Friday, June 11, 2010

How to cosleep safely: A tutorial in pictures

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I decided to take the Attachment Parenting principle of "Ensure Safe Sleep" literally and do a little presentation of exactly how we cosleep safely, and have since Mikko was born three years ago.

Now, other attachment parents choose different sleep setups — see Amber Strocel's excellent and picture-filled guest post on "Flexibility and finding sleep" for a rundown of some of the most common options — so this post isn't meant to be prescriptive but rather to spark ideas for how you might put together a safe cosleeping environment that works for you. We have chosen to share one family bed for the three of us, and this is how we've managed it successfully.

How to cosleep safely: A tutorial in pictures = Hobo Mama

I'm going to start with making the mama comfortable, because there's no point being miserable while you cosleep! I like to use three pillows (count 'em!), down for safety reasons from the five pillows I used to support my aching bulk during pregnancy. I put one pillow under my head, one behind my back, and one between my knees. Here's a little more on each:

  • Head pillow: Some cosleepers swear off all pillows at head level due to smothering concerns. I am a very stationary sleeper, and I keep my pillow tucked behind my head as I sleep and rest my cheek on the very corner (or did when Mikko was a newborn, at least; I'm not worried anymore now that he's a very sturdy 3). I also keep one arm up that by default holds the pillow in place. It's up to you whether you feel comfortable using a head pillow, but if you do, some simple precautions like that are wise.
  • Back pillow: I sleep on my side so I can nurse lying down. I give my back some support by really wedging a pillow into the small of my back. Not gently — shove it on down there! I use a regular bed pillow, but other mamas find a firmer or different shaped pillow works better for them; you can try out sofa cushions and bolsters and other decorative pillows and see. I need the pillow to stay put — I found out from hotel travel that it otherwise doesn't unless I have something firm behind it to push against. In my case, it's a trunk that doubles as my nightstand. For you, it might be a wall or other furniture.
  • Knee pillow: I use a folded-up body pillow, because that's what I have. I think a regular bed pillow would work just the same, or a specialty knee pillow might be even cozier. (I've coveted them a time or two!) The reason for a knee pillow is it better aligns your hips, to help keep both your back and your hips from aching. At first I used to not like having my knees separated, but I'm so used to it now that when I don't have the pillow between them all I can feel is knobbiness, and my hips immediately protest!
As long as you keep the back pillow behind your back (including switching sides with it if you do the same with your nursing baby; I just lean over farther to change breasts), neither the back pillow nor the knee pillow should pose a safety risk. What they will do is let you nurse and sleep comfortably!

All right, besides the pillows, you can see the brown text that shows where the baby would go. I forgot to put down the wool puddle pad blanket we used when Mikko was still doing elimination communication and cloth diapering, and I'm not retaking the picture, so too bad. I also forgot to airbrush out my fabulous Pirate's Booty temporary tattoo on my hand, so there's that.

But, anyway, the wool blanket we have is soft and thin organic merino wool and will help protect your sheets from leaks of breastmilk or accidental pees if you keep it well lanolized. If you get the baby/crib size blanket, it can lie flat underneath you and your baby, so your weight can help keep it in place. I never saw our wool blanket shift on our flannel sheets in any way that would put it dangerously close to our baby's face.

When the baby is breastfeeding, the head will be even with your breasts, but I found that Mikko liked to push up afterward and sleep closer to the top of the mattress. For that reason, make sure there are no gaps between your mattress and the wall or headboard. I actually do see one in this picture, which shows you how cavalier we can be now we have a preschooler in bed instead of a newborn! But you should do as I say and not as I do and all that.

How to cosleep safely: A tutorial in pictures = Hobo Mama

Here I am pretending to sleep. Why? I have no idea.

And here's the part where I read the captions to you.

If you have long hair, tie your hair back in a braid or ponytail. There's otherwise a small risk of strangling your baby with your own hair. (I mean, seriously, could Edgar Allan Poe devise anything more horrifying?)

Pull the blankets up so that they come up roughly to your waist or chest, and the same on your baby. Keep them below armpit level on your baby in any case. Often, Mikko had no blankets on him (by choice), but he has always been a very warm little guy.

In the picture, I'm safely using just a thin sheet. In real life (ahem), I use a feather duvet. I leave that to your discretion. I usually pulled the duvet over just me, and used a smaller and lighter baby blanket to cover Mikko's legs.

To keep my upper body warm, I wear a long-sleeve button-down pajama shirt — flannel men's shirt in the winter, and thinner cotton ladies' one in the summer. (Yes, it's still sorta winter here. I live in Seattle.)

Keep in mind that cosleeping babies don't need to be as bundled as solitary-sleeping ones. To keep a cosleeping baby warm, we found that in the summer only a t-shirt and diaper were necessary. In the winter, we go with a long-sleeve close-fitting t-shirt, and long pajama pants now that he's potty trained. Before that, we just kept him in a diaper or nakey-butt to make nighttime pottying or changing easier on our groggy selves. You can use BabyLegs or similar to keep warm any little legs that regularly kick the blankets off.

Speaking of grogginess, I can't be bothered with fancy-schmancey nursing nightwear with holes and clasps. Under my opened button-down shirt, I wear a stretchy camisole with shelf bra, the kind you buy in three-packs at Costco. Through experience, I've found it's more comfortable on my shoulder to take down the strap that's on the bottom arm before I go to sleep so it doesn't dig in. Then, throughout the night, as Mikko rolls over to nurse, I just slide one or the other breast out the top of the cami's neckline. Easy as pie! In the days I was leaking, the slight pressure of the cami, plus the dual layers of the shelf bra it contains, was enough to contain most breastmilk leakage.

Pants for the mother are optional. I just had to say it. (ETA: I do tuck any drawstrings into the waistband, so that they're not a choking hazard.)

Here's something you can't really see from the picture, but we have a king-size mattress set directly on the floor, no boxspring or bedframe. Behind my back, I have this awesome foam bed rail from Because it goes underneath the fitted bottom sheet, I feel it's safer than a traditional bed rail because there are no gaps for a baby to roll against and perhaps get caught in and suffocate. I put that at the foot of the trunk behind my back to afford a little more roll-off protection on that side.

However, from the time I got down side-lying nursing, I've kept Mikko comfortably ensconced between Sam and me in the middle, so there's no rolling off to contend with. For absolute safety, I've heard not to let babies sleep next to partners, other non-mama adults (babysitters, grandparents, etc.), or other children; while I agree with keeping fragile babies separate from toddlers who sleep like butterflies, I think the decision on whether your partner is a safe cosleeping companion is something the two of you have to consider for yourselves. My father, for instance, routinely acts out violence in his sleep (there are many mostly funny family stories about his sleepwalking exploits); I would never recommend that a non-mother who sleepwalks, acts out dreams, or rolls around vigorously be placed next to a vulnerable baby. (Breastfeeding mothers, on the other hand, have protective instincts activated through breastfeeding and can cosleep safely, assuming they're not under the influence of any arousal-affecting drugs or medications.)

With Sam, on the other hand, I had no reason, over our nine years of marriage thus far, to suspect him of nocturnal turbulence. He sleeps on the very far side of the bed and stays there the whole night. (Doesn't that sound romantic! Truthfully, before cosleeping, we used to snuggle for the first half-hour or so and then part ways to actually sleep.)

To be absolutely certain, we bought the king-size mattress so that there are literally feet of room between us, and Mikko as a baby stayed nice and squished up on my side of the bed. Sam's pillows and blankets were far away, though I would always make sure of that fact before and during the night.

Another crucial way to ensure safe sleeping with a partner is to make sure your partner is aware of the baby's presence in bed and takes equal responsibility for the baby's safety. Don't bring the baby in while your partner's asleep, for instance; make sure both of your are conscious of the newborn in bed if your partner is near enough to roll over or fling a blanket that direction.

So that's what I've got! This is the way we've been able to cosleep safely. I look forward to redesigning our sleep situation if and when we decide to add another newborn to the mix

How to cosleep safely: A tutorial in pictures = Hobo Mama

Here my 3-year-old decides to "help" me with my tutorial

How to cosleep safely: A tutorial in pictures = Hobo Mama

… and settles in for a snack. To get more sleep, also enjoy my pictorial on how to do side-lying nursing!

A big thanks to the patient Sam for being our photographer, and to our building's window cleaners who let in so much more natural light today!

For more on the benefits of cosleeping, read my winning essay on why I love cosleeping so much. And check back for more great cosleeping articles when the API carnival posts!

What type of cosleeping or other sleeping arrangements have worked for you? Any tips to share?

How to cosleep safely: A tutorial in pictures == Hobo Mama

Safety Disclaimer: I am not a health or safety professional.
In sharing how we do things in our family, I am not trying to suggest
bed sharing is right for you. Please consider the safety issues,
and take all precautions when considering where your children will
sleep. Most government agencies and health professionals warn against
bed sharing with infants, particularly under six months.
You need to consider this decision carefully and make a choice you can
own. Don't rest your children's well-being on any one blog post, even mine.


Dionna @ Code Name: Mama said...

Awesome!! Those pillows are incredibly important. When Kieran was little I had 3 pillows, one under my head and 1 on either side of my body. So the one behind me supports my back, and the one in front of me supported/protected Kieran. Now it doesn't protect as much (we need more protection from his toddler flailing ;)).
p.s. I totally think you should have kept the tats ;)

TopHat said...

I didn't know about the whole "babies could overheat" thing- and then when I went to nurse my daughter on the second night of her life, I found her burning up in her PJs right next to me! I immediately took all her clothes off except the diaper and she's been naked in bed ever since (she's 26 months now). She has always been very sensitive to heat and we've never put her in pajamas since because of it. Actually, lately, she refuses to wear diapers, too. We're glad she stays dry at night!

My parents got her pajamas for Christmas this year and she thinks they are regular clothes because she's never worn pajamas!

Jake Aryeh Marcus said...

Seriously cute pix! I never had a need for all those pillows so for some, you can do with less.

Can't overstate how much better every one sleeps once you get the hang of side lying nursing. And what I called "the flop over" which is nursing with the higher up breast. You can nurse all night without really waking up fully. I worry about sleepy parents feeding in rocking chairs and falling asleep with babies in their arms.

Amber said...

I wish this tutorial was around when I started co-sleeping. I was so incredibly uncomfortable doing the actual nursing and then finding a way to sleep right after that.

I woke up with sooo many neck cramps. Actually... I still do from time to time. What can I say; I'm a delicate flower (just kidding)

What we did after much trial and error is kick dada out of the bed (sorry, dada) and put two king pillows on either side. Then when we would switch sides, I would always get to have a pillow to support my back and he would not be able to roll off the bed.

Another great use for a pillow was when I had my gallbladder taken out. His foot was perfectly positioned to kick my belly button - right where the incision was! So for a few weeks I literally slept with a thin pillow between me and him, waist down. By then he was already 2 so the "no pillows near him" wasn't a big deal.

Unknown said...

Adorable - love the pictures! I think it's especially cute that at 3yo Mikko breastfeeds in the same position as Ella (who's 7mo)...except Ella likes to put her feet up over my legs :) Great tutorial - we essentially sleep the same way (and we have always felt comfortable with her between my husband and I in bed).

Kristin @ Intrepid Murmurings said...

Great post! There are so many details that I think sometimes keep people from feeling comfortable cosleeping but it is SO worth it, both to cosleep and to assure you are doing it safely so you can relax and not worry.

Love your essay, that was great.

Side-lying nursing saved my sanity with my oldest. When my twins came along, I could not figure out what I was going to do! Eventually I slept with them literally on top of me, with a few pillow props to keep us all comfortable and stable. Sounds crazy, but it was TOTALLY worth it to be able to lie down and sleep while they were nursing and sleeping too. I was absolutely aware of them, and also totally relaxed and able to sleep. Sadly, I don't have any pics, despite it being the way the three of us spent much of the night for at least 4 months...

Momma Jorje said...

So long as Sasha is in contact with me, I am very aware of her stirring while I sleep. This is how we pull off her sleeping naked in bed with me (no diaper!). I have found that I can't sleep naked because if she can latch on without me really waking, I'll sleep through it til she wets our bed.

However, she has been known to sit up and change direction in her sleep, so I have to keep a pillow above her head and a pillow or wadded blanket at her feet. She crawls in her sleep, too!

Momma Jorje said...

Oh! With my older daughter, we slept on a queen size mattress and box springs on the floor (same now). We got a toddler bed, removed one rail, and pinned it between our bed and the wall. This was after newborn stage! This way, I was able to roll into her bed to nurse, then roll back to sleep comfortably.

A toddler bed turns out to be the same height as a queen set on the floor. :-)

Inder-ific said...

I love this post!! The pictures are awesome! Also, that is EXACTLY how Joe and I sleep, down to the slightest detail (including the button down men's PJ top, but not including the camisole strap trick, which is smart). I do switch sides a couple times a night though - I never figured out the whole nurse on the top boob trick. Maybe it's not too late ...

Love it!

Michelle @ The Parent Vortex said...

Great tutorial! Don't know why I never thought of using a men's flannel shirt to stay warm, but it's a great idea. I tend to wear an old ratty sweatshirt in the winter, but it gets all bunched up under my armpits. Even after co-sleeping with two babies there are new things to learn. :) thanks!

Kristina said...

I've been co-sleeping for 6 yrs (2 babies) and it seems I've been doing it all wrong!! I never had more than 1 pillow. Ha! So much to learn.

Jenna said...

Awesome pictures. I wish I had learned of the joys of cosleeping when I had an itty bitty one. We also use no boxsping or frame. A good chunk of our son's infancy he was either in the hospital or hooked up to too much stuff (lines, oxygen, feeds, etc) to get into our bed.
Then between 12 and 24 months or so he slept on his crib mattress on the floor next to our mattress and since he's gotten his own room, he now goes to sleep in his big boy bed then wakes up at 2 am every night and crawls in with us. Since he's almost 3 I really don't think about safety precautions but this would be very useful ideas for a baby!

Melodie said...

I never used all those pillows because I need to feel a little more free but this is an awesome post.

Unknown said...

I love co-sleeping with my baby. It's funny with my first I said I never would, and he ended up being colic and co-sleeping was the only way we survived.

BTW you might want to check out my blog (the giveaway winners page ;)

Lauren Wayne said...

It looks like we're divided on the pillows thing. :) I have a bad back anyway, and pregnancy did a number on my hips; they still haven't healed. So I would say: If you're waking up all achy from cosleeping, try some extra pillows. If not, you don't need them!

Dionna: Love that you use a pillow for protection! If only I could have one in front of my face for when Mikko turns completely upside down in bed and kicks me in the head!

TopHat: Totally! Both Mikko and Sam are like little furnaces, always warm. Sam's brother's always so hot that he cut the sleeves off all his shirts, seriously. And he lives in Michigan. It sounds like your daughter just needs the cool breezes! :)

Jake: All right, I might have to call it "the flop over," because that's totally what I do, too. So much easier than switching sides! And, yes, side-lying nursing is so much safer and easier than getting up to feed. I was very happy when I got the hang of it.

Amber: I also am a delicate flower! :) I like your pillow ideas (ouch about your gallbladder incision!).

Andrea!!!: I also love seeing you comment around town, because I can scream your name in my head. It just looks so exciting. Mikko varies between legs up and down, so they're even more alike! It's funny to try to fit those long legs in somewhere.

Kristin: I am going to have to quote you on how to nurse lying down with twins. I've nursed semi-reclining with Mikko on top of me when he's been congested, because it's really helped him breathe better, so I can see how that would work and be stable for two. Yea!

Momma Jorje: Very cool how so many of you can sleep with naked babies! I love EC combined with cosleeping. Your ambulatory baby sounds like my dad. ;) I love the extra sidecarred bed idea; I'd heard of it before with a crib, but a toddler bed next to a queen mattress & box springs — perfect, too!

inder: I knew we were soulmates! :) You should totally try the top boob thing. It might depend partially on breast size (mine are big, i.e.), but I think any size could do it if you just pitch forward to whatever angle works best.

Michelle: I tried different nursing pjs and nightgowns and non-button-down shirts before figuring out this worked the best. As you said, with a regular (closed-front) shirt, you have to pull it either up or down, and it tends to get bunched and uncomfortable. With nursing openings, I was spending too much time fiddling with them. And nightgowns were a horror show; I'd wake up absolutely soaked from leaking milk! But that might be just me...

Kristina: Ha! If you've been doing it for 6 years, I imagine you're doing it just right. Maybe you could write us a tutorial!

Jenna: Poor baby! I'm glad he's got his cozy routine worked out now, and nice that you get a little time alone and then a snuggly little guy joining you. Sounds like the best of both worlds!

Melodie: You keep being free. :)

Shairbearg: Totally! And, I KNOW! I'm so excited I WON! I will get back to you soon soon. :)

Joy@WDDCH said...

We cosleep and it truly has been safe and a godsend. While other moms are freaking out over their child's "sleep schedule" or yawning into their coffee mug I'm pretty chipper and well-rested.

I pretty much do similar things to you!

Frantic Holly said...

What an awesome tutorial! I so needed something like this when our son was little. He only sleeps with us now when DH is working.

Holly Mayer said...

Thanks for the tutorial! I tried to co sleep with my daughter (now 2.5) but she was a wiggler from day one. I mean all over rolling and twitching. I could never sleep so she moved to her own space for sleeping. Also we never figured out nursing lying down.
I hope with this next one due in about 6 weeks we will have a nice calm boy who will nurse lying down.

BeanMa said...

Hobo Mom! I love your blog. I love this post! I have so much catch-up reading to do here.

I don't even put a blanket on my daughter's waist. She gets cold ... but I tend to let her wear a sweater rather than deal with blankets.

Lauren Wayne said...

Holly: If you have another wiggler but want to try cosleeping again, you might benefit from a side-car arrangement. E.g., take the side off a crib and push it up against your bed, or push a toddler bed without one rail against a mattress and box springs as Jorje said. (Experiment to see what height works best; you want no gaps or changes in elevation between mattresses.) Something like this:

Then your baby has a place to lie separately and kick and roll at will, and you can pull him over to feed, but then put him back over into the crib/toddler bed to sleep. But I would definitely try the side-lying nursing! So much easier than sitting up. (Lol — I sound lazy!) I'll be writing a separate tutorial for that soon.

Olivia said...

I wish I had read this when I was still pregnant. We still figured it out eventually. Side-lying nursing is truly my favorite postion, lol. I sleep in a button down night shirt and add a zippered sweatshirt if I need extra warmth.

I still turn over to switch sides because I'm usually in need of a different position. When she was a newborn I would lay her on a receiveing blanket and when it came time to switch sides I would sit up on my knees and slide her over using the blanket; now I roll her over ;)

Joy@WDDCH said...

Holly- my second daughter (I have three girls!) didn't cosleep with us. Each baby is unique and different. She was so independent (still is) and loved sleeping in her own space. Maybe your next will be more into it!

copperdo1022 said...

love the flop over :) I can't do it when they are super tiny but once they get to be at least 4-6 weeks, no more moving around to switch it!

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