PROFESSOR HELEN BALL, Durham Infancy & Sleep Centre, Department of Anthropology, Durham University, UK
Originally published April 2016 and republished with the express permission of the author.
Image courtsey of Kathryn O’Donnell, sourced from the Baby Sleep Info Source (Basis) website, made available under a Creative Commons License.
Putting bedsharing babies in the picture
In February 2015 an editorial published in the British Medical Journal (the BMJ) responded to the National Institute for Clinical Excellence guidance on co-sleeping and SIDS issued shortly before. While the editorial itself was uncontroversial, the same could not be said for the photo chosen to illustrate the piece, which was of a young baby sleeping next to his mother with his face pressed into a pillow—quite clearly a suffocation hazard.
At Durham University’s Parent-Infant Sleep Lab we have been instrumental in researching how parents and babies co-sleep, so this was an error we could not ignore! In posting an online response about the picture, we explained why positioning this image under the headline “Making informed choices on co-sleeping with your baby” was particularly ironic, and why it was important for all media—not just medical journals—to model safer bedsharing in their illustrations. The link between SIDS and prone sleeping has been the focus of SIDS reduction campaigns since the nineties, as has guidance to parents to avoid having their babies sleep on pillows and other suffocation hazards. One of the informed choices parents should be making when they opt to co-sleep is how to do so as safely as possible (and not as depicted by the BMJ)! See The Safe Sleep Seven.
Several days later (and possibly because it attracted 109 “thumbs-up” on the BMJ website) an editor contacted us to say they would like to include the comment as a letter to the editor in the next print edition, and illustrate it with a more suitable image—so could we please provide one? We trawled the stock image banks, and discovered very few suitable photos. We shared the best of these on the Facebook wall connected to our Infant Sleep website and asked our followers for their opinions. After much debate a suitable picture was chosen and duly published in the BMJ, alongside our response, by way of correction.
Pleased that our small action had been positively received, we muttered a little about the need for the media to have access to images of safer infant sleep scenarios to illustrate their stories, and got back to work. A few months later though, the topic was back in our minds when the U.S. National Institute for Child Health & Development released a set of Safe Sleep photo resources for media and health professionals to use to illustrate infant sleep articles and information. Disappointingly we found the resource to be devoid of images that depicted bedsharing or co-sleeping. This was presumably because in the U.S. parents are advised NEVER to sleep with their babies, advice which is highly controversial to many.
Fortunately the United Kingdom is taking a more enlightened approach (NICE 2014) in accepting that bedsharing is a common means by which new parents cope with the sleep disruption that is an inevitability of life with a new baby (a topic about which we have recently published new research: Rudzik and Ball 2015 and Ball et al 2016). And so, late in the year and without any funding, we grasped the opportunity to address NICHD’s omission and create an image bank of photos illustrating safer ways of parent-infant co-sleeping. This, we reasoned, would help to normalize safe bedsharing and what it entails, by making it easier for the producers of publications to find high quality images they can download for free.
One day in August, another Facebook announcement resulted in half a dozen volunteer families attending the sleep lab with their babies to be photographed by an award-winning baby photographer from Sheffield, who was persuaded to donate his time and expertise to the project by one of our supporters. In addition, we solicited images from parents unable to visit the lab on photo-day who submitted their own photos to an online competition. The final product is an image bank of high quality images that are available for downloading free of charge and in several resolutions, under a creative commons license. The image bank can be reached from the Baby Sleep Info Source (Basis) home page and the Durham Infancy & Sleep Centre website. Please spread the word!
Many thanks to Rob Mank of Rob Mank Photography for his time and expertise, and to Emma Ridley of My First Beats whose idea the image bank was. Thanks to all parents and babies who took part in the photo shoot and competition, and to Cassandra Yuill for her organizational work on the project.
Ball, H. The BMJ illustrates hazardous co-sleeping BMJ 2015; 350:h993.
Ball, H., Howell, D., Bryant, A., Best, E., Russell, C. & Ward-Platt, M. Bed-sharing by breastfeeding mothers: who bed-shares, and what is the relationship with breastfeeding duration? Acta Paediatrica 2016 in press.
National Institute for Health and Care Excellence. Addendum to Clinical guideline 37, Postnatal Care. Routine postnatal care of women and their babies 2014.
Rudzik, A., & Ball, H. Exploring Maternal Perceptions of Infant Sleep and Feeding Method among Mothers in the United Kingdom: A Qualitative Focus Group Study. Maternal and Child Health Journal 2015.
Helen Ball BSC, MA, PhD, is Professor of Anthropology at Durham University, where she is Director of the Durham Infancy & Sleep Centre and a Fellow of the Wolfson Research Institute. Together with her team of postdoctoral and PhD students Helen has been conducting studies of parent-infant sleep in the lab, the community and in local hospitals for the past 20 years. She is a member of the LLLGB Panel of Professional Advisors, the NCT Research Advisory Board, and has just assumed the role of Chair of the Lullaby Trust Scientific Committee. She pioneers the translation of academic research on infant sleep into evidence for use by parents and health care staff via Baby Sleep Info Source (BASiS),. See the preface she wrote to Sweet Sleep and her feature on Infant Sleep.