The new baby sleep advice

The Public Health Agency of Canada’s new suggestion for preventing SIDS has parents tossing and turning for no good reason

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I’ve seen some wacky parenting advice in my time. But recently I came across one of the oddest and least practical suggestions ever: To prevent sudden infant death syndrome (SIDS), parents should sleep on a mattress on the floor of their baby’s room. That, in effect, is one of the strategies the Public Health Agency of Canada (PHAC) is saying parents should consider in a new brochure called Safe Sleep for Your Baby.

To be fair, this tidbit is only one small part of the PHAC’s largely excellent brochure designed to prevent SIDS. Constructing sound advice for “safe sleep,” as authorities call it, is tricky because while research has uncovered numerous risk factors for SIDS, the science doesn’t always translate into simple safety rules that make sense for all families.

Why is the PHAC suggesting parents sleep on a mattress in their baby’s room? That originates with research showing that babies who die in their sleep are less likely than average to have been in the same room as their parents.
I’ve read those studies, along with a lot of other research, and had many conversations with SIDS researchers. I can tell you with certainty that the research on room sharing is nowhere near as compelling as the evidence showing that SIDS risk is dramatically reduced by placing a baby on her back for sleep and by not smoking around the baby.

The science about room sharing is not yet clear enough to be a basis for advice that includes “putting a mattress next to his or her crib in your baby’s room” as a way to room-share. Ironically, I credit the PHAC for trying to be flexible here. The agency seems to understand that many parents (29 out of 47 in my own little poll) have bedrooms too small for a crib. Even if you can fit a baby bassinet in your room, as many parents do for the first few months, most babies grow out of it well before six months. In my poll, two-thirds of the kids had outgrown the bassinet by four months. Two months is a long time to sleep on a mattress when you’ve got a perfectly nice bed to sleep in.

And you know what? All this room-sharing advice is really meant to steer parents away from bed sharing — sleeping with baby in the same bed. Authorities have decided that they have to say all bed sharing is dangerous, even though it’s crystal clear that it’s really only risky in certain circumstances: when there is smoking or drug or alcohol use, when bed sharing occurs on a couch or in a disorganized, crowded or too-soft bed and, sadly, if the household is socio-economically deprived. But they think that’s too complicated to explain to parents (I disagree). So they offer room sharing, including camping out on a mattress in the baby’s room, as a sort of compromise.

It’s not a good one because it will create anxiety.

Recently, I spoke with a mom-to-be who had read Safe Sleep for Your Baby online and was in knots because she knows the crib won’t fit in her bedroom and she’s not keen on the mattress-on-the-floor thing. Not good.

Good worry is worry about things you have some control over — like traffic safety. But making parents worry about things they have little control over like the size of their bedrooms (or that they prefer to sleep in their actual bed) is bad worry. We underestimate the negative impact of parental worry at our peril. Many think today’s parents are overly uptight and protective. Well, keep giving them advice like this and let’s see just how neurotic they get.

Health promoters should give directions only when the science is clear. In areas where it isn’t clear, they should just keep mum. No advice at all is better than bad advice.