Why it is important to present all the facts about the legitimate functions and affirmed benefits of breastsleeping

We are completely perplexed by the recent commentary by Wennergren (1) that accompanied our article entitled ‘There is no such thing as infant sleep, there is no such thing as breastfeeding, there is only breastleeping’ (2). Wennergren claims that we completely dismiss or ignore other bedsharing outcome research including his own and one by Carpenter et al. (3) that led them to conclude that across all mother–infant dyads, the safest place for babies under three months of age to sleep is necessarily in their own cot. And, yet, of the 3,279 words in the main text of our paper, 872 words (~25%) were spent describing the specific findings that cover the facts about bedsharing he claims are missing. But after we summarise their data, which led them to reaffirm the Swedish SIDS recommendations, we point out that, as the authors themselves report, many key social factors including sleep position, pacifier use, and elicit drug or alcohol use were not available (4: p. 78) all of which, we pointed out, are known to significantly determine SIDS risks. The absence of such critical confounding factors precludes attributing causation solely to the practice of bedsharing itself and not each specific risk factor that increases the likelihood of any one infant dying. Alongside those contextual details, we also cite the nine published challenges to the validity of Carpenter et al. paper from colleagues with clinical, epidemiological, statistical and social science backgrounds. Since publishing our breastsleeping paper and alongside the existing epidemiological, laboratory and observational data we presented therein, we find further convincing support that mothers presence and the skin-to-skin contact she offers as part of the suite of bedsharing behaviours when done safely is value added and not a risk or pathology. Boundy et al. (5) present the results of a large, beautifully designed systematic review and meta-analysis of kangaroo mother care in relationship to neonatal outcomes. The analysis involves 1,035 studies with 124 studies meeting their strict inclusion criteria. Amongst low birthweight babies, who are more likely to die from SIDS, compared with conventional care kangaroo maternal care (skin to skin) was associated with 36% lower infant mortality, decreased risk of neonatal sepsis, hypothermia, hyperthermia, hypoglycaemia and lower hospital readmissions for the infants given skin to skin. Moreover, as our paper argued, they found also that early, sustained contact (amongst the skin-to-skin-treated babies) led to increased exclusive breastfeeding for a longer duration (4 months). Finally, increased contact with the mothers body during the first 30 days of life led to lower mean respiratory rates and pain measures with higher oxygen saturation, temperature and head circumference growth, validating the notion of potential beneficial physiologic regulation that can occur, when mothers practice the safest form of bedsharing which is encapsulated by breastsleeping (2).