Last week, I broached the topic of co-sleeping . The reception was almost unanimously positive, with plenty of you chiming in with your own c0-sleeping success stories. Before you toss the crib, however, realize that co-sleeping isn’t as simple as flopping down in bed with your baby and drifting off to sleep. Co-sleeping is a healthy, effective, and arguably “natural” way to raise independent children, but it must be done safely. Remember those studies I cited last week where co-sleeping was associated with infant deaths? Yeah, when co-sleeping is done poorly or incorrectly or unsafely, it becomes an effective way to harm children. Sadly, most parents no longer have access to the “village,” that treasure trove of knowledge full of parents and grandparents and aunts and uncles and infinite cousins with parenting advice for days, so we read books, and articles, and magazines, and blogs for tips and knowledge. These aren’t the same, sure, but they are helpful in their own way. Certainly better than left to fend for ourselves.
So, how does one co-sleep safely?
First off, let’s go over what not to do. Let’s identify unsafe co-sleeping. It may sound like a lot of don’ts, but c’mon – these are our kids!
Do not smoke, drink, or use drugs that affect judgment and awareness (prescription, illegal, or over the counter – think Tylenol PM), especially before bed.
Overlaying (where a sleeping parent absentmindedly rolls over onto the child) is a rare occurrence that pretty much only happens when the parent is too messed up to wake up and realize they’ve just rolled over onto a small human. A sober, alert parent will wake up if it ever happens. Heck, I sometimes have to hide the ball from Buddha (my lab) in bed at night to keep him from pestering me to toss it, and if I roll over onto it, I wake up in a flash. A huge part of the benefit of co-sleeping is the increased awareness of the baby’s position and status, but being inebriated removes that entirely.
Avoid tobacco altogether.
You know how when a smoker comes into the room, you know it just from sniffing? That smell only lingers because the smoke itself – with all the tars and toxins – lingers on the clothes, in the hair, and on the skin of the person who smokes. Now imagine how much of that smoke the baby will be ingesting, and just how little smoke is needed to hurt the little thing. This goes for mom, dad, and, you know what? Just make the entire house smoke-free and don’t let people smoke around the baby. They’re a lot more sensitive to the stuff than we are.
Don’t let babies sleep next to other children or pets.
As sensitive as your dog is, there’s a good chance he’ll think nothing of walking all over this strange new creature in the night, scratching its tender feet, or laying a fluffy tail across its nasal passageway. Toddlers, who are even less thoughtful than dogs and have opposable thumbs, are probably even worse.
Do not co-sleep on the couch, sofa, loveseat, or recliner.
Couches are plush and cushy, and they have cushions that infant heads slip between all too easily. They’re elevated off the ground and relatively narrow, meaning the baby can easily fall off and crack something. I’ll make an allowance for rickety wooden rocking chairs, but avoid doing so in a room full of cats.
Be careful with very small, very young infants.
By virtue of their diminutive size, very small infants are more susceptible to being smothered, crushed, or otherwise roughly manhandled. Plus, if this is your first kid, or your first attempt at co-sleeping, you’re already going to be nervous about what to do and how to do it and likely sleep-deprived . Consider room-sharing for the first few weeks to months, where the baby sleeps in an adjoining cot or mattress. You can still reach out and touch those cute puffy cheeks, but you won’t worry about making any catastrophic mistakes.
Don’t co-sleep if you’re a heavy sleeper, are excessively sleep deprived, are obese (disregard if you’re a bodybuilder with obese BMI; just cool it on the pec popping) and/or have sleep apnea.
These conditions will all reduce one’s ability to stay apprised of what’s going on in the bed. You need to be sensitive to your child if you’re going to share the bed safely. They may also make any mistakes made all the more damaging. If you’re severely sleep deprived – which will happen fairly often – consider keeping an adjoining cot/bed/crib in the room next to your bed so that you can still room share when necessary.
Don’t use thick bedding.
Huge frothy comforters full of imitation goose down are unnecessary for most people and downright dangerous (suffocation, smothering, overheating risk) for young babies. Even normal pillows and blankets can be excessive for infants; consider that most crib babies are bedded down with minimal bedding, a sheet or light blanket at most. That’s kinda what the adult co-sleeping bed should look like, too.
Don’t use overly soft mattresses.
Don’t use anything that you or the baby can “sink” into, like beanbag mattresses or those really soft beds that some people seem to like. Water beds are out, obviously, and not just because it’s no longer the 1980s.
Don’t co-sleep if not everyone is onboard.
Co-sleeping is a family event. Both mom and dad need to be up for it for it to work. If there’s major anxiety  about the method, I have to think it’s going to manifest as poor sleep (or worse).
Keep the bed low, preferably on the floor.
Make sure the bed is as low as you can manage it. This will make any falls less catastrophic, and as a bonus, it will force you to do more “floor living.” Those with carpeting can get away with higher beds, while those with hardwood flooring are advised to go a bit lower.
Use a firm mattress.
There should be minimal “give” to the sleeping  surface. This will reduce the chance of suffocation.
Use a tight-fitting sheet.
Make sure the sheet fits well, without bunching up. Bunched up sheets can be a choking or suffocation hazard.
Studies show that breast feeding makes for safe co-sleeping, while bottle feeding is associated with SIDS. According to James McKenna, the “breast feeding-bedsharing landscape is highly differentiated from the bottle feeding-bedsharing landscape.” (PDF ) In his clinical experience, “breast feeding mothers typically keep their babies away from pillows, position their infants on their backs, placing them below their shoulders, while raising their arms above them,” and they “lay on their sides… in ways that can prevent accidental overlays.”
Put the kid next to mom, not wedged in between mom and dad.
By virtue of not having given birth, the dad is going to be less “connected” to the baby and possibly less aware during the night. Plus, a big advantage of co-sleeping is the ease of breast feeding, and you don’t want your baby getting confused in the middle of the night, reaching for the wrong breast, and ending up with a mouthful of hairy man nipple (although that would definitely establish a connection between father and child).
Place your baby on its back to sleep.
Sleeping in the supine position (on its back) is the safest way for a baby to sleep and reduces the risk of SIDS .
Eliminate any crevasses that the baby could fall into.
If the bed is up against a wall or headboard, make sure it is flush against the surface – no cracks or openings. Some people even pull their bed away from the wall to eliminate the possibility of getting stuck between the bed and the wall. If you can’t eliminate the crevasses, consider pulling the bed away from the wall. Products like these  are also helpful for preventing falls or crevasse wedging.
Get a bigger bed.
When it comes to co-sleeping, bigger is usually better, particularly when you start introducing multiple co-sleepers.
Pay close attention to the list of don’ts up above.
Don’t do the don’ts.
I’d highly recommend picking up a copy of James McKenna’s book on the subject, Sleeping With Your Baby: A Parent’s Guide to Cosleeping . It’s under $10, it’s a quick read, and it’s written by the premier expert.
And whatever happens, don’t feel like you have to co-sleep. Try room sharing, perhaps, which offers most of the same benefits as bed sharing. Convert cribs into side-cars  that sit alongside the adult bed, thereby making it bigger. Just do what works for you and your family.
Now let’s hear from you guys. Co-sleepers: how did you do it? What did you learn? What didn’t you do? How did you determine co-sleeping was right for you? Everyone else: what made you choose the methods you chose? Let’s get a good discussion going. Let’s get our own village established.