats sexual modesty in clothing and speech, privacy for intercourse, ceremonial license, and joking and avoidance. Sexual modesty is found to be uncorrelated with a number of sex taboos, but positively correlated with the attempt to confine sexual intercourse within marriage. This combination of sex restrictions, termed modesty-chastity, is very much the property of peasant societies, as opposed to primitice societies. The most sexually free cases in the sample tend to have a narrowly genital orientation to sex and to be preoccupied with sexual jokes and obscenity. The conclusion lists the full range of sex restrictions and sexual fears and proposes a germinal sex problem, best accounted for in Freudian terms.
Developed an internal scale of measurement for attributes assessing several nonintellectual behaviors of children including fighting, following directions, maturity, happiness, dependence on teachers, distractibility, danger to self and others, enthusiasm for school, and learning difficulty. Approximately 1,500 children from 4 school districts served as Ss. First, behavioral descriptors for each of the attributes were collected; second, the most valid were selected by a 2-step reallocation process; third, teachers assigned scale values of the descriptors; fourth, grade level specificity was tested; and finally, reliability of the scales was estimated. Scales developed for the 11 attributes, ranged in reliability from .70 for often sick or upset under stress, to 1.0 for fighting or quarreling. (23 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Reviews the literature to assess the effects of cosleeping. Findings indicate that the prevalence of cosleeping varies greatly across racial groups; Black families report the greatest incidence followed by Hispanic and White families. Cosleeping in White families often occurs in reaction to circumstances related to sleep problems while cosleeping in Black families reflects a subcultural sleeping pattern. Family stress, ambivalent maternal attitude, increased disruptive sleep patterns, decreased parental education, and maternal depressed mood were found to be significantly associated with cosleeping in White, but not Black, families. Evidence suggests that cosleeping may temporarily suppress, but does not solve, a child's sleep problems. Cosleeping is found more in single parent homes and with parents who would cosleep as children themselves. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
FACTORS CONSIDERED ARE CITY OF RESIDENCE, HOUSEHOLD SIZE, NUMBER OF GENERATIONS IN THE HOUSE, LIFE STYLE, SOCIAL CLASS, AND DENSITY. 10 TABLES INDICATE THE CORRELATIONS OF THE VARIABLES. THE GENERAL FINDING WAS THAT MORE MEMBERS OF THE FAMILY SLEEP TOGETHER IN JAPAN, THEREBY EMPHASIZING FAMILY VS. PERSONAL DEPENDENCE. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This study investigated parent—child interactions during sleep onset and nighttime arousals in a rural sample of preschool children. The role of co-sleeping in relation to sleep habits and night waking was examined using parental self-report of both current and retrospective sleep patterns. The results showed that Solitary Sleepers engaged in more complex bedtime routines, and had more longstanding and stronger attachment to security objects and sleep aids, than did Co-sleepers. Infancy precursors to co-sleeping in early childhood were a history of breastfeeding, night feedings in the parent's bed, and returning to sleep in the parent's bed.
Thesis (Ph. D.)--New York University, 1995. Includes bibliographical references. Photocopy.
Objective To investigate the risks of the sudden infant death syndrome and factors that may contribute to unsafe sleeping environments. Design Three year, population based case-control study. Parental interviews were conducted for each sudden infant death and for four controls matched for age, locality, and time of sleep. Setting Fire regions in England with a total population of over 17 million people. Subjects 325 babies who died and 1300 control infants. Results In die multivariate analysis infants who shared their parents' bed and were then put back in their own cot had no increased risk (odds ratio 0.67; 95% confidence interval 0.22 to 2.00). There was an increased risk for infants who shared the bed for the whole sleep or were taken to and found in the parental bed (9.78; 4.02 to 23.83), infants who slept in a separate room from their parents (10.49; 4.26 to 25.81), and infants who shared a sofa (48.99; 5.04 to 475.60). The risk associated with being found in the parental bed was not significant for older infants (> 14 weeks) or for infants of parents who did not smoke and became non-significant after adjustment for recent maternal alcohol consumption(> 2 units), use of duvets ( > 4 togs), parental tiredness (infant slept less than or equal to 4 hours for longest sleep in previous 24 hours), and overcrowded housing conditions (> 2 people per room of the house). Conclusions There are certain circumstances when bed sharing should be avoided, particularly for infants under four months old. Parents sleeping on a sofa Midi infants should always be avoided. There is no evidence that bed sharing is hazardous for infants of parents who do not smoke.
Caudill and Plath (1966) point out that “If a third of life is passed in bed, with whom this time is spent is not a trivial matter” (p. 344). They further argue that children co-sleeping with parents expresses a cultural emphasis on the nurturant aspects of family life and a deemphasis on its sexual aspects. They postulate that in Japanese society, it relates to the strength of the family bond. In America we typically assume that children do not sleep with their parents, and that if they do, they shouldn’t. Because we assume that children don’t sleep with their parents, there are very few studies in this area, and because we assume that it shouldn’t happen, most of the studies that have been done involve psychiatric populations (Kaplan and Poznanski, 1974; Oleinick et al., 1966; Sperling, 1971). Predictably, the reason given as to why children shouldn’t sleep with parents is that it arouses sexual anxiety (Kaplan and Poznanski; Sperling). The present study is an attempt to collect more detailed descriptive data about both the do and the should aspects of co-sleeping in American society: Do American parents sleep with their children? Do they feel that they should or shouldn’t be sleeping with their children? Do they perceive it as a cultural taboo?
Sixteen accidental deaths of infants occurred in Wayne County (Detroit) during 1974-1975 as a result of unsafe sleeping environments. Thirteen of these deaths resulted from different modes of asphyxia, two were due to falls, and one drowned. Differential diagnoses are pointed out.
It is estimated that over 600 infants die each year in the United States due to unsafe sleeping conditions. Despite the magnitude and importance of this problem, little has been provided to the public in the form of preventive education. Federal regulations, passed in 1974, control the manufacture of new cribs but do not affect the existing unsafe cribs.
Suggestions for the prevention of such fatal accidents are outlined, in cluding a safety check list for infant beds. The cooperation of all health professionals is required to educate the public of these dangers to their infants.
A randomly selected community sample of 303 parents of 2- and 3-year-olds were interviewed about child sleep behaviors and completed the Child Behavior Checklist for Ages 2-3, a standardized rating scale for child problem behaviors. Most parents (55%) reported that the child slept in their bed at least occasionally and for at least part of the night, particularly during periods of minor stress or disruption of the family routine. The prevalence of cosleeping did not vary by the child's age or sex, but frequent cosleeping (more than once per week) was more common among nonwhite families and single-mother households. Cosleeping was not significantly related to child behavior problems, but frequent cosleepers were more likely to report sleep problems, including difficulty getting to sleep and night waking. Children who were still cosleeping frequently 1 year after the initial assessment maintained high levels of sleep problems, compared with those who stopped cosleeping and non-cosleepers. Cosleeping is common at this age and is not related to general maladjustment. However, frequent cosleeping is closely intertwined with child sleep problems.
To examine ethnic differences in postneonatal mortality and the incidence of sudden infant death in England and Wales during 1982-5 records were analysed, the mother's country of birth being used to determine ethnic group. Postneonatal mortality was highest in infants of mothers born in Pakistan (6.4/1000 live births) followed by infants of mothers born in the Caribbean (4.5) and the United Kingdom and Republic of Ireland (4.1). Crude rates were lower in infants of mothers born in India (3.9/1000), east and west Africa (3.0), and Bangladesh (2.8) than in infants of mothers born in the United Kingdom despite less favourable birth weights. Mortality ratios standardised separately for maternal age, parity, and social class were significantly higher in infants of mothers born in Pakistan and lower in those of mothers born in Bangladesh. The ratio for infants of Caribbean mothers was significantly higher when adjusted for maternal age. Ratios for infants of Indian and east African mothers did not show significant differences after standardisation. An important finding was a low incidence of sudden infant death in infants of Asian origin. This was paralleled by lower mortality from respiratory causes. During 1975-85 postneonatal mortality in all immigrant groups except Pakistanis fell to a similar or lower rate than that in the United Kingdom group; Pakistanis showed a persistent excess. During 1984-5 several immigrant groups (from the Republic of Ireland, India, west Africa, and the Caribbean) recorded an increase in postneonatal mortality. Surveillance of postneonatal mortality among ethnic communities should be continued, and research is needed to identify the causes underlying the differences.
This discussion has reviewed evidence leading to the conceptualization of an accelerated maturation hypothesis concerning the etiology of SIDS. This theory, while one of many, has several appealing consequences. First, it provides for an integration of a number of epidemiologic and pathologic findings in SIDS. Second, it accounts for the unique age distribution of SIDS. Finally, it would explain the frequently noted relationship between SIDS and such factors as upper respiratory infection and sleep deprivation or disruption. Perhaps the most appealing aspect of this hypothesis is that it should be relatively easy to examine experimentally.
The prevalence and correlates of sleeping in the parental bed among healthy children between 6 months and 4 years of age are described. One hundred fifty children were enrolled in an interview study on the basis of "well-child" care appointments in representative pediatric facilities. The sample created was similar in demographic characteristics to census data for the Cleveland area. In this cross section of families in a large US city, cosleeping was a routine and recent practice in 35% of white and 70% of black families. Cosleeping in both racial groups was associated with approaches to sleep management at bedtime that emphasized parental involvement and body contact. Specifically, cosleeping children were significantly more likely to fall asleep out of bed and to have adult company and body contact at bedtime. Among white families only, cosleeping was associated with the older child, lower level of parental education, less professional training, increased family stress, a more ambivalent maternal attitude toward the child, and disruptive sleep problems in the child.
Prior research on whether parents and children ever share a bed is scanty. Some experts have written that if parents take their frightened child into bed with them, there will be "devil to pay." Using a questionnaire, we surveyed 415 upper-middle-class parents of 576 children. We asked if, when their child awoke ill or frightened, they took the child into their bed. They commonly did. We question whether explanations that ascribe the cause of psychopathologic disorders to specific events may not be too simplistic. To date, too much attention may have been paid to the events, such as parents and children sharing a bed, are not enough has been devoted to the context, motivation, and setting in which these events occur.
Recent research suggests that body vitamin D levels are decreased in coronary heart disease and diabetes, but it is unclear which cardiovascular risk factors are related to vitamin D status.
To examine the relation between vitamin D status and major cardiovascular risk factors.
Serum 25-hydroxyvitamin D3, a marker of recent sun exposure and vitamin D status, was measured in 390 New Zealand residents (95 Pacific Islanders, 74 Maori and 221 others mostly of European descent), who were part of a larger cross-sectional survey of a workforce (n = 5677) aged 40-64 years.
Serum 25-hydroxyvitamin D3 levels were significantly lower in Pacific Islanders (mean (SE) = 56 (3) nmol/L; p = 0.0001) and Maoris (68 (3) nmol/L; p = 0.036) compared with Europeans (75 (2) nmol/L) after adjusting for age, sex and time of year. Also adjusting for ethnic group, 25-hydroxyvitamin D3 was higher in people doing vigorous (aerobic) leisure physical activities (71 (2) nmol/L; p = 0.0066) and moderate (non-aerobic) activities (68 (3) nmol/L; p = 0.12) compared with those who were inactive (63 (2) nmol/L). However, 25-hydroxyvitamin D3 was unrelated to body mass index, serum lipids, blood pressure or cigarette smoking.
People with increased skin pigmentation, such as Polynesians, and people who are inactive, have decreased body levels of vitamin D; this might partly explain their increased risk of cardiovascular disease.
Further develop New Zealand public health policy on infant bed sharing by quantifying the number of sudden infant death syndrome (SIDS) cases attributable to bed sharing among infants of smoking and nonsmoking mothers.
A large nation-wide case control study covering a region with 78% of all births in New Zealand during 1987-90. Interviews were completed with parents of 393 (81.0% of total) cases who died from the sudden infant death syndrome in the postneonatal age group, and 1592 (88.4% of total) controls who were a representative sample of all hospital births in the study region.
The proportion of control infants who usually bed shared in the last 2 weeks was 65.7% in Maori, 73.7% in Pacific Island people and 35.5% in Europeans (44.5% in all ethnic groups combined, and half of these for less than 2 hours per night). There was an interaction between maternal smoking and infant bed sharing on the risk of sudden infant death separately in Maori, Pacific Island and European infants with the risk being highest in infants exposed to both risk factors. 26% of SIDS deaths were explained by bed sharing among infants of smoking mothers (who comprised 16% of the total infant population) and 3% by bed sharing among infants of non-smoking mothers (28% of total infant population).
Infant bed sharing is common. The majority of SIDS deaths that are attributed to be sharing occur among infants of smoking mothers. A policy which advises all infants not to bed share is estimated to potentially save an extra 3% of SIDS compared to a policy targeted only on infants of smoking mothers. If public attitudes are favorable to bed sharing, there could be a marginal cost (against its acceptance) by including infants of non-smoking mothers in the recommendation not to bed share. These findings should not be interpreted as indicating that bed sharing where the mother is a nonsmoker is safe or protective against SIDS.