Sleeping

When did you start questioning the reliability and integrity of medical groups such as the American Medical Association or the American Academy of Pediatrics? (If you are not questioning, this Musing may not be for you.) The Covid years left many skeptical, while dissemination of ideas such as that cutting off the healthy breasts of a psychologically fragile sixteen-year-old girl is scientifically supported, prodded many more to doubt.

Like most people of my generation, I was brought up to respect and follow the advice of doctors. When Dr. Monoson paid a house call and prescribed truly foul green medicine, I swallowed—not that my mother gave me a choice. Later, blessed with good health and multiple pregnancies, I trusted my obstetrician and pediatrician and I knew that they related to me as an individual rather than a nameless patient. My current G.P. is great and when a health crisis hit a few years back, I treasured the surgeon who saw me through a few difficult months.

Yet, I have little respect for the organizations that speak for these professionals* and their pronouncements from on high. Personally, my reservations started with the “Back to Sleep” campaign in the early 1990s. This crusade was an early example of a tsunami of negative news that turned having a baby into a fear-ridden activity. Sudden Infant Death Syndrome, where putting a seemingly perfectly healthy baby down for a nap or for the night who then doesn’t wake up, is devastating. Suggesting that the baby’s death was caused or at least assisted by sleeping on his or her stomach and that keeping them on their backs would avoid death was psychologically calamitous. How could the average mother take that risk?

Having had six infants sleep on their tummies, as was true for most babies before this movement, I ignored the proclamations that accompanied our youngest child’s birth. Frequently getting up with a newborn is acceptable; making it more difficult for a newborn, infant, and baby to sleep soundly, sounded ridiculous. Negative consequences of back sleeping were simply ignored. It didn’t seem reasonable to accept that my own instincts as well as the wisdom of mothers through the ages was suddenly decisively proven wrong. A small amount of research that I quickly did suggested that there were any number of potential contributing factors to SIDS that weighed in more strongly than the baby’s sleeping position, including attending day care, yet no one seemed interested in talking about those. I questioned whether mothers exhausted by their baby’s poor sleeping were having more accidents in the home and while driving, but the blaring ads promoting back sleep didn’t seem to share my curiosity.

About 35 years have passed. Is it too cynical to note that children’s sleep is now an industry? Expensive swaddling outfits have replaced blankets, noise machines and blackout curtains train babies to need exclusive equipment in order to fall asleep, sleep coaches abound, and specialists with distinctive equipment will help you undo the damage to heads and muscular tone that results from back sleeping.

Had my personal motherhood experience started ten years later than it did, I might have unthinkingly participated in the ‘back to sleep’ movement. I probably wouldn’t have thought to question whether the entire crusade was based on controlled, scientific studies (I believe the answer is no). What I wouldn’t have realized is that, intentionally or not, the act of giving birth and having children was in the process of turning from a joyous and exciting adventure that, admittedly, was sometimes accompanied by tragedy and heartbreak, into an intimidating and fearful experience that was beyond the physical, psychological, and emotional ability of most human beings to navigate on their own. How much sadder my life and that of my children would have been.

* Only 15% of American doctors belong to the AMA. This is a sharp decline from the early 1950s when 75% of physicians were members. (Interesting, but not well known.)

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