Breastfeeding and mother-infant sleep proximity: implications for infant care

Abstract

Research into mother–infant cosleeping with breastfeeding represents a relatively new area for behavioral and physiological investigation inspired by evolutionary thinking. This topic within the evolutionary medicine rubric might well be the furthest along in terms of how much of the data produced by laboratory and in-home field studies is regularly incorporated into medical discourse and public policy, as this chapter by Ball and Klingaman describes. Diverse theoretical and empirical data are used to better understand the ongoing debate in Western industrialized countries concerning where babies should sleep and how and where nighttime infant feedings should occur. According to the dominant Western medical paradigm, infants belong in their own space for sleeping, and only if awake should the mother bring a baby to bed to breastfeed— and then neither can fall asleep until they are back in their proper arrangements. A sleeping mother constitutes a direct threat to the safety of her infant, this view claims. Ball and Klingaman point out, however, that it is only among economically deprived cultural subgroups (where breastfeeding is rare) and where bed sharing is practiced in a dangerous manner are infant deaths statistically overrepresented. In addition, the authors describe how and why more optimal breastfeeding depends on close sensory mother–infant contact during both the night and day. And, as their review reveals, many mother–infant bed-sharing studies suggest that the mother’s body regulates the infant’s physiology in many beneficial ways. In turn, the infant’s increased breastfeeding frequency, stimulated by maternal proximity, induces positive changes in the mother’s uterus while sustaining, if not improving, her milk supply. The ease of breastfeeding with bed sharing also tends to increase the duration that mothers breastfeed. To sleep or not to sleep with baby, then, represents a quintessential anthropological practice that is articulated by Ball and Klingaman’s evidence-based and evolutionary based discussion.