Mother-infant cosleeping, breastfeeding and sudden infant death syndrome: what biological anthropology has discovered about normal infant sleep and pediatric sleep medicine.

Bibliographic Collection: 
MOCA Reference, APE
Publication Type: Journal Article
Authors: McKenna, James J; Ball, Helen L; Gettler, Lee T
Year of Publication: 2007
Journal: Am J Phys Anthropol
Volume: Suppl 45
Pagination: 133-61
Date Published: 2007
Publication Language: eng
ISSN: 1096-8644
Keywords: Adult, Animals, Anthropology, Physical, Beds, Behavior, Animal, Biological Evolution, Breast Feeding, Cross-cultural comparison, Ecology, Female, Global Health, History, 20th Century, Humans, Infant, Infant Care, Infant, Newborn, Mother-Child Relations, Pediatrics, Polysomnography, Primates, Research, sleep, Sudden Infant Death

Twenty years ago a new area of inquiry was launched when anthropologists proposed that an evolutionary perspective on infancy could contribute to our understanding of unexplained infant deaths. Here we review two decades of research examining parent-infant sleep practices and the variability of maternal and infant sleep physiology and behavior in social and solitary sleeping environments. The results challenge clinical wisdom regarding "normal" infant sleep, and over the past two decades the perspective of evolutionary pediatrics has challenged the supremacy of pediatric sleep medicine in defining what are appropriate sleep environments and behaviors for healthy human infants. In this review, we employ a biocultural approach that integrates diverse lines of evidence in order to illustrate the limitations of pediatric sleep medicine in adopting a view of infants that prioritizes recent western social values over the human infant's biological heritage. We review what is known regarding infant sleeping arrangements among nonhuman primates and briefly explore the possible paleoecological context within which early human sleep patterns and parent-infant sleeping arrangements might have evolved. The first challenges made by anthropologists to the pediatric and SIDS research communities are traced, and two decades of studies into the behavior and physiology of mothers and infants sleeping together are presented up to the present. Laboratory, hospital and home studies are used to assess the biological functions of shared mother-infant sleep, especially with regard to breastfeeding promotion and SIDS reduction. Finally, we encourage other anthropologists to participate in pediatric sleep research using the unique skills and insights anthropological data provide. By employing comparative, evolutionary and cross-cultural perspectives an anthropological approach stimulates new research insights that influence the traditional medical paradigm and help to make it more inclusive. That this review will potentially stimulate similar research by other anthropologists is one obvious goal. That this article might do so makes it ever more possible that anthropologically inspired work on infant sleep will ultimately lead to infant sleep scientists, pediatricians, and parents becoming more informed about the consequences of caring for human infants in ways that are not congruent with their evolutionary biology.

DOI: 10.1002/ajpa.20736
Alternate Journal: Am. J. Phys. Anthropol.
Related MOCA Topics: