Parents experience a lack of formal and informal education on normal newborn sleep patterns. This absence of information through group prenatal classes or perinatal appointments with healthcare providers results in unrealistic expectations of life with their newborn. Coupled with geographic isolation from extended family support systems or extended family members who have different recollections of newborn sleep patterns, parents turn to crowdsourcing information on social media. The prolific advertising of sleep training on social media platforms increases parental fear, leaving parents overwhelmed with the increasingly contradictory information on sleep and strategies for coping.

This presentation will address the situations that lead to unsafe bed sharing and social pressure to sleep train. Participants will have an understanding of the concerns that parents bring to sleep classes for both infants and toddlers. Collaborative strategies for responsive nighttime parenting that respects brain development; attachment theory, nighttime feeds, and balanced with parents need for sleep and self-care will be the focus. Opportunities for education that include online, individual and group opportunities will be offered including a collaborative effort between parents, family, community and healthcare providers.

Sleep deprivation and disruption of an individual’s circadian patterns in the postnatal period are frequently cited as contributing factors in the development of postpartum depression, anxiety (PPD&A) or postpartum post-traumatic stress symptoms (P-PTSS). These factors are increased for the birthing parent of twins, triplets or more, who is more likely to bring two or more newborns home after experiencing perinatal complications and related interventions, and infants’ preterm birth, low birth weight and other complications, often resulting in neonatal intensive care unit stays. Even for a relatively ideal multiple pregnancy and birth, caring for two or more newborns – each having as many needs as any single-birth newborn – round-the-clock parenting generally leads to profound and often long-term sleep deprivation. When significant sleep deprivation affects a parent’s daytime behavior, all family members are affected. Yet current “safe sleep” recommendations or nighttime strategies promoting better sleep for parents and a single infant, including safer bedsharing techniques, are more difficult logistically to implement. These recommendations and strategies may also be less safe to implement with multiple infants. This session will examine the factors contributing to disruptive sleep for parents of multiples and develop strategies that meet both infants and parents needs for adequate sleep.

Bedsharing promotes breastfeeding, but many authorities recommend against bedsharing for all mothers, citing safety concerns, particularly risk of sudden infant death syndrome or suffocation risks. Here we will review the normal physiology of mother-infant sleep, and the historical context in which such recommendations evolved. In addition, many populations have high rates of bedsharing with low rates of death. In this context, we will review the evidence around bedsharing and the most current evidence-based recommendations. Some risk factors for SIDS are more powerful than others, and we will review the best ways to minimize such risks, including a social-determinants of health approach. In some circumstances, bedsharing may carry particular risks and it is important to be able to discuss these issues with parents without stigma. We will discuss counseling of all parents in the “risk-minimization” approach, which would also allow for promotion of breastfeeding.