ABSTRACT
We try to keep in mind cultural influences on the advice we give. We remind ourselves
that much of what comes to the pediatrician’s attention, as problematic sleep behavior-
children who have difficulty falling asleep alone at bedtime, who wake at night and ask
for parental attention, or who continue to nurse at night-is problematic only in relation
to our society’s expectations, rather than to some more general standard of what con-
stitutes difficult behavior in the young child. Our pediatric advice on transitional objects,
breast feeding, cosleeping may be unknowingly biased toward traditional Euro Amer-
icanviews of childrearing, especially those about bedtime and nighttime behavior. Thus,
in giving advice about sleep, pediatric health professionals might dowell to be aware of
their own cultural values, to examine closely their patients cultural and family contexts,
and to assess parental reactions to children’s sleep behaviors. (1)
Who sleeps by whom is not merely a personal or private activity. Instead it is
social practice, like burying the dead or expressing gratitude for gifts or eating
meals with your family, or honoring the practice of a monogamous marriage, which
(for those engaged in the practice) is invested with moral and social meaning for a
person’s reputation and good standing in the community. (2)
Inclinical pediatrics, cosleeping is thepolitical third rail. If you touch it, youdie. (3)
In this chapter, we have contributed a new conclusion to the first version pub-
lished in the earlier edition, slightly modified and updated recent developments
as regards research into mother-infant cosleeping in the form of bedsharing, and
have contributed a new last section that critiques recommendations against any
and all bedsharing. But mostly, we provide here (without modification) a cultural
background to our thinking about what constitutes ‘‘normal, healthy, and
desirable’’ infant sleep and show the interconnectedness between scientific
research, cultural values, concerns for morality, and sleeping arrangements that
are characteristic of Western society. Specific biological and psychological
evidence is put forth supporting the views of Sadeh and Anders (4,5) and Anders
(6) on the importance of understanding what is ‘‘appropriate’’ infant sleep on the
basis of the overall social and physical context within which it occurs.