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.