What happens when you decide to Bed Share with your Infant? Kim's birth story & Expert insight on Infant Sleep

In today's episode I finish my conversation with Kim about her experience, both having kids and becoming a sleep coach. 

NOTE: I should mention upfront that we talk about a full term still birth and how Kim managed that very challenging experience.

She also shares WHAT MAKES BED SHARING SAFE OR UNSAFE (generally speaking) 

and gives TIPS about what's generally considered NORMAL FOR INFANT SLEEP and WHY WE SEE DISRUPTIONS IN SLEEP even after things have been going well!

We pick up where we left off last week. Kim is talking about the benefits of starting to understand what cultural anthropologists and others define as normal sleep patterns for infants.

AAP Guidelines
https://safesleep.mo.gov/american-academy-of-pediatrics-recommendations/#:~:text=Infants%20should%20be%20placed%20in,position%20as%20soon%20as%20possible

Academic work that contest elements of the AAP Guidelines
https://publications.aap.org/pediatrics/article-abstract/153/4/e2023064675/196919/The-Tension-Between-AAP-Safe-Sleep-Guidelines-and?redirectedFrom=fulltext

Connect with Kim
Website: https://intuitiveparentingdc.com/

The Responsive Family Sleep Podcast: https://intuitiveparentingdc.com/podcast

https://www.instagram.com/intuitive_parenting_dc/

https://www.facebook.com/intuitiveparentingdc

Transcript

Paulette  0:00  
 Welcome to what you didn't expect in fertility, pregnancy and birth, how we think and feel about this enormous transition often lives in the gap between what we expected and what we actually experienced. This gap exists in part because of how we tend to talk about and portray these events on all kinds of media in a one dimensional way, everything was amazing, but it's more often the case that there are beautiful things that happen and at the same time really challenging things that happen. This show shares true experiences, both the easy parts and the difficult parts, and how we manage what we didn't expect, the intense things that can happen in the course of this transition can impact how you see yourself, how you see your partner and how you parent. The better we understand what happened to us, the better we can manage all the things that follow. I'm your host, Paulette Kamenecka. I'm a writer and an economist and the mother of two girls, and I met many, many challenges in this process, none of which I expected in today's episode, I finished my conversation with Kim Hawley about her experience both having kids and becoming a sleep coach. I should mention up front that we talk about a full term stillbirth, and how can manage that very challenging experience. She also shares what makes bed sharing safe or unsafe, generally speaking, and give some tips about what's generally considered normal for infant sleep, and why we see disruptions in sleep even after things have been going well, we pick up where we left off. Last week, Kim is talking about the benefits of starting to understand what cultural anthropologists and others define as normal sleep patterns for inference,

Kim  1:53  
it also gave me some ideas of things that we could do. Okay, so it felt right,

Paulette  1:58  
but let's talk for a second specifically about your son. It sounds like one of the issues was that you wanted it to feel less erratic, that you wanted some sense of what's common in terms of sleeping and waking was he was it hard to put him down.

Kim  2:14  
He was always a nap fighter, and he was always a night owl, which he still is. That's just who he is. Yeah. So everyone's putting their babies to bed at seven, and I'm like, my baby goes to sleep at 930 and he is a night out that is just who he is. He didn't have an earlier bedtime until he started preschool, and that was quite the struggle to shift his rhythm. Yeah. So it wasn't that I wanted to control his sleep. Is that I wanted to understand it Okay, which I think is a little different than a lot of people. I didn't mind if there was some shifting and flexibility. I didn't want it to be rigid. I didn't want to schedule, but I wanted to understand why his naps might space the way they are, or what we can do when we're really struggling. I didn't get all this from my initial reading. Some of this is me looking back now with with much more knowledge. But yeah, what I really wanted is to understand it. And what I was hearing from everybody wasn't about understanding it, it was about micromanaging it and controlling it. And I wanted to understand what, where, what's our starting point, what's our foundation, and then I can make decisions if I want to do something differently, but I wasn't getting that understanding from a lot of places.

Paulette  3:24  
Yeah, it may be that most people are trying to control it because they don't understand it, or they probably Yeah, of where it would naturally be as a new parent, sleep loss is so significant and so draining and hard makes everything else harder. So most people feel like it's imperative to figure that out at some point, and I could figure it out in quotes, something that makes your lives work.

Kim  3:49  
Yes, and for us, we started bed sharing, and that wouldn't be a lot of people's choices, but for us, it worked well, we could do it safely, and I got a million times more sleep, and it was safer because I wasn't dozing off nursing my baby in ways that wasn't safe. And so that was a big strategy for us that worked. That wouldn't be the right choice for everybody, but that worked really well for us, and got us a lot more sleep.

Paulette  4:11  
So I think popular opinion that bed sharing isn't safe. Do you have more information on that?

Kim  4:19  
Yeah, there's a lot of reasons that we consider bed sharing to be unsafe. For some people, it is unsafe. It's not universally safe, but it can be done safely. We have quite a bit of research on what is and is not safe, and in some countries, the tides really starting to shift on recommendations, like UK talks about safe bed sharing with everybody, every single solitary parent, they get safe. Could crib, sheep, crib, sleeping information they get safe or safer. Bed, sharing information. So

Paulette  4:47  
what makes it safe and what makes it unsafe? If we can generalize,

Kim  4:51  
some things are parent specific, it's safer if you're nursing, it's safe. We have to be sober, no drinking with dinner, but also no medications that would make you sleep super deeply. Okay? Non smoker during pregnancy and after same as your partner, no baby exposed to cigarette smoke. Baby needs to be full term and healthy, so low birth weight and premature babies are at an increased risk. They need to be up there on their back, unless they're nursing. They need to be lightly dressed and not swaddled. We don't want to overheat them. Want their hands free. They need to be at chest height, right? But often parents will curl around baby right on their side. And then we need to think about the softness of the bed. The perimeter. Are there gaps? Is there excess bedding? How do we keep the area clear around baby? You know, there's very high level down there.

Paulette  5:40  
And why did you want to do bed sharing, other than like for your sleep? I

Kim  5:44  
wasn't going to do bed sharing. Remember, I was working on an infant mortality reduction public health program at the time, and one of the metrics we tracked in a bad way was the number of families bed sharing. And that was not good. We wanted that to be low. But I also have a background in cultural anthropology, and so I know that most of the world bed shares, yeah, right, yeah. And that yeah, Western countries are not common in the way that we care for infants, more broadly than just sleep.

Paulette  6:10  
So well, let me stop you there for one second. Most of the world bed shares without high infant mortality, I'm assuming Correct, correct, yes. So they, I mean some

Kim  6:19  
countries bed share with high infant mortality, but not necessarily because the necessarily, because the bed sharing, right? Yes, of course. But also countries like Japan, very low infant mortality, very high rates of bed sharing,

Paulette  6:29  
super interesting. So what are they at? What flipped you?

Kim  6:34  
I mean, I was kind of already doing it, like most parents last couple hours a night. Couldn't get him back in his bassinet, right?

Paulette  6:41  
Because she's there, and he'd start crying, yeah, okay. So

Kim  6:45  
I'd spend some time with him on my chest, or doze off with him nursing. And then when we hit that four month mark, where was my existential crisis of I have no idea what I'm doing and what is this even supposed to look like? It got worse. I couldn't I had gone back to work. I couldn't transfer him. It was so much harder, and one of the sources that lactation consult gave me was James McKenna, and he's one of the leading researchers on maternal infant shared sleep, and he's done laboratory studies and hooked everybody up to monitors and all sorts of stuff. And so I started going down the sort of research side of things, rather than just knowing this is the thing that people do in many countries, and also realizing that I was doing it anyway. And so I read enough research and enough of the politics that went in to the AAP guidelines.

Paulette  7:34  
So I don't know anything about the politics of the AAP guidelines. I do know that AAP stands for American Academy of Pediatrics. And with respect to sleep, they address issues like sleep position for the infant, what kind of surface the infant should be on, what should and should not be on the sleeping surface with the infant. And importantly, for this conversation, advise against bed sharing until the baby is six months old. I include a link in the show notes if you want to see the whole list from the AAP. Again, I'm not exactly sure what Kim was referencing, but when I dunked a toe into this research online, I immediately found academic work disagreeing with some of the guidelines, especially with respect to the co sleeping guidance, which, as Kim says, contradicts what other countries are doing who maintain low infant mortality rates? I'll leave links to some of this discussion. I found in the show notes, if you're interested in more details on that issue,

Kim  8:29  
that I felt very comfortable and that we were at very low risk, and I needed to get sleep. And yeah,

Paulette  8:37  
and so in this bed sharing, does the baby sleep with one parent next to him, and otherwise the side of the bed

Kim  8:45  
at that point, put baby in between me and my husband, okay, and we started bed sharing more routinely when he was four or five months. So he was pretty sturdy at that point, yeah, and my husband felt very comfortable that he was aware of where he was okay, good. So other people might make different decisions based on their own sleep personalities and their partner's sleep personalities, and people have really deep sleepers, or sleeper things like that, that might be different 100%

Paulette  9:10  
it is a very individualized choice. Yeah, and why don't you tell us a little bit about the benefits of bed sharing, other than you may sleep better with that, because you don't have to get up. And

Kim  9:21  
yeah, I mean, for my baby, he would just help himself to nurse. So I don't know how many times he nursed, he didn't wake me out. It was rare after that that he needed me to resettle him in a way that took more than minimal effort. And then if he did, then I would kick my husband and be like, go rock him in the rocking chair for a little bit, if nursing wasn't immediately settling him on those air times or in a big developmental leap, right then my husband was happy to get up, rock him for a little bit, and then hand him back to me. And so I did most of the nighttime parenting, but for the vast majority of that, it was very easy, and I was still getting a pretty reasonable amount of of good rest.

Paulette  10:00  
So that sounds super successful with your first one. It sounds like you have more children. Is it, how many monkeys can we fit in bed? Or how does it work when you have more kids?

Kim  10:09  
Well, my kids are pretty far apart because I had a full term loss in between. Yeah, it was, it was pretty devastating. And so you want

Paulette  10:19  
to talk about that? Or No,

Kim  10:20  
I mean, we could talk about it a little she, we don't still don't know why, right? I was full term. Everything was going fine. Went in for our midwife checkup. We were at the point where should we keep going? Should we get induced? Right? Like, because far back. But also, it was a VBAC, so, you know, inductions, yeah, nudging labor along is a whole different conversation when you're having feedback. And then she didn't have a heart rate. She just had no heartbeat. And so it was during labor, I was in, like, the early stages of labor, they've been having some contractions, but they hadn't really been. I lost my mucus plug. I was one centimeter and 50% of faced, or something like that, 8% of face, something like that. So not in any sort of active labor, but also my body was preparing for labor, I guess is a better

Paulette  11:07  
way to but it wasn't like in the throes of stressful labor. No, no, it wasn't like that. No, no. Did you guys end up getting the placenta exams and all that stuff, or that wasn't available?

Kim  11:21  
They did an examination. I don't remember to be I feel like I Trauma blocked some of that stuff out. Of course, I was induced. I did have a vaginal birth with her, and she was super tangled in her cord, and they didn't really find much beyond that. So, and I, I did decline some of the testing they could have done, like an autopsy. It just super freaked me out. And I was just like, I can't I again,

Paulette  11:45  
lots of there. And the other thing is, all those decisions are coming at a time when you're in complete shock, yeah, and preparing. You

Kim  11:53  
still have to give birth, right? Way too much to ask. And you're like, I can't think about that now, because I still have to have a baby, and I literally cannot think about so I like the best duel ever. And she got called in by my midwives right away. And we're laying 80s pop and trash talking, and people come in all super sad face, because I put something on the door when you have a loss, and we're in there totally goofing off, and they'll, I don't know how to read this room, because I had to compartmentalize, right? I had to set that all aside to process later. And luckily, I do look who I'm still friends with. Um, that's awesome. You got it. She just got it. We're gonna get through this. We're not gonna vote on what's actually happening here, so that you can get through this, and then we can kind of deal, so

Paulette  12:43  
what? And so my only question about this is because you brought it up for the first verb, is there a really long cord? And that's why he was breech, because he flipped around some long cord thing. Or so she had a

Kim  12:54  
really long cord and was wrapped. And then my living daughter, who is five years younger than my son, she had a really long cord and was tangled up in it, and was obviously just fine. So I'm curious. I don't know anything about his cordless. I wonder if that was part of it, just because both my daughters had really long cords and were, like, not just once or twice, three, four times, wrapped around it, because all my babies were very active, and the very the girls

Paulette  13:19  
were smaller than the boy. No, actually,

Kim  13:22  
my daughter, who was still born, she was about the same size to an ounce, an ounce smaller, so technically, and then my daughter was who my living daughter? She was bigger than both of them. Wow.

Paulette  13:36  
Well, I think an act of heroism to try again. Our first one was super complicated and almost didn't survive. I

Kim  13:43  
Oh, you know, I wanted my husband didn't want to try kind of back and forth and be like hashing out a lot. I did grief counseling for a while, and it was helpful. Ish,

Paulette  13:58  
help is hard to find.

Kim  13:59  
Honestly, my first my son's birth, was more traumatic than my daughter's birth, if you isolate out the loss piece, right? Which is traumatic? Yep, the birth was not traumatic because and I'd been planning an out of hospital birth again, but at this point we had a robust in hospital midwifery practice that my out of hospital midwives were very closely aligned with so we had no heartbeat. We were smoothly transferred in. They did an ultrasound. We had the best care. Everything I wanted that they could possibly do was respected. They bent over backwards to take such good care of us

Paulette  14:43  
that's that's awesome, and I totally applaud that, and I'm grateful for you for that.

Kim  14:48  
So with my living daughter, I was induced because we were not going to let my body go until it could go into labor on its own, because it wasn't doing that in a timeline that anyone was comfortable with, and it took a lot longer than we thought it would, right? And one of my midwives was like, I think you had some trauma that was stored in your body somatically that you needed to work through. And I don't know the how you could have worked through it better beforehand. I think you had to work through it in labor. I mean, maybe immediate PTSD support would have helped afterwards, it took a little bit longer than we expected. And she was like, I think you just had some stuff that your body needed to work through. Because that whole pregnancy, half of me didn't believe even though this baby was doing perfectly well, she was handling labor beautifully. The nurses kept being like, you have the best heart rate tracing on the board. She's doing so well. I'm like, Nah, she's gonna die. There's no way she's

Paulette  15:40  
gonna actually not that sounds like there's some there must be some truth in that, right? Your body stores a lot of information not necessarily accessible to you. So with the second one, do we co sleep again? Yes.

Kim  15:55  
And honestly, from day one, and part of it was because it worked really well. Yeah, yeah. Part of it was also anxiety. I'm like, she is right here next to me, yeah? And even just having her like me had the aside car bastard for her, and even just putting her in there makes me anxious. I don't think I really had postpartum anxiety with her, but there were just certain things that kind of made me anxious. I

Paulette  16:20  
get why you're calling it anxiety. I also think it feels rational. Yeah, right, given your experience, how could you not feel that way?

Kim  16:28  
I mean, that's really family specific, right? We kind of leaned into a family bed for a long time, because right when we were going to kick my oldest out of our bed when I was pregnant with my second, then we had a loss, and we were just like a, his world just got completely upended. And B, I as a parent, have zero capacity to make any changes right now. Yeah, you know, parenting through trauma, you don't have anything extra. You're not even really showing up as a very good parent at that point. I mean, you're doing your best. Yeah? You know what? There is a

Paulette  16:59  
view, yes, yeah. So,

Kim  17:01  
you know, in a broad sense, I think that really depends on the family, and for our families, that's just all about little nudges and little changes and

Paulette  17:09  
stuff that sounds awesome. So you, based on your experience, that's what made you become a holistic sleep consultant. Is that right? Yeah.

Kim  17:19  
I mean, for me, what really led me to that was being in a world as a new parent where I didn't know what was normal, I couldn't easily find what was normal, and basically all I was hearing was leave your baby to cry, right from my friends and I thought we had pretty similar parenting values, and I don't mean that as a judgment To them, but it fundamentally felt wrong to me. And I was like, okay, it's fine, but why is that all I can find, right? And so I didn't like that. I didn't like that. It was so hard to find information that was more based in normal baby development and UV centered that relationship, parent, a parent, baby relationship, that connection, which, as my oldest grew older, became a big part of how we were parenting, right? And so, kind of starting with the research I started doing when he was a baby, and sort of moving forward to finding actual certifications that were more based in that sort of attachment, developmental, holistic way of viewing sleep. I was like, Oh, my God, this is a legit thing. Someone is actually knowledgeable enough to certify people in and I just kind of fell in love. I took it kind of on a whim, actually. I took my first sleep certification after I lost my daughter, because I was doing some early parent education stuff at that point, and some lactation stuff. And I was like, I can't work with parents and babies anymore. Oh, my God. And so I took some time off. I wasn't working at all. I was like, I'm going to take the certification because it's interesting looking, and let's see if I can engage with new parent information without it being traumatizing. And so certification felt like a safe way to do that right, as opposed to actually trying to work at that point. And so it was actually sort of my entry

Paulette  19:11  
that's super interesting, and I feel like brave. So this does sound like a really good nexus of science and public health that you're already interested in. And why don't you tell us a little bit about your practice now, what do you find people most concerned about? What kind of advice do you give? And I will couch that in everyone has their own approach to sleep, and it's very personalized. And I wish we had done the family bed, and I wish I'd known anything about attachment before I had kids, and we did the cry it out method, right? Which felt terrible, and it didn't feel right to me. I had no idea what else to do. I was working and doing a bunch of other things, so I went in the flow, even though Yeah, and it's all you hear yes, and that's what everyone tells you they're doing that sort of normalizes it. Also, if you follow that path, don't necessarily understand the costs, because no one is talking about that. So if only I could do it over again. What would you tell me? How do you how you talk to new parents about this stuff?

Kim  20:15  
Yeah, and, I mean, I think it is really important to say that every family has to make their own choices and their own value systems and knowing their baby and their baby's temperament and what feels right to them, right and so I think sometimes when you talk about alternatives to cry it out and sort of more connected ways of dealing with sleep, people feel attacked. And I don't think that. I know that's not what I mean. I don't judge parents for the decisions they make. Parenting is hard and messy, and we're all just trying to do the best that we can, but I also know what it was like to be a parent who couldn't find something that matched their values or they felt comfortable with and so that's what I like to give people, is that there is an option that is not cried out sleep training type stuff, but it's also not just you can't do anything. You just have to let, yeah,

Paulette  21:06  
run to the crib every five seconds, and

Kim  21:08  
yeah, things unfold. And so for me, it's a lot about let's understand what's normal. Let's understand who your baby is, and let's try to work with their own natural sleep rhythms, and looking at all the different factors that impact how we sleep, and then if we need to make changes, let's do it in a way that is supporting baby through or toddler, you know, through smaller steps that we can support them through. So we're not kind of shoving them into a big change. We're helping them by doing that change into smaller steps and supporting them through that. And I feel like when it comes to sleep, there isn't one right solution for everybody, and that's what we really need to understand. Every baby is different. Every family is different. Bedroom is a great option for some families, it's horrible option for other families, right? Some families do really well, yes, sharing nighttime parenting. Some families can't. There's just so many options. But also we can expect a highly sensitive baby to sleep like an easy going babies. And so there's that expectation management piece that if you have a baby who's you know, got some ongoing medical complexities that make them uncomfortable or they're highly sensitive, then we're going to have a different path than a baby who's real chill and easy going, Yeah, and so to really kind of meet our baby where they're where they're at, and also work towards something that feels sustainable, and also a good dose of thinking outside the box and being creative, right? What's the goal here? Is the goal here that your baby sleeps exactly like this in here? Or is the goal here to get more sleep, right? Because those can be different pathways, sometimes for different families,

Paulette  22:49  
that's super cool. I wonder if we can just there. Every baby's different, every family is different, but there are some things that are consistent, like no baby has a schedule before four months is that the right cut off or ish?

Kim  23:06  
So consistency of sleep is actually a temperament trait, and so some babies do find patterns in the three four month mark, but they're going to change a lot, right? And I say most babies are going to find more regular patterns closer to six months. Okay, that's useful. So I think temperament is the biggest thing that shapes sleep, temperament and health conditions, those are the two things that hugely shape your sleep journey, that are completely outside of our control and define temperament for us. Yeah, so with certain eight traits that shape who we are and how we react to the world. So body regularity, that's a temperament trait, intensity, that's a temperament trait, your sensitivity to environment and things bothering you in your environment. Temperament trait, how much activity you need. Temperament trait. So a lot of the things that, if we're thinking that we have a baby that needs a lot of sleep and is really easy going, right, we're going to different things. And if we have a low sleep needs baby who needs baby who needs a ton of activity in order for their body to sleep soundly, right? And so that's where it doesn't all look the same. We have to really figure out, what does your baby or your toddler or your child need for them to get their sound dispersion asleep?

Paulette  24:18  
And are there regular periods of sleep disruption because of brain development. Or how does that work?

Kim  24:26  
Usually, anytime your baby is in a rapid period of development, whether that's gross motor skills, language, you know, cognitive sleep is going to go kind of sideways and off the rails. So often that's somewhere around four months. Some are around eight, nine months, somewhere around 18 months. Sometimes there's another one in there, around 12, 1314, months, when they start walking. But those are just rough times. They're not exact. They're really just around these periods where we tend to have a lot of clustered development that happens.

Paulette  24:58  
But even that is useful to know, because I often think it will be going, quote, unquote, well, and then your baby hits six months or something, sleep is gone. And the parents are like, what's going on? You used to have this down, and now it's gone. And it makes sense,

Kim  25:11  
yeah, if you have an early crawler, you might see that earlier, right? Crawling, super sleep disruptive. Learning to walk, super sleep disruptive. And so if you have a baby that skews earlier than some of those periods of disrupted sleep might skew earlier.

Paulette  25:25  
And do you know if that's true throughout childhood? I mean,

Kim  25:30  
I think we can think of it like anytime there's a lot going on, humans have trouble sleeping, right? So lots of change, or things that make you feel a little bit more unsettled, or your body's processing, brain's processing a lot of stuff in your sleep, you're more likely to have, you know, more wakeful sleep.

Paulette  25:47  
Well, it's super interesting. I'm

Kim  25:49  
so grateful to hear your story and talk to you and learn about this. Definitely. It's been so wonderful talking with you. So where can people find you? So my practice is called intuitive parenting. And my website is intuitive parenting, dc.com, I actually have my own it's called the responsive family sleep podcast. And I'm on Instagram at intuitive underscore parenting, underscore DC,

Paulette  26:15  
awesome. Well, we'll put all those things in the show notes. Awesome. Thanks so much for coming on, Kim.

Unknown Speaker  26:19  
Thank you for having me.

Paulette  26:22  
Thanks again to Kim for sharing both her varied experiences of her pregnancies and births and the path that led her to become a sleep consultant, even at the most general level, establishing a baseline for what's true on average for infant sleep seems really valuable, as does the insight that temperament is a significant driver of sleep patterns that didn't occur to me to think of sleep in that way. It didn't occur to me to think of sleep in that way when my kids were infants, and I wish I'd had I also appreciate her effort to normalize the fact that sleep looks different in different families based on these factors and more, and the job of the parent may be to figure out how to best meet the infant needs in the family context, understanding that it will likely look different from what's going on at your friend's house. To get more information about Kim and her practice, I include ways to connect with her in the show notes, as well as links to some of the references she mentioned on infant sleep. Thanks for listening. If you liked this episode, please share it with friends and feel free to rate and review the show. It's how other people find us. We'll be back next week With another inspiring story You

Speaker 2  27:34  
Hey.

Paulette  29:25  
Sorry brother.

Okay.

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