Maggie Cain had no intention of sharing a bed with her 1-month-old son until his constant wailing caused many sleepless nights in the household.
Cain, 34, of Glendale, Minn., quickly learned that the only way to console her son, Gabriel Stillmank, was to take him out of his side-car sleeper and bring him to bed with her. Once in the bed, he would quickly calm down and fall back asleep.
"He clearly wanted to be with me," she said.
Within a few weeks, both mom and baby were sleeping better at night. And though Cain originally feared sleeping through Gabriel's cries, she said the pair usually roused at about the same time.
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Gabriel is now a healthy 10-month-old who loves to laugh and smile. Cain says he still cries, but much more infrequently and just when he needs something. However, he's still sleeping in the bed with his parents, a practice that is frowned upon by many health care professionals and organizations.
Though many experts say bed-sharing with an infant is a risk factor for sudden infant death syndrome, or SIDS, Cain and others say it's a means to create and maintain a natural bond between the mom and infant, particularly if the mother is breastfeeding.
"I co-sleep because I want him to trust that I'm going to be there for him, taking care of him, all the time, (and know) he'll never be alone," she said. "That's very important to me."
Earlier this month, the Milwaukee Health Department reported that 18 infants younger than 1 died between December and May and that an unsafe sleeping environment might have been a contributing factor. Of the 18 cases, 16 infants were co-sleeping with an adult or a sibling at the time of death, the agency reported. Last year, there were nine deaths related to unsafe sleep environments during the same period.
Essentially, it all boils down to one question: Is there a safe way to sleep with a baby?
"Sleeping near the mother for breastfeeding is natural and intended," said James McKenna, director of the Mother-Baby Behavioral Sleep Laboratory at the University of Notre Dame. "But there may be a problem with how it's being practiced.
"I support the choice of parents to sleep safely with their infants, but I don't recommend that mothers not breastfeeding bring their babies to bed to sleep," he said.
Milwaukee Health Commissioner Bevan Baker says babies should have their own place to sleep.
"We understand that having a baby close by is important to a mom or dad, but having a baby in a separate but nearby place such as a cradle, bassinette or crib is what we advise," he said. Predictably, some parents disagree.
"It's the baby's choice," said parent Tiffany Woodson. "Parents know their babies, and they decide on their own what to do."
Woodson bought a bassinette before her baby was born because she wanted her son to sleep safely. She placed it beside her bed and makes sure that her son, Kenneth Neal, is placed on his back each night.
"His bed is his bed, and my bed is my bed," said Woodson, 20, of Milwaukee. "He needs his own space just like I need mine."
But lately the 2-month-old has wanted to come to bed with her. Reluctantly, Woodson says, she shares her bed to keep him quiet through the night.
"But I'd rather have him in his bassinette," she said.
SIDS claims the lives of about 2,500 infants each year, according to the American SIDS Institute. SIDS refers to deaths that remain unexplained after all known causes have been ruled out through autopsy, investigation and medical history.
According to the National Institute of Child Health and Human Development, the national SIDS rate has fallen almost 50 percent since the launch of the Back to Sleep campaign in 1994, which urges parents to put their infants to sleep on their backs. Parents also have been told to remove all soft bedding from the crib and, in 2005, the American Academy of Pediatrics released new guidelines saying that babies should always sleep alone.
"Infants may be brought into bed for nursing or comforting but should be returned to their own crib or bassinette when the parent is ready to return to sleep," the agency advises.
Patricia McManus, executive director of the Black Health Coalition of Wisconsin, said that just because a baby is in bed with an adult doesn't mean that the sleeping environment is unsafe.
"People have defined it as a risk factor, and I don't dispute this," she said. "But unless there's direct asphyxiation, then you can't blame it on co-sleeping."
McManus and the Black Health Coalition are part of Milwaukee's Pediatric Death Review team and work with women and infants through their Milwaukee Healthy Beginnings Project.
However, it's not a given that all moms who breastfeed will provide a safe sleeping environment for their infants, said Laura Reno, director of public relations for First Candle/SIDS Alliance, a non-profit infant health organization based in Baltimore.
"When it comes down to it, there isn't any parent who wants to take any risk that could kill their baby," she said. "To us, there is no such thing as safe co-sleeping because it doesn't work for all babies."
Reno said that while researchers have found that babies who die of SIDS have an underlying abnormality in the part of the brain stem that controls heart rate, respiration and other body regulations, there are still stressors that cause some babies to be at higher risk than others.
A 2003 survey sponsored by the National Institute of Child Health and Human Development found that bed-sharing increased from 5.5 percent to 12.8 percent between 1993 and 2000, with almost 50 percent of the nearly 8,500 participants saying their infants had slept with them in the previous two weeks.
"Having a crib in the house doesn't mean that babies aren't bed-sharing," McKenna said.
McKenna said his studies have found that babies who sleep with their moms are "physiologically linked" to their parents because they breathe better during the night, wake almost simultaneously with their moms and are easily aroused because they never fall into deep sleep. In addition, a mom guards her baby by nearly cocooning the infant - placing the baby near her shoulder then turning her body toward the baby with her knees tucked. They have not observed the same patterns among bottle-feeding moms, he said.