Co-sleeping prolongs breast-feeding but safety a concern, study says

Two new studies, both released Monday, offer additional evidence -- if any were really needed -- that breast-feeding can be really, really difficult for mothers.

In one analysis, published in the journal Pediatrics, researchers interviewed first-time mothers at the UC Davis Medical Center to assess their breast-feeding practices, concerns and problems before they gave birth and on several occasions over the first two months of their babies' lives.  They found that 92% of mothers reported breast-feeding concerns at the peak time of difficulty (their child's third day of life) -- including problems feeding, concerns about milk supply, concerns about their ability to breast-feed and pain. 

Women who reported problems were less likely to continue breast-feeding than those who didn't, so the authors recommended that all newborns be evaluated by a lactation expert.

The second study, in JAMA Pediatrics, examined the relationship between bed-sharing and breast-feeding -- a controversial subject, because research has linked bed-sharing to increased risk of sudden infant death syndrome and suffocation. 

The research team examined data from a study called the Infant Feeding Practices Study II, which surveyed several thousand women around the U.S., ages 18 or older, who gave birth to healthy singleton babies.  The mothers answered one questionnaire before they had their babies and 10  follow-up questionnaires over the following year -- which examined feeding and sleeping practices.

Compiling the results, the researchers found that babies who slept on the same "sleeping surfaces" as their mothers tended to breast-feed longer than those who did not.  The "durations of any and exclusive breastfeeding were longest in the often bedsharing group, and shortest in the rare and non-feeding groups." (Babies who slept in infant co-sleepers, which attach to the side of a parent's bed, were not considered to be bed-sharing.)

In this study, as in the Pediatrics report, around 90% of mothers interviewed said they had breast-feeding problems in the period immediately after childbirth. But even though bed-sharing may mitigate some of those problems, the study's authors warned that the benefits of the practice "must be tempered by the known safety risks associated with infant-parent bedsharing" and that there were other factors also associated with breast-feeding success, such as older maternal age and higher education.

"We are supportive of the recommendations to place infants to sleep in a separate but proximate location rather than sleeping in the same bed," they wrote.

But they also noted that the study did not examine whether separate-but-proximate sleeping arrangements, such as co-sleepers or placing a crib in the parents' bedroom, promote breast-feeding as successfully as bed-sharing does.

They called for new research to help find out. In the meantime, new mothers' feeding struggles are likely to continue.

The U.S. Centers for Disease Control offers information about breast-feeding.

The American Academy of Pediatrics (publisher of the journal Pediatrics) also offers a breastfeeding webpage, and a policy on bedsharing.

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