Bed-Sharing and SIDS with Tracy Cassels, PhD

Badass Breastfeeding Podcast

Tracy Cassels, PhD is BACK!  This week, Abby talks with Tracy about SIDS, sleep, breastfeeding, and the science behind it all.  You don’t want to miss it!! 

If you are a new listener, we would love to hear from you.  Please consider leaving us a review on itunes or sending us an email with your suggestions and comments to badassbreastfeedingpodcast@gmail.com

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Things we talked about: 

If you don’t already know of her, who is Tracy Cassels, PhD?  [4:21]

Difference between SIDS and suffocation  [13:20]

The infant breathing process (so fascinating!) [15:55]

SIDS in different sleep environments [24:03]

Resources for professionals [35:10]

Precocial mammals?  That’s us! [46:17]

Intentionality and sleep environment [57:27]

Our babies expect to be close to us [1:02:00]

Where to find and follow Tracy [1:18:00]

*This Episode is sponsored by Original Sprout and Sheila Darling Coaching

Links to information we discussed or episodes you should check out!

https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.12652

https://www.instagram.com/tracycasselsphd/

https://evolutionaryparenting.com/

https://www.basisonline.org.uk/about-us/ 

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https://badassbreastfeedingpodcast.com/consultations/     

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https://diannecassidyconsulting.com/milklytheblog/

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• Dianne Cassidy http://www.diannecassidyconsulting.com

Music we use~

Music: "Levels of Greatness" from "We Used to Paint Stars in the Sky (2012)" courtesy of Scott Holmes at freemusicarchive.org/music/Scott Holmes

Transcript

Dianne (00:00:00):

Welcome to the Badass Breastfeeding Podcast. This is Dianne, your lactation consultant.

Abby (00:00:25):

and I'm Abby, the badass breastfeeder and today's episode is brought to you by Sheila Darling Coaching. Sheila Darling is a social worker, certified hypnotherapist and mindfulness meditation teacher, and could be your start to a more peaceful life. And today's episode is also brought to you by Original Sprout. Original sprout carries safe, effective, and pediatrician, tested shampoos, conditioners, styling, and body care products produced and packaged in California USA. Um, and we'll hear more from our sponsors later, um, but please head to badassbreastfeedingpodcast.com and check out our sponsor page. If you need anything, check there and see if you can give any of our sponsors your business, because they do make this podcast possible. And while you're there, scroll down and enter your email address and get episodes sent straight to your inbox every Monday. Uh, and now Dianne has our review of the week.

Dianne (00:01:18):

Absolutely it is from, I want to say this, right? Cause it's adorable, Nebtot I think that's very cute. And she says, we're keeping it real. I'm not a breastfeeding mama yet, but I work with them every day, the NICU, and started listening to this podcast to get an idea of how my patients are thinking and feeling and how I can best support breastfeeding moms of premature and special care infants. I've binged almost every episode at this point and love keeping up with all the relevant new information I've learned so much about lactation and breastfeeding just by listening to this podcast than I did in nursing school, or my years working as a nurse. From evidence-based information about alcohol consumption, comfort nursing, and co-sleeping the host of this podcast Keep it real. I recommend this to any pregnant mama or a new mom, or even if you're just interested in learning more about breastfeeding and how to support the breastfeeders in your life.

Abby (00:02:11):

Oh my God. That is the coolest thing ever Just spreading that to all the joy to the, to those little NICU babies. Oh my God.

Dianne (00:02:21):

I know. So amazing.

Abby (00:02:22):

And all the people there and being able to kind of intercept the misinformation as it's coming through and being able to give the people and the parents, there like just good, helpful information. That's amazing. It is.

Dianne (00:02:33):

It is amazing. And you know, one of the things that we see coming out of, you know, healthcare institutions and, you know, doctor's offices and all of that stuff is it might've been evidence-based information 25 years ago. Right. We need the relevant information that's happening right now. And that's what we try to bring you because that's what we're interested in. Like we don't care about what, you know, great aunt Sally did 30 years ago. We need to know what's happening now. And I love that she is working to get this information so that she can pass it on. And that's amazing. Thank you so much for that. You're doing so much for the moms and the babies that need you. I mean, that's fantastic. So, and she put that on iTunes. So, um, that really helps us a lot when you can put the reviews on iTunes, but if you can't, you can absolutely send us an email at badassbreastfeeding podcast@gmail.com. Um, and we would get it there too. So thank you. Awesome. And now, ah, we've got a great episode.

Abby (00:03:39):

hold onto your seats because Tracy Cassels from evolutionary parenting is back! We're talking about SIDS And let's get to it cause it is a killer interview. Welcome Tracy. Back to the badass breastfeeding podcast.

Tracy (00:04:01):

Well thank you for having me back. I've been waiting for my invite again. So yeah,

Abby (00:04:06):

You're the first person that we've actually had on twice.

Tracy (00:04:09):

Really? cool.

Abby (00:04:11):

You're the, you're the president of the 2 timers club

Tracy (00:04:14):

I love it. I will take that role. That's one I will relish. Thank you.

Abby (00:04:21):

You are, uh, the badass behind evolutionary parenting. You have, you have a PhD in developmental psychology, right? .

Tracy (00:04:32):

Yeah. So my master's is clinical. Yeah. So my ma is clinical psych and my PhD is developmental. I kind of switched gears a little bit there.

Abby (00:04:39):

Yeah, well that's good. Um, and uh, we would, last time you were here, we talked about, uh, nighttime breastfeeding and that episode has become one of our most like top five downloaded episodes of our 180 whatever episodes we have.

Tracy (00:04:59):

That's awesome. But it's something that I think obviously bad-ass breastfeeding people breastfeed at night. This is something that is so central to the breastfeeding relationship. I think.

Abby (00:05:10):

it is. And I, and I told My husband, I said, I said I was interviewing, um, Tracy Cassels from evolutionary parenting, you know, on the podcast saying he was like, man, we've been reading that blog and looking to that person for parenting, you know, resources since Jack was a baby and he's going to be 10. He's like, that's amazing.

Tracy (00:05:34):

It's crazy to think. Sometimes I go back to the time of like, cause I started it because Jack's almost the same age as Maddie, my daughter and she's 10 and a bit now like 10 and a half and yeah, cause it started with her and I look at where she's at and it's sometimes insane to think that it's been so long. It's a string going on. I mean, I still feel like I'm still my feet, so I don't know how slow a learner I am, but apparently not the fastest learner on the planet.

Abby (00:06:03):

Remember social media back then.

Tracy (00:06:05):

Oh God.

Abby (00:06:06):

Yes, it's crazy. But I feel like that was just God, it's insane. Insane. Like wild West.

Tracy (00:06:16):

It was. Yeah. That's the perfect analogy. The wild West, because that's really what it felt like. And now I, at least I also feel that I don't know about you, but I think I'm able now to put it in perspective, as opposed to before, where it felt like it was the be-all and end-all of how we shared information, how it got out there. I mean, it's still a medium now and it's a, it's an important one for a lot of families, but at least I feel mentally, I'm not kind of wondering what the hell is going on every day. Like I still question that, but in a different way, because I just don't understand technology. So there's a different element there, but I don't feel as beholden to understand and master it. Like we used to.

Abby (00:06:58):

Totally, absolutely. I used to like read blogs and study like social media and how to like deal with whatever was crazy, you know? And, and I think it, like, I w it definitely of course led to this community and to the communities that we have, which is fantastic because they feel like it also leads to, it opens up new parents. I mean, there's parents, people that listen to this podcast are I think mainly not all, but mainly have new babies. Yeah. You know, when they're getting this information and they don't have to deal with the wild West, I mean, they do because that's social media always, but not so much with the wondering where to go. What's happening

Tracy (00:07:42):

Also funny. Cause I go back and you think back to when we started, because we were in touch very early and it feels like we lost a lot of people along the way. Yeah. There were so many Different groups and it's been interesting to see it evolve and change over time. And it's, um, you know, there's always, I guess, new, new fads, new people talking about stuff, but it's kind of nice to have, you know, someone like you still there that I'm like, Abby's still here. I'm not alone. I don't feel like the old days are trying to do everything.

Abby (00:08:14):

Oh my God. I do feel that way Sometimes I'm like, I'm old. Do I even relate to these new parents. But I mean, I feel like there's so much information that they need to have. That's just universal.

Tracy (00:08:22):

Well, exactly. And that's kind of how I try to feel too. And I mean, at least with breastfeeding, I still remind myself. I think I'm nearing the end, but, um, I've been breastfeeding for 10 years and my son is five still going and I never stopped. I didn't have a break. I was tandem both kids when, you know, he came along. But I'm like, I can tell he's nearing that end point. I think it's going to be this year at some point. And I'm like, okay, at least still have that relevance going,

Abby (00:08:49):

But it's yeah. I mean, yeah, this is the first year that I have not been a breastfeeder.

Tracy (00:08:54):

Yeah. You Have that knowledge. And that's what I think is so important in a culture where, especially with something like breastfeeding, it's still not normalized. People still don't have, you know, the grandmother, the mothers, the aunts that all did it. They could turn to that in some ways our, our old age and coming in, I feel adds a level of, I don't want to use the word wisdom cause I really don't ever feel very wise, um, experience. Yeah, yeah. That people can relate to. And I think that's what a lot of new parents do need is an under someone who understands what it's like and has come out the other end to say, Hey, look, we're all still here. Our kids aren't entitled little brats because we breastfed on demand. They sleep, even though they might've woken regularly, all these things we can speak to and have a level of, we're not in it in the moment just telling you it's going to be fine. We've really been through it and come out the other side for it.

Abby (00:09:55):

That's true. That's great. I agree. Yeah. Well today, yes. What, we're switching gears a little bit for today because one of the things that when Dianne and I were talking about, uh, we love to talk about bed sharing. Bed sharing is one of our topics besides obviously breastfeeding, but bed sharing is so intertwined an goes together with breastfeeding, that when we talk about it, we're often presented with this information that either a person or the person's family, you know, a listener says, I would love to bed share, but you know, my husband is afraid of SIDS. My doctor says we shouldn't because it causes SIDS. And you know, and I thought, and I'm thinking we need to really break this down because this conversation is getting very, there's so much misinformation around this conversation as well.

Tracy (00:10:47):

It, there is a lot that is missing from this. And I, you know, I want to be generous and say that the people that are are saying this, the people that are giving this information do it because they care about babies, right. That the, everyone is concerned about the wellbeing of babies. But I'm going to start by saying that what I find fascinating, the more I look into this, the more I look into the research on it. Um, you know, we're seeing a shift towards more nuanced bed sharing messages in a lot of countries where I think they value infants and parents more. I think that the main push against bed sharing still comes from the U S and you know, let's be honest, there are not a lot of baby or family friendly policies there. And I don't mean to sound negative nilly judgemental. Like I'm in Canada, we have a year's mat leave. We have, you know, a lot of supports in place for families. And so I still have to go to questioning even the motivation behind this harsh messaging. Cause I don't think it is inherently about saving babies. Um, so I'll start with that. And the reason I say that and part of it goes, and this is a quote that I absolutely love. So I don't know if any, hopefully your readers know Helen Ball, she's a researcher at Durham university, the founder of Basis, the baby sleep information source. She researches infant sleep breastfeeding in particular with respect to it. Um, in, you know, she's an anthropologist. So across various cultural lenses, and when she's talking about SIDS she had this quote that I loved and it says "the guidance you're given is around trying to prevent something that we don't understand the cause for." And I think it's so important to think about that. That when people say it causes SIDS, it is unsafe. No, actually we don't know what causes SIDS. We have no idea.

Abby (00:12:54):

Right, exactly. It's sudden and it's unexplained and it happens to an infant. That's all I know we have all these suspicions. We have all these correlations, we have all these wonderings, but we don't know. Yeah. And when you're, and when you're sleeping in a bed and Somebody who has been drinking or is on drugs rolls over onto a baby, that's not SIDS.

Tracy (00:13:20):

That is not. And I think that's what's. So I think let's start by disentangling SIDS from suffocation. Which is what you're describing is, Oh, there are infant deaths in parental beds. And of course there are because as you described, we have a culture that, um, we have a lot of drinking. We have smoking, which we know is a risk factor. Um, we have parents that are working full time, two, three jobs coming home and trying to take care of an infant because they don't have appropriate paid leave. There's a lot of things in place that create hazardous circumstances for infant sleep. And the problem is if we don't disentangle those from SIDS or from something else, we're giving blanket recommendations that people aren't listening to. So even from a safety perspective, I mean, some will, and generally those people are at lower risk anyway, because the people that don't listen tend to be white, higher education, higher SES, they have resources that already protect their children. And so if we are just looking at them, well, that's not the full picture. The people that tend to ignore the messaging are those that may come from other cultures. Those that may not have choices in the matter. I mean, we think about separate infant sleep spaces. Not everyone has access to resources for that. Um, you know, and there's so much going on that the disentangle. So we want to get away from, you know, first understand that SIDS is unexplained and there's, I think for people to understand that triple risk hypothesis surrounding it, which means that we tend to view in the research that there are three main features. So there's a genetic susceptibility, which is in part seemingly they're the babies. Some babies just seem born. Something tends to be wrong. That is in their genes. And we don't necessarily know what we know that some autopsies showed that there can be brainstem abnormalities in some babies that may affect their ability to breathe, um, or heart rate regulation, all these things. So that's, in some cases, the second part is that there are certain features, there's this critical period, um, of the environment that's going on. So it's not the environment like bed sharing, but there's a critical period time. So it seems to peak, as we know between two to four months of age and something's happening in development, then I know, uh, Jim McKenna has argued that there's a shift in breathing at that point that may account for it. So infants in the first couple of months actually have an autonomic breathing process. They just breathe kind of without their brain actively doing it or effortfully doing it. And around two to four months is when that shifts towards a more effortful system. And if something goes wrong, as it's learning that system, you do get in a lot of babies, some periodic breathing where they might stop for a bit and then the brain recognizes oxygen desaturation. And so it gets kids breathing again. So that's a more common occurrence. So you have this age factor too, but then you have, what's thought to be this third piece. And this is where bed sharing comes in in the research, which is, it is some environmental stressor is what we think. And these are all based on studies that are not of the highest quality. Um, so, but when we look at stressors, you know, you probably, most people hear of bed sharing as like the biggest, but the other one would be things like sleeping on one's belly, right? So that prone, sleeping position, um, is really important versus supine. So all these things kind of go towards what we want infants do. So that's that whole put your baby to sleep on their back campaign. Um, that that's, you know, those are the three factors going in and it's that third where bed sharing came up in the literature on SIDS for bed. And so we'll get to suffocation later cause that's different. But as Helen, so aptly put is we're trying to understand something. We don't know the cause for. So to get there, we start looking at all these different factors. How do we understand that? And bed sharing cropped up in a lot of studies. And one of the things I always caution people to remember is these studies are highly flawed and it is so hard to make people realize how bad. But one thing I found out recently is that the NHS, I think it's the NHS in the UK has assessments of the validity of evidence for specific policies. And they reviewed the evidence on bed sharing, causing SIDS as a link between bed sharing and SIDS and across all the studies, they found that the evidence level was very poor. It was the lowest level of quality that, that you had in terms of evidence. So I think it's really important to remember that when you hear studies say this, that the other they're really not very valid studies. So that's, I think a really key piece for people to remember here.

Abby (00:18:28):

That's really interesting. And that's a pretty important when we're making these sweeping, um, you know, making these sweeping national international, uh, recommendations based on, you know, things that are not relevant and that are not even, you know, well done or the, the, the findings are not, we don't even know if the findings are true

Tracy (00:18:55):

It's and it's not surprising. I mean, I've looked at this myself when I, I did a piece on why there's this conflicting information on bed sharing risk. And you know, it really comes down to some of the, the measures in these studies are so poorly addressed and really it's in the way that we talk about safe bed sharing versus unsafe bed sharing. And unfortunately in a lot of cultures where it's just this don't bed share, there is no distinction between the two and there ought to be because we know that there are certain circumstances that make bed sharing more hazardous. And it's funny because I see some people on the side of pro bed sharing that liked to ignore that as well under the guise of, but we've always slept with our babies. So therefore, how could sleeping with your baby be dangerous? And yes, we always slept with our babies, not in this modern environment. And if you look back across human history and you look at other cultures where bed sharing is incredibly common sleep, setups, sleep environments are very different. So you even just think about the adult bed. Our mattresses can be incredibly soft, which is not the case in a lot of Asian cultures were bed sharings, quite the norm. They often sleep on futons or harder mattresses that don't allow for infants to kind of get sucked in rolled in and end up suffocating with their face in the mattress. They don't have tons of pillows.

Abby (00:20:25):

I had a Japanese boyfriend in high school. His bed was like a tiny mattress on top of this piece of wood . It was just, there was no give there's no nothing. It's true. It's totally Very firm.

Tracy (00:20:42):

Exactly. And that's, but that keeps babies safe. Right? You think about a crib mattress. They're very hard. And the reason for that is to keep them from falling in. So we do have to be cognizant that we have a lot of these different environmental things, just like drinking and certain drugs. We have medications that cause drowsiness that certainly didn't exist 500 a thousand, 20,000 years ago. This was not something that was commonly found around. Smoking. Um, I know there's been tobacco use for years in a lot of indigenous cultures. However, their tobacco use is very different than our modern cigarettes, right? It's not necessarily therefore the tobacco, that's the problem. It's all the other shit basically that's in it. Exactly. So we have to be aware that yes, our environment is different. And so when we start talking about bed sharing, it's not the same across individuals. It's not the same family to family. And looking at those external factors that we know impact sleep is really important to understanding the research because a lot of studies they'll say, well, they accounted for drinking. They accounted for smoking. They accounted for all these things, how they accounted for them is some of the biggest problems in some of these earlier studies. So I know I have read and reviewed ones where they counted any drinking in a 24 hour period prior to sleep. Um, and found of course, that drinking did not predict any increased risk of death or suffocation. Well, yeah, cause if you have a glass of wine at lunch, chances are, that's not impacting the way in which you sleep with your baby overnight. Um, so we have, you know, there's this big issue there that how we look at these things smoking for example, is who smokes for a long time There was no assessment of if any parents smoked, it counted well babies don't often always sleep next to a partner. And so if it's the partner that smokes and we do see this in research with Asian families where there's a very high rate of male smoking in a lot of Asian cultures, um, you're not seeing an effect. It's the person who is sleeping next to the baby is smoking that you see this stronger effect. So when we look across these studies for years, we've seen this just abysmal recording of these other variables. And so it's forced us to, I mean, it forced researchers to kind of say, Hey, wait a second. There's something else going on. We've got a better look at this. But from a policy perspective, everyone's still pulling the same. No, we just can't do it. That it's bed sharing is inherently dangerous. That's the problem. And it's just not right. Like this is this isn't, we don't have evidence of that.

Abby (00:23:38):

Right. And when it comes to, to SIDS and SIDS is obviously a very horrible thing, but SIDS happens anywhere the baby sleeps. Yeah. Right. It's not, it's not correlated. Or I don't know this- is it correlated to any particular sleep environment? Or if you look at actual real research citizens happening across the board

Tracy (00:24:03):

It's well, so there is an increased risk of SIDS. Some studies do find it, as I said, with bed sharing, we question, you know, the validity of those as we saw the are considered very low quality. Um, they do tend to happen in car seats. More that upright reclining seems to lead to SIDS because it's hard for them to say suffocation, uh, because they're not suffocating in the car seat, but there does seem to be something about that. Upright the head tilting down that is linked to a greater risk of SIDS, but we don't see big campaigns telling people not to put their kids to sleep in the car seat. Right. That's not what we're seeing here. Certainly not pictures of babies with knives next to them. Um, in that environment, you know, one of the more interesting findings, and this is why I say I find it so hard to say the care like the issue is about saving babies, because one of the risk factors that fascinates me because it does come up above and beyond just the positioning of the baby and everything is actually daycare. And so you're looking at, at crib or cot sleeping at that point. Um, but for young babies in this risk factor, the first couple of days, sometimes up to the first week is considered an independent risk for SIDS. And it's thought to be that when we talk about these environmental stressors, that the stress of separation from a caregiver of a new environment of perhaps being cared for, for an extended period, by someone you don't have an attachment to is a stressor enough for some of these kids that the proportion of kids one would expect to die of SIDS in daycare, based on who's in it, the base rates, et cetera, it is much higher than that. And this is even when you account for sleeping, positioning, safe, sleep environments, everything like that. So, you know, we talk about these environmental stressors. That's when, but we don't see people saying, Hey, maybe kids shouldn't be entering daycare in the two to four month range that maybe we should be offering families paid, leave to stay home with their baby during this higher risk or this vulnerability period. And so, yeah. So I guess there's, there are certain situations where again, we see a correlation, but because the research only tells us that we see more kids dying in this than we might expect, or that don't, it's, um, it's really hard to still make causal implications. Right. So is that the car seat? Well in car seat safety, yes. We think there may be something because we don't have plausible other explanations. It's not like parents put their kid in the car seat and the parents drinking would affect how the kid sleeps in a car seat. Um, but other than that, you know, we still have to be cautious about the interpretation because we don't know the cause. So what is it about the car seat that causes infants to have a higher risk of SIDS? We assume it's the positioning of the head that, that curled in the head down. But we don't know.

Abby (00:27:05):

And we'll be right back with more from Tracy Cassles. From evolutionary parenting in just a moment today's episode is brought to you by Sheila Darling coaching, a new baby can add intense amounts of anxiety and depression, no sleep, feeling overwhelmed, looking at your sweet baby and wondering how this tiny human can cause so much chaos. The transition to Parenthood is an entire identity shift. You weren't prepared for. If one more person tells you that this time goes by so quickly, you might just punch them in the face, transitioning to a new family member. It takes patience self-compassion and support. Sheila Darling coaching can be that professional support person that Dianne and I are always saying, there is no shame in getting Sheila Darling is a social worker, certified hypnotherapist and mindfulness meditation teacher. And could be your start to a more peaceful life head to Sheiladarling.com to schedule your consultation today and mentioned the badass breastfeeding podcast when scheduling your consultation and receive 10% off of a coaching package. And today's episode is also brought to you by Original Sprout. Original sprout carries safe, effective, and pediatrician, tested shampoos, conditioners, styling, and body care products produce and packaged in California USA. The leave-in conditioners, lightweight formula is made with the nourishing emollients and arnica for split ends, making it ideal for detangling any eliminating frizz from damaged hair. The miracle detangler is perfect to making combing hair easier for babies, toddlers, children, and anyone with long hair. The Rosemary can help prevent lice. All of original spouts products are Parabon and falate free vegan, and cruelty-free their proprietary formulas contain nourishing extracts from fruits, vegetables, and flowers that the whole family can enjoy. They are not just for babies anymore. Check out the entire line@originalsprout.com and use code badass for 25% off your purchase. That's original sprout.com code badass 25% off of your purchase. Um, and these sponsors and their promo codes can be found in our show notes under this episode at badassbreastfeedingpodcast.com our show notes. Uh, we'll also include further information about things we talked about in this episode, and at badassbreastfeeding podcast.com, you will also find breastfeeding resources, all of our other episodes and information about scheduling your very own one-on-one online consultation, lactation consultation with Dianne. And now We're going to get back to our interview with Dr. Tracy Cassles. I remember reading somewhere, I think it was the La Leche League, um, safe, safe sleep, seven yeah. Thing. Um, which was really interesting. And I knew it was something, it was just recently and it was something I had never heard before. Um, it said that in the United States, um, these really extreme bed, anti bed sharing campaigns and stuff like that, um, you know, there's, there's certain communities that are experiencing, I can't remember if they said SIDS or if they were just saying bed sharing issues or problems or, or communities that, where there are heavy drug use and heavy drinking, um, that these communities, so they're like poor communities, maybe, maybe black communities. I can't remember exactly what it said. Um, but the gist of it was there's these communities that are dealing more with infant death situations, um, that are hard to reach, which I think is funny because yeah. Hard to reach because you don't, nobody provides these communities, any resources or anything, sadly. Yeah. Um, so because these communities are hard to reach, they have decided to make these really extreme policies and recommendations to try to protect those babies. Um, and I find that interesting because I think that actually, when it comes down to it, not even when it comes down to it very obviously, and very openly, we don't value those communities. No. You know, as you were saying, we don't value babies. We don't value those people at all.

Tracy (00:31:31):

No. And this is that really speaks to work a couple of years ago, uh, Cecilia Tamari and Melissa Burdick came out with a paper on syndemics theory, looking at bed, sharing through a syndemics theory framework, which really looks at other systems around whether we can consider bed sharing a risk factor. And, and they in looking at the data, looking at these sociological factors really hit home. That yeah, bed sharing is not a risk factor. What is a risk factor are all these other systems in place that disenfranchise and don't support communities that are already at risk because of health-related issues, poverty-related issues, resources, support, et cetera, all of those things are missing. And that is the crux of where we're seeing problems. And it's why we see disproportionate numbers of SIDS or bed sharing deaths in these communities. And arguably this hard line stance doesn't speak to them. It doesn't do anything but punish people for having a problem that was created by the culture and communities around them, by the people who are giving those recommendations. Exactly. Yes. And when I say it, that's what I say when I say community is I don't mean their community. I mean, the rest of our society, that's set up these systems and then we're saying, well, you have problems with the systems. And now we're going to punish you for not being able to overcome the systems we're putting you in, even though they go down to the very fabric of how you parent the DNA of your children. I mean, epigenetics tells us time And again, that many of the issues that families face are passed down at a genetic, like at an epigenetic levels. So when parents have faced systemic racism, poverty, um, lack of resources, trauma that all go into these communities that they're rampant there that affects their, the expression of their DNA. And then that passes on to their children. So their children are born primed for these adverse conditions and that affects their stress reactivity. It affects their lifelong health unless we can set up systems that might once again shift the expression of these genes.

Abby (00:33:54):

That's really interesting. Um, and when I, when, when you think about what would, what would the alternative be? What would a perfect system be? Um, I would, you know, one of the things that's interesting to me, what I, we know what we talk about with breastfeeding information, bed sharing, these kinds of things are helpful information, you know, ideally it would be coming from well everywhere, but also like the doctor's office. Like when you go, when you have your baby, um, and you're in the, in the doctor's office where you are, um, there for the very topic of your baby, what you, you know, there's always these flyers sitting around, right. You know, a little like little, little pamphlets. Yeah. There's, there's never any pamphlets that are like, Oh, here's some information about safe bed sharing. Here's some information on breastfeeding. You know, I, I don't know. I feel like what you always see is like how you can get more tests, Hey, look out for, because we have the test for it, which you can pay us to get, you know, we live in this ultra, I mean, in the United States, we live in this ultra ultra capitalist nation that only cares about making money and does not care at all about providing information to families.

Tracy (00:35:10):

And this is, you know, I would say if you want to see a shift, so I'm going back to Helen Ball because I just absolutely adore the work they're doing there, but part of what they do at Basis, this baby sleep information source, because they are jointed with UNICEF and the lullaby trust, which is a charity in the UK. They are non-profit. Um, they have created for health professionals webinars on how to talk about SIDS, how to talk about safe bed, sharing, how to talk about infant sleep. And they have resources, free resources for professionals to use and modify for their own needs. So these are things that you can just steal from them, set up on your own and be able to talk to families in a way that addresses these concerns gets to their unique situations, um, and provide the type of support that's needed. And they're becoming more common in the UK. I know British Columbia here in Canada, has it set up as well? Where now the conversation around bed sharing is no longer don't do it. It's okay. Let's go through when you go meet with your, um, health visitor, cause you get in BC, you get a home visit from a nurse. If you don't have a midwife, if you have a midwife, your midwife comes and does the home visits up to six weeks postpartum and they will now sit and have this conversation. Okay. Well, do you smoke? Are you on any medication? Are you drinking? Let's take a look at your bed. What's the setup here. And even down to the fact that, you know, one of the things that comes up a lot for families is people try and do the sidecar crib or a cot. I get stuck saying cot a lot. Cause I, I deal with a lot of UK and Australian people that sidecar situation, but what's acknowledged is if you're breastfeeding a baby back to sleep, I mean, I dare you to stay awake. Like I don't know about you, but that is like one of the calmest most. Okay. And now I'm drifting off into sleep so well I'm, isn't that the purpose exactly. Right. That's supposed to elicit sleep in your baby and you, right. We're supposed to kind of sleep together with our kids. And so they have this situation to say, okay, let's look at the environment, let's see how to make it safe for you and your baby. And so it's become a more nuanced discussion that they can have. So my point to this is saying, if you are a parent and you go into your doctor's office, go to its basis.org, um, I, I'm not sure.

Abby (00:37:41):

Uh, we can put it in the we'll, we'll put it in the show notes.

Tracy (00:37:45):

there, you can go there and basically bring a handout, something to your doctor and say, have you done this course? No. Well then I would really recommend you do, because you know what? I don't want to talk about sleep until you've done it. Like this is for health professionals and you can advocate for yourself that way you can say when you are up to date on the research, which is given by a group of professionals, academics who do this research and they've been awarded, um, Helen Ball was that, uh, they got a award from the Queens thing. I'm so not British. I don't know what these awards are, but I know they went there's pictures of Helen with Prince Charles. I'm like, God, this award, right? Like they have done amazing work. And this is, and it's free. Doctors don't need to pay for it. So it fits within that capitalist framework of look, you can get all this and you don't have to pay for it. I mean, it's a capitalist rate. Right? Right. Like you're banking off the socialism in, in the UK to benefit the capitalist system here. But Hey, at this stage, we'll take it.

Abby (00:38:52):

Yeah. I feel like that's very similar here with the breastfeeding information that doctors may or may not have Because medical school certainly Doesn't teach it to them. It's not a part of medical curriculum, safe bed sharing. Sure As hell is not a part of a medical curriculum. And if you run into a doctor, like my pediatrician that we have now is very well versed in breastfeeding and bed sharing. And he's very supportive of it, but that's because he On his own, on his Own time to go research that Yeah. And doctors, they're not all going to do that. School's Not teaching them. And then they have to, then they're like, Oh, I got to do all this extra stuff.

Tracy (00:39:33):

Well, and that's what I love about. Helen's basically it's a three and a half hour webinar kind of thing. You watch the videos, then there's an hour and a half Q and A that you can attend live if you have it. And it's geared towards health professionals. And so, yeah, there's a bit of time that you would need to put into it, but all the resources are there for you to take from, and it is a wealth of information that I think would benefit most doctors, clients, right? Like if you have new families that you're working with having this information and having the tools like they have, the screen are all the questions you need to ask. You don't even need to think about it. You could print it up, hand it to your clients, have them fill it out in the waiting room. And you'll get a better idea as to how to talk about bed sharing with them. It's I mean, it's just, it's such a wonderful resource. So, and I think it's going to be up to patients going in and saying, Hey, have you seen this? Would you do this? And getting more and more doctors in the U S to take part.

Abby (00:40:37):

I love that. I love that idea of having you guys going to this website, which we will figure out the exact one. Print that out. And you, and if your, you know, your doctor brings up stuff while you shouldn't be sharing a bed with your baby, well, you shouldn't, you know this insane. We can have this conversation when you get some formal education, formal information about this topic.

Tracy (00:41:05):

Yeah. And to be fair as parents, this is not limited to health professionals. I mean, it's geared towards them, but as parents, you are totally able to sign up. If you want to do this and these webinars, they're not the webinars themselves. The resources are free. The webinar was 50 pounds. I think. So it's not a huge expense. It's not something For those of you don't know that's money, British dollars. My son, my son, we were watching the British wipe out that show wipe out. Yeah, there was a British one. He was like the PA the, um, the prize is 10,000 pounds. And my son goes 10,000 pounds of what? I was like, no, no, no, wait, sorry. It's money.

Tracy (00:41:54):

But it's, I think it compared to the Us dollar, it would probably work out to about 60 bucks. I think. Um, I know Canadian was a lot more than that, but that's our dollar problem. Um, but that is, it's really not expensive. And it is such a valuable course when they offer them. And you can just sign up on basis to be notified via emails when they run them. And I, I can guarantee it is so worth your health professionals doing them. And it's so worth parents. If you have the time and you have the resources, which I acknowledge, not everyone does, but if you do, I think you having that knowledge would also empower people to talk to their health professionals with more because when you go in and someone says don't bed share, and you say, actually, you know what? I am actually well aware of the research. And did you know that in the UK, the quality of evidence for this is considered basically piss poor. And so let's have a conversation about safety because I am, you know, not drinking alcohol before bed. Although I may enjoy my glass of wine at lunch or whatnot, I'm not smoking. I don't have a soft mattress or this or that. I don't have pillows. I have set up my bed in a way that is safe for my baby and myself. And especially if you're breastfeeding, you know, this is another issue we should talk about. But the relationship between breastfeeding duration and bed sharing is there's a relationship to how well it facilitates the breastfeeding relationship. And it may not be causal, but it's certainly a relationship there. And we know when you go back to the SIDS issue, breastfeeding is a protective factor against it. For whatever reason, it halves the risk of SIDS. So, you know, you're balancing out bed sharing, which of course, if you listen to the, the poor studies, they say, it can be upwards of four or five, six times the risk, but, you know, and in that case, it might outweigh breastfeeding. But really we now know that it's not, it's just unsafe bed sharing. And when we look at safe bed sharing, there really doesn't seem to be a lot of evidence that it increases the risk of SIDS. So if you're breastfeeding as well, then you have that added protection and it's worth noting here. I think one of the problems about dead babies is that no one wants them at all. We want a guaranteed solution that says we will never have this because there will be people who bed share safely, who breastfeed, who do everything right? And their baby dies of SIDS. And it is such a hard thing to accept because we feel like if do it right, it should be fine. But when we go down to the fact that as we start to go back to that triple risk hypothesis, sometimes we just have, you know, whether it's a brainstem abnormality or something else that goes on, you know, we can't control everything.We can't control all of the environments. We can only do our best. And, you know, I love how Jim McKenna often when he talks about it will say to parents, you have to ask yourself if the worst happened, how would you feel about your choice? And I know personally, I can only speak to myself, but I, I thought about that. Like I always planned on bed sharing. It was just, that was part of my, you know, my mom did with my sister. So, and she's so much younger than me that that was like in terms of formative learning, seeing that. Um, but I, I always thought, yeah, you know what? I would want my baby, knowing that they were with me and loved and cuddled and supported at all times. I, that was that for me, would far outweigh the devastation of being embedded. And I think knowing the research means I wouldn't be that person that says, Oh, what did I do? And that's why I think, knowing this research and why say for parents, if you want to take that webinar with Helen Ball and Charlotte Russell and all of the team over at Basis, there it is that knowledge can be invaluable in you making your decision making, because it allows you to feel confident in the choices. So you don't doubt if the worst word ever happened and, you know, God forbid it would never would for families, but it does that. You would feel confident in what you did in providing. And, and this goes to, you know, another issue that all plays into this. There's the breastfeeding is what kind of mammals are we? And we're precocial and precocial, and precocial mammals. I can't say it like say that five times fast. Um, what that means Though, for people is that our babies are born expecting constant contact, expecting regular feeds and predominantly they expect breastfeeding, but of course we know not everyone can breastfeed and there's, but they expect regular feeds period. And they expect this relationship to continue for quite a while. And when we violate that, that can be highly stressful for them. And so we want to balance these, these safe measures that we seem to put in place. It's like sleep training, we treat sleep training, and we treat bed sharing, or rather solitary sleep as things that should protect our, our infants, but we're ignoring their psychological wellbeing, their species, expectant behaviors, and these other features that are central to their, their ability to thrive. Does that make sense?

Abby (00:47:16):

Yeah, absolutely. Makes sense. And I think when you go back to the beginning, it doesn't actually protect them.

Tracy (00:47:22):

well, that's it? Yeah. Yes. And that is, and it would be safe to use a sidecar cot or a bassinet next to the bed. If you have factors that are not modifiable for you, if there is, you know, I've worked with families where, you know, in one case I know a mother was, she was in a wheelchair. She had no control over her lower limbs at night. So there's a lot of periodic movement that could be dangerous. And so they use that next to the bed, the bassinet next. And then the sidecar cot because that enabled everyone safety. That was not a situation where there was a safe bed sharing option. And there will be those cases. Some people are on medications, they have to take for their wellbeing. And you should never sacrifice that because this sidecar cot, especially the sidecar cot is found in research to be equally beneficial, to breastfeeding and everything, right. It is you have that proximity. You can get your hand onto your baby easily, which reassures them, that you're there. It's easy to kind of bring them close for breastfeeding and then put them back. If you don't fell asleep. That's the one little side part there, but lots of people managed to get them kind of in a breastfeeding position and then move them back over. Um, all of these things enabled that safe environment. And it's something that I think too many families kind of, because we're not talking about it. We're not giving those options and we're not having these necessary discussions. Right.

Abby (00:48:54):

Because there are families that shouldn't bed share. Like we're not saying that everyone should bed share and Oh my God, forget all the warnings. Like, no, we need to understand the warnings. And you need to understand whether they apply to you or not.

Tracy (00:49:06):

And that's exactly what doctor's offices are missing. And exactly what, again, going back that basis, information source would give them the questions and the tools to ask to go down and go ahead. Oh, sorry. I was just saying to go down and then basically identify what are your risk factors? And then how do we work on it? Do we work on quitting smoking? Do we work on substance abuse problems? Do we look, are there better medications that might allow you to bed share and treat whatever it is that you're using medication for? These are questions that should fit with this holistic view of health.

Abby (00:49:41):

Yeah. And I love the, I love the idea of parents taking advantage of, of, of gaining these resources. However you do it, um, because you actually don't. And I think it's important to remember. You don't need your doctor's permission to bed share. You don't need to convince your doctor that you can bed share, and then have them give you approval. They are not the boss of you. They are somebody who works for you, who should have good information. And if they don't, it's great. If you want to take the time to try to educate them, but also that's not your job. And if you don't have the, you know, the energy or the, you know, if you don't feel like doing that because you're dealing with having a new baby, you know, then you gain this information and you go about your business. Yeah. I know. And that's, that's having this information can empower you to make this decision and to be safe with your children without, you know, dealing with the very uneducated medical system around you.

Tracy (00:50:37):

I think it's worth saying sometimes, although we say to parents who are in it to advocate for yourself, sometimes I think it's up to us who are out of it, but still seeing these doctors, right. We still go to say, Hey, you know what, this isn't my problem anymore, but I'm going to share with you this information, because right now it's not my battle, but I'm going to bring it up to you and fight that battle for others. So that, you know, I don't need to listen to your views on bed sharing. But if you're out of it, you can happily go to your doctor and say, Hey, you know what? I saw this, I heard about this on a podcast. And I think you should really look into taking this training and having this system in place for your clients. And you know, it, it, it removes you from having them well, what are you doing? Well, it's like, I don't have a baby anymore. So it doesn't even matter what I'm doing, but I think you need to educate yourself on this. And it's, it is easier when you're out of the fray to advocate often, because you're not tired. You're not stressed. You're not terrified. You're not wondering what the heck is going on day to day. Um, you have the wherewithal to advocate in that way.

Abby (00:51:38):

I think that's such a great point too, because a lot of people will say to me, they're like, Oh, um, you know, it was so great hanging out here, but like, I don't have a baby anymore. I'm not breastfeeding anymore. So I'm going to leave. And it's like, don't leave, don't. Stay here and get the information and be that person who can, you know, who's been through it. Who can like support people who are coming in to the parenting community and can, you know, everything that you're saying, you know, you don't have to just, I'm not a breastfeed anymore. So none of that applies to me anymore. No, this all, it's all connected and we can all continue to try to change the system.

Tracy (00:52:14):

Exactly. And you know, one other thing I wanted to touch it, and I'm sorry, I'm gonna just switch gears for a minute here, because I think it's important too. When it comes to the research, one of the things I see endlessly and I I'm baffled by it. But when I hear about, you know, on Facebook, there are groups about safe infant sleep and everything, and they tend to be militant, anti bed sharing, um, about an anti bed sharing across all ages. It's just, you should never sleep with your baby. And this is something I want to dispel because even according to the piss poor evidence that we have these studies, they still find that post four months there is no increased risk. And some of them even find a decreased risk of SIDS with bed sharing after four months of age. So even from a, this quote unquote evidence-based whatnot perspective, which isn't evidence-based because it's piss poor evidence, but you know, you work with what you got, I guess, um, really you're looking at a short period now, unfortunately, it's that period that really speaks to us as precocial mammals of wanting this constant proximity, this safety, this always being there. So at the very least people should be co-sleeping in the form of having your baby in the same room right next to the bed with you and stuff. During that time period, no one is advocating, put your baby in a separate room. And in fact, speaking of the sleep situations and what we're seeing in the research that seems to raise the risk of SIDS is having your baby in a separate room from you. So that whole nursery that you decorate and have made beautiful. It's a laundry hamper right now. So just accept that and move on from that and make sure your baby's in the room with you at the very least, but anyone who's trying to tell you that the evidence does not support bed sharing posts like forever is blindly unaware of anything to do with science regarding this. And I think that's really important to have in mind because there can be a ton of pressure and I've met families where they have one-year-old and they're terrified to bed share with them, even though there may be needs and everything. And so it becomes this, ah, what are we, you know, I shouldn't, it's not safe and you're going at one year of age, you're more likely to get hurt yourself from the one-year-old kicking you and punching you in the face, in their sleep, then that having an issue. So, I mean, there's really, no, you're not having to worry about here. Um, provided again with a one-year-old if you were blackout drunk, whatnot. Yeah. That would not be safe because you're still bigger than them could roll over onto them and, and cause harm. But again, we're talking about this responsible situation. So there is, you know, even at that point, if some people feel like, you know what, for my safety, I want to get through that four months and I can safely babies fit in a bassinet at that point, they can be right next to the bed. Whatnot, go for that. The other thing though, is always make sure if you're doing that, as we touched on earlier, when you are breastfeeding a baby back to sleep, it is very common for mothers who are nursing or chest feeding to fall asleep while they are doing so, because the hormones do that. So even if you say, I am not bed sharing at this stage, if you are breastfeeding or chest feeding, you need to make sure that whatever environment you do that in it is safe for you to fall asleep with your baby. So I always say to families, I don't care what your plans are. Look at your bedding situation and make sure that when you bring that baby into bed to feed assume you're going to fall asleep. Maybe you won't. And I hear people say all the time, Oh no, no, no. I never felt it's hard for me to fall asleep. Yeah. You have not experienced the hormone rush that comes with breastfeeding, a baby.

Abby (00:56:04):

or the exhaustion of new Parenthood.

Tracy (00:56:06):

Exactly. Coupled with being exhausted. Anyway. So do that just assume, because you know, assuming you're going to fall asleep, doesn't harm you. It just allows you to take precautions. And you know what, if you are superhuman and you don't fall asleep ever kudos to you, but I'm also scared about your ability to sleep otherwise, but that is great. You're fine. Has it harmed you to set up your bed in a way that would be safe if it happened? No, because we're not talking about major changes that you would have to undertake. So therefore it's really just an insurance policy against what might happen. Hopefully it doesn't. But if it does, you know, that you don't have to wake up and just either wake up to the worst or wake up and feel, Oh my God, that can never happen again. And then you panic about what to do.

Abby (00:57:00):

That's how so many times people end up falling asleep in recliners, right? Or in the couch or something. These places that are so unsafe. Cause it's like, I don't want a bed share. I'm totally fine. I'm going to be in this chair. I don't fall asleep ever. And you know, then you're totally exhausted and you fall asleep and then your baby slips into the crack. And that's, that's what we're talking about. Like safe versus unsafe. You're so much safer being in a safe bed.

Tracy (00:57:27):

And this is actually, you asked earlier about the environments and I can't believe I forgot to mention it, but yes, sleeping in a recliner or on a sofa are associated with high, high risks of SIDS or suffocation really. And it does it, it is suffocation. Um, however, and this is the fascinating bit that I think goes, and I feel like there should be the take home message for everyone. And why I advocate, you know, prepping for things is there is, and it's, it's small, but there's a case study that was done in research with Jim McKenna and Helen Ball in a supervised sleep lab where they have the bed, you know, parents go in to sleep overnight and they have the videography, which they're assessing what is naturalistic, how people go for sleep. And they have a sofa in there cause they're there all night. Right? And they have the bed and TV, all that stuff. And the mother in one of these case studies intentionally chose to sleep on the sofa. And what they observed was when it was intentional, she structured it in a way that actually it looked safe for baby. She made sure baby was not near this, the edge where a baby could go in. She positioned herself in that sea position around the baby. There was for whatever reason the sofa was that thing. So perhaps more than anything. And we definitely need more research on this. It seems like the intentionality around your sleeping environment is so important because when we're intentional with what we're doing and it's not, we go to the sofa cause we're tired and we're going to try and nurse on the sofa to stay awake or nurse in the recliner to stay awake. And then we don't, we become aware of the risks around us and we make modifications to minimize them. And that is so crucial, whatever the environment it is. And you know, we do have to acknowledge that in some places, the sofa may be the only spot that a mother and baby can safely sleep in their in house. If they have a partner who is in bed and a high risk of rolling over on the baby or drinks or smokes, this may feel like the safest option. And so I don't want to ever say absolutely never, never get on the sofa, even though it's a very high risk when done unintentionally. And I mean, we're talking one of the highest risks possible, um, in terms of the numbers, but when done intentionally, there's at least initial evidence in terms of these case studies that maybe it can be done safely when parents are made aware of what are these risk factors? Where could baby fall within the cracks? How would I stop this? How would I position myself to protect my baby and you know, so that we can actually allow for a variety of circumstances to lead, to safer sleep for everyone involved.

Abby (01:00:14):

That's a really Great point. Yeah. Be, be intentional. Do the research and be intentional in creating a safe environment for you and your baby.

Tracy (01:00:23):

and for breastfeeding. Like we kind of touched on, I mean, it's really one of those things that if you're breastfeeding, you are probably going to end up bed sharing At some point it's even just part of The night. And it is, you know, we look at night feeds seem to really drive our supply. It's one of those factors, all those people telling you, no, no, no. If they feed enough during the day, you're fine. We know that there is research that women who, who night ween early, tend to breastfeed for a shorter duration of time all around. And this is really important to remember that our babies are supposed to feed regularly overnight. This whole idea of no, they don't need it is just bullshit.Um, and maybe arguably, you could say, yes, they eat enough. They'll grow, but that's not all that breastfeeding is offering or chest feeding. That's not all that it's offering. And so there's a lot there that, you know, from the comfort from regulation of the vagus nerve, to all sorts of things from pain relief, we know that breast milk has pain, relieving functions. And we know that that first heck two, three years filled with a lot of different ups and downs in terms of, uh, growth spurts, teething, um, you know, whatever digestion issues when they start solids at the time, like all these things can be alleviated or at least ameliorated by having the breast milk. So there's a lot of reasons for kids to nurse overnight that we've just ignored because I think this medical model tells us, you only look at growth and food intake as opposed to the holistic that this is part of a relationship that happens. And, um, you know, so our babies do expect that and our babies independent of that expect to be close to us. They expect to have that proximity met their needs for that are really, really strong because that signals to them that they are safe because our babies are born so immature that they, they know almost an innate level. It's not a cognitive level, but they know they're at risk. If they're not close to a caregiver, that our job is to keep them safe from everything in the world outside. And we can't do that if they're apart from us,

Abby (01:02:41):

Right. It's not, it's not, it, this is not a trend. It's not a, you know, something that we think is cool in 2021, this is a biologically normal way for a baby to sleep.

Tracy (01:02:53):

Yeah, exactly. And it's not just, you know, biologically normal, I would say it's almost necessary, um, for their development to be close. Like we do. I think there's a reason we see that double the risk of SIDS when we put babies in their own room is that we're taxing that stress system because they don't expect to be alone. They don't expect. And that is really scary for them. And they may not have the wherewithal to call out to us to let us know in those early times, you know, and there's sleep differences in how, you know, the quality of sleep that babies have. Um, we often talk there's, there's evidence that, especially in the early days, babies who sleep alone, fall into this much deeper sleep. And I know that sounds lovely, right. Deep sleep. Great. Right. But we actually know that falling into deep sleep in the patterns with infants is a physiological indication of stress. Yeah. So this is something that stresses our babies out. So sometimes when people say no, but if I put my baby in the crib, away from me, they sleep longer, they sleep quote unquote better. That's actually not what's happening. That is an infant stress response to fall into that deeper sleep. And so we, Oh, sorry. No, go ahead. It's not just saying so we one but deeper. Exactly, exactly. That deep sleep. It is one of those. I think it's one of the reasons why we see that independent risk for daycare is they get stressed. They fall into the deep sleep. It becomes harder for that brain, especially at that two to four month period where, you know, as Dr. McKenna hypothesizes, that, that switch well, it, it, it does happen that switch from automatic to effortful breathing. That is not a hypothesis. That's just a biological function. But if that's what's linked to SIDS, is that yeah. If you fall into that deep sleep, your brain's ability to remember to be online and do things it's like when you learn to drive. And I think it's probably a good analogy when you're learning to drive. It's not automatic yet. Right. And so if you think about it, you need the safe environment to test it out. And in those safe environments, you might be a little, your body might be a little off on edge or what it's doing, but that's fine. But if you throw in a big stressor, you are not driving safely at all, and it is highly stressful. And that's with us having cognitive awareness, everything. When you think about the, the baby system moving from this autonomic process towards this effortful one, and they're put under intense stress, that's going to make it even harder for that effortful system to work. Right. Yeah.

Abby (01:05:44):

That's really interesting.

Tracy (01:05:46):

Yeah. So I think that's probably a good analogy for it. And so I think when we think about babies at this time, I mean that need for proximity is just, it's so paramount. And you know, there's a really interesting study that I saw get cited the other day for drove me nuts. But they were saying, see, look, bed sharing causes stressful sleep. And in the study, what they did is they assessed regular bed sharers and non-regular bed sharers for sleep. And yes, the regular bed shares when they assess their sleep, showed this stressful pattern of sleep. What, whoever sighted this didn't get was that they were assessing the regular bed shares sleeping solitarily. So these are kids that are used to sleeping with the parent. They've separated them now and they see this stressful sleep pattern. So you sit there going, Oh my Lord, why? But this is, you know, and, and too often, and I think it's one of the biggest problems in academia with studies being behind a paywall people get abstracts. And let's be honest, there's a lot of parents in these science groups and whatnot who likened themselves to knowing everything because they read the abstracts and you really, really can't do that folks. It is, there is so much in, you know, if you're interested in a study, one little tip is that most researchers, if you send them an email saying, Hey, could I get a copy of your paper? I'd say 98% of the time, they're going to be like, sure, here you go, enjoy. They are able to do that. It does mean that extra step, but if you're going to be going around spouting evidence of something, because you saw it based on an abstract, you really should be reading the whole paper first, just a little, you know, the side note on science there, take the time. Exactly. And so, you know, the other side to this is that these babies that didn't bed share regularly did seem at this age. And this was an older age. I think it was, I can't even remember actually to be perfectly honest, but I think it was closer to a year. Um, they had developed a sleep pattern that wasn't as stressful being separated. Right. And so we know that does happen over time. We don't know how long it takes. We don't know other repercussions. We don't know the breastfeeding, all that other stuff that goes along with it. But we do know that when babies first separate in sleep, as we see in infancy in early infancy, it is stressful and it leads to stressful sleep. So we want to make sure that our babies, especially in these young periods are close to us safely, bed sharing, if you want to. And it works for you and you have the resources to do it. If not in a co-sleeping arrangement with your baby next to the bed for you during that time. And then to expect that when you do more move, pardon me, towards more solitary sleep, that will be stressful for our babies. Um, and it will be for a period how long that period is. We just don't know.

Abby (01:08:49):

I have a kid who's almost seven who sleeps with me. And when he tries to experiment, sleeping on his own, he doesn't sleep very well. Yeah. And he ends up back in my bed. He like, he, like, he chooses he's almost seven, so he can choose, like, I'm going to try to sleep on my bunk bed today. Okay. And he wakes up sooner than he would. He doesn't wake up really when he's next to me, when he's in there, he wakes up and he's like, where I am coming back in here. And you know, it's some people want, yeah, it's fine with me. And some people want to like try to push it and I don't have the energy, but exactly

Tracy (01:09:24):

Right at the, I always was called lazy parents home that I do. And I'll be honest. I have a five-year-old and ten-year-old, we bet share. We have the family bed and it's been a conscious choice that we're quite happy with. Um, it doesn't, you know, that doesn't really bother us, but everyone sleeps better this way. And you know, my daughter has a room, has a bed in it. She can use it if she wants to. Um, if she has a sleep over, she might have a friend, you know what I mean? Her and a friend might go in and do that. But that's, you know, that idea of shared sleep. And this is something that I think gets lost in all this, this bed sharing. We need to teach our kids to sleep alone, uh, which is also the anti. I think part of the bed sharing debate is like I said, I don't trust that it's solely about safety. We have a real push in our society to get kids and everyone's sleeping independently. And that is contrary to not just baby norms, but human norms. We are a social species. We are social primates, um, social mammals. We expect to sleep together because that group cohesion keeps us safe. And so when we look at Hunter gatherer societies, indigenous groups shared sleep is the norm. And you know, depending on the culture, really the youngest, you see kids moving away from bed sharing with parents is around two to three years of age. And in those cultures, they don't move to solitary sleep. They move to sleeping with other kids is what happens in many of them. So it's not a shift of you're now on your own. That's just a different peer group to sleep with. And in others where we see a bit more of this longer term bed sharing, you know, there's many Asian cultures that still have the bed, the room where everyone sleeps up through high school and beyond. Like, it's just it's the sleep room is what happens. Um, but even in Hunter gatherer societies where there is a separation, um, eventually for boys, it tends to be around age eight that they find their own little spot. Again, it's still social sleep because the whole tribal often sleep in a similar location around the fire, but they'll find their own spot kind of further away from parents and for girls it's adolescents, it's teenagers, it's 12, 13, 14 years of age. Um, so this idea of this early push for independence, doesn't mirror our evolutionary history and it doesn't mirror. You know, many cultures have maintained that evolutionary history in terms of sleep going forward. And that's what has been missing. We we've deviated from it for, I would say capitalist and other reasons. And, um, but that's not a biological norm. It's not a species expectant behavior. And so I hear people worry about a kid, Oh, the kid's going to be in my room forever. They really won't, but it may be a longer time if you're open to it. But also if you're not, there are ways to facilitate it later when your child has the cognitive capacity to cope with some of that stress. And you have the ability to talk to them about this transition and this change so that you can alleviate that fear and the anxiety that they will experience upon the separation. Whenever it happens.

Abby (01:12:42):

Yeah. We go through it cause I have Jack is going to be, like I said, 10, and he has been in his bunk for, I don't know, like a year and a half maybe. And he chose to do that. And I was shocked actually. I was like, really? Cause he's always been so, you know, in, you know, into the bed and he breastfed until he was six and a half. And um, I was like, he's going to be in this bed for a while. And Exley gets up really early and he was tired of being woken up at five o'clock in the morning. So he changed it all I know. And so he pushed, he decided that he was going to kind of push through that nervousness about getting through his, you know, into his own bed. And he was just like, I'm going to do it. And sometimes we, you know, sometimes my husband will actually go in there and sleep on the bottom bunk because he wants somebody in there. Um, but yeah, they do, you know, they work it out exactly to make decisions.

Tracy (01:13:36):

And he had that capacity to understand I'm going to feel a little stressed, but I know someone's there. I can ask for someone to join me. There's a whole, when communication increases, there is so much more ability for us to meet those needs in different ways. It doesn't have to be just that, that shared sleep space. But when our kids are younger, they often don't, well, they can't communicate as well. We know something may be wrong, but you know, especially when it comes to fear and anxiety, it usually just manifests as crying or distress. And we may not even know why sometimes, you know, many of us who have older kids have experienced that time, that our kids become afraid of something that is so bizarre. We don't understand what, right. Like suddenly there's a book that they're like, don't even bring that near me and Oh yeah. They don't understand why. And so if we think that they can't even fathom that level of something, they're afraid of they're how are they going to understand that they are safe when separated from the people that keep them safe and we have to expect that they can't. And so if we wait until they're older, then it really does help build that up. That we're able to kind of work with it and say, okay, let's talk about how you're safe. Let's come up with strategies to feel safe and know that you can still be there, that they will feel more adept. Cause you can say to them, Hey, if you find this too much, just come on, back in, come join us for a night. And we'll, you know, you can try it another night and they're old enough to understand that. And that is such a difference in helping them learn. I think these, you know, we all talk about self soothing and I know that's a big fucking shit show show when it comes to pardon of my language, sleep training, because everyone claims that, Oh, you leave a baby to be stressed out on their own. They're totally gonna learn to manage that. And no, they're Not, that's not how we learn Skills. I mean, re it's just unfair. It's a whole other topic. But when we have, you know, when our kids know that we're there for them and they're able to have that communication, we can build those emotion regulation skills, but it happens first through co-regulation, which is that proximity and everything. And then through active, helping them teach and learn, they have to have the cognitive capacity to take that information in. And if they don't, they're not going to learn it appropriately. It's as simple as that,

Abby (01:16:01):

I think that I came up with our next topic For the next time you come to our podcast. When you, when you are then president of the three timers club, we can talk about self soothing,

Tracy (01:16:14):

Oh God. Yeah. I will get on that. I have had recently some, uh, some stuff on there that is, um, very, very frustrating to say the least.

Abby (01:16:25):

it's such an infuriating conversation.

Tracy (01:16:27):

It really is. And it's um, and the problem is you hear it from, I feel people that should know better. And you know, I, I hear, you know, whenever I hear of like a psychologist talking about it, especially like, uh, you know, people that work with clients. So whether it's, you know, counseling, clinical, whatever, um, I always just think I'm like, so if you have a client come in, who's really upset about something is your treatment that you just walk out of the room and leave them alone for an hour. And then you bill them. You're like, is that, that what's happens there. And of course it's not, that's not, you know, it's not how we treat distress, but somehow with kids, we expect something different. So yes. Happy to talk about we'll save extra long for that one. Yeah. And I will apologize in advance for all the swears that will come out on that one.

Abby (01:17:14):

It's okay. It's called badass for a reason. I know people are like, I can't believe that you curse. I'm like it's called the badass breastfeeder Where did you think you were?

Tracy (01:17:28):

I know I didn't do. People are like, you swear. I'm like far more than I should, but it's hard not to when it's on these topics, right? Like we're surrounded by a culture that almost is forcing. I'm just going to blame. I'm not going to take any personal responsibility for my swearing. I'm just going to blame culture around me.

Abby (01:17:49):

It's true though. Tracy, where can people find you? Because I know everyone wants to follow you. If you're not already following her, you need to find her at where can we find you?

Tracy (01:18:00):

So the website itself is evolutionaryparenting.com and there's blogs, resources, all that fun stuff for everyone. Um, I am on Facebook a bit. I have someone else Amy that helps run the page cause I'm not, not super great at it. Um, I have a secondary page, Tracy Cassels, PhD that is a bit more a sleep support based as opposed to just science around parenting, which is more of, I have joined Instagram. I joined a couple months ago and I think I'm getting it my first week was a bit of a shit show. And I think I shared things that looked like Picasso paintings and then like repeatedly shared other people's posts 10 million times in a row without meaning to, because I didn't understand the platform, but I think I've got it down now. So I have not had many mistakes in a while. So you can find me there. It's under @TracycasselsPhD, uh, and Cassels is a CAS S ELs. It's not like a castle. Um, and I think that, Oh, I'm on Twitter, but I use that just personally. It's not really kind of for my stuff, but that's just, I it's an outlet for politics and it's a fun one. So, um, yeah. Right. There's that? And I have a podcast now, which you are coming on. Yes, no, yes. Which I am very excited about. So you can come listen to Abby, talk to me about breastfeeding advocacy and all these other issues that will get her to swear. So a year we are scheduled for March and I just started it at the end. Well, it, it started a couple of years ago. No, like four years ago I did one episode. Then two years later I did one and I finally found a rhythm here, but, um, yeah, it is the evolutionary parenting podcast. It's on all of these, these spots where you go. And basically it's a lot of interviews with people who, both researchers who are doing this research. So I've had already some interviews with people that do sleep training, which is interesting. I've got to stop doing that because it makes me angry. Um, but also others that do fascinating research. So this week's episode that just came out recently was with Dr. Megan Azhad and I guess this'll date whenever we actually spoke about this as to when it goes live. But, um, Megan is a researcher at the university of Manitoba and she researched the effects of artificial sweetener use in pregnancy, on offspring. So she's looked at the gut. She's amazing. I just am in awe of her work. And I have my next podcast that I'm recording is I'm going to pronounce it wrong because all these names, but I think it's Sheeran? You know, those Gaelic Welsh names that you just can't pronounce, right. Halcrow who is at, uh, in New Zealand at the university of Vontay get she's a bio archeologist. So she puts it, she studies dead babies to understand parenting practices and I am right. Like, it's just so cool. So I have a lot of those. And then I have people like Abby to come on to talk about more of this advocacy side of things. So, um, please do check it out. I am, I'm loving it because I'm getting a chance to go back and I don't know about you Abby, but I always feel like, Oh, in another life, I wish I'd studied that. Or in another life, I wish I'd gone back and done this. And it's allowed me to do that, um, in so many ways. And it's been so lovely, like I had Greer uh, Kirschenbaum, who is the world's first neuroscientists doula on a few weeks ago and she just talked about the brain development and pregnancy and beyond. And it's just, it's so fascinating to hear exactly what's going on. So yeah, it's that, that's my new exciting project that I'm working on this year. So,

Abby (01:21:39):

So check that out and I'll go at badass breastfeeding podcast.com y'all we can put, we'll have all these direct links where you can just click through and follow follow and listen, listen.

Tracy (01:21:49):

Um, yeah. Yeah. And that'll come and listen to Abby in March when it it's done there. Yeah, exactly. Exactly. So I'm excited for that. So yeah. So thank you so much for having me and thank you for opening up the discussion on sleep because it's so nice too often. I see breastfeeding separated from sleep and I really don't think you can do that. So many sleep issues are intertwined with the breastfeeding relationship. And, um, it's so nice to have that acknowledged on such a big platform like you have. Yeah.

Abby (01:22:17):

We love, we love, we love the sleep conversation and I agree. I feel like it's so intertwined that they have to go together. They have to, yeah.

Tracy (01:22:25):

Let that one. You can't breastfeed the way you really probably want to, without accepting some changes in the sleep like that whole solitary sleep and breastfeeding really is hard. I'm not saying it's impossible, but it's hard to manage. So we have to have these discussions for families because it's important to what they want to gain from that breastfeeding relationship as well. Yeah.

Abby (01:22:49):

Well thank you again, so, so much. And we can't wait to find out what topic we're going to discuss next time you're here.

Tracy (01:22:55):

Ah, well I think it's self-soothing now you've just convinced me that it's gotta be guys, if you have any,

Abby (01:23:02):

If anyone has suggestions Is there anything that you want to hear about? Let us know. Uh, we'll get together.

Speaker 1 (01:23:06):

It all together. All right. Thank you so much. Thank you so much, Abby. [inaudible].