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Co-sleeping is the practice where the child sleeps in bed with his parents. Not surprisingly, it is one of the most hotly debated and controversial topics related to pediatric sleep. Let’s see why.
Some people argue that co-sleeping is the right and natural way to raise a child because the practice fosters a stronger bond and a more secure attachment.
Conversely, others will tell you that co-sleeping is risky, ridiculous, or even dangerous and they don’t want it for their family.
So, which approach holds the truth?
First, it’s important to understand that co-sleeping is not magic. Although some proponents of the family bed would disagree, numerous couples have reported that their babies did not necessarily sleep deeper or longer because their parents were close by. In fact, some parents found that their child slept longer and woke less frequently when they stopped co-sleeping and moved him into his own crib.
However, whether families choose to co-sleep or have their children sleep independently is a personal decision, and if both parents and child are safe, rested, and fulfilled, then co-sleeping is nothing to worry about.
If you decide do co-sleep, this commitment requires some very careful thinking about what you and your spouse feel is right for you as individuals, as a couple, and as a family.
Ask yourselves the following questions:
•	Is it nice to think about enjoying the coziness of sleeping in close proximity, or does one or more of us tend to stay active during sleeping – potentially disrupting the others?
•	Does everyone in our family want to co-sleep, or are we leaning toward it because one of us feels strongly?
•	Are we willing to commit to being quiet after our child falls asleep, or do we like to watch TV or talk in bed?
•	Will we enjoy being able to feed our baby more often throughout the night, or will having him next to us make it tougher to wean nighttime feeds?
•	Are we agreeable to getting into bed when our child does, to ensure his safety?
•	For working parents, does sleeping next to our child allow us to feel more connected to him?
As expected, co-sleeping has both advantages and disadvantages.
Let’s take a closer look at them.

Advantages:
•	Constant closeness whenever the child is awake. Many children and parents enjoy this feeling.
•	Immediate action and support for any sleep-related problem
•	The ability to nurse and respond to other nighttime wakings without getting up
•	More time to spend with the child
•	Possibly better sleep for both the child and the parents, if the child was sleeping poorly to begin with
Disadvantages:
•	Parents may sleep poorly if their children are restless sleepers
•	Parents may end up sleeping in separate rooms, and they may become angry at their child or with each other
•	Children’s and adults’ sleep cycles do not coincide
•	Parents may have to go to bed at a very early hour with their children and be left with little time for their own evening activities
•	Parents have little privacy
•	There may be a slight increase in the risk to the infant from SIDS and related causes.

The decision to co-sleep should be yours, made by the parent – or parents – and based on your own personal philosophies, not on pressure from your child or anyone else. Another family’s good or bad experience with co-sleeping should not influence your decision: your child is unique and your family is not the same.

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I want out! That’s the message your toddler will send – one way or another – when he’s ready to wave goodbye to the crib and say hello to a big-kid bed. Your child might actually verbalize displeasure, or more likely, simply climb out of the crib.
So, what needs to be done?
First, resist the temptation to move him too early. Most experts recommend doings so around age 3. Unless your child is climbing out of his crib or needs more space than a crib can provide – his body is growing at an astounding rate – it’s better to keep him in the crib, which allows him to feel safe.
This way, your child can feel comfortable taking giant developmental leaps during the day but still regress to the security of his old crib at night.
Moreover, until age 3, toddlers are very impulsive, and your child’s difficulty in understanding and being able to follow directions or rules (like staying in bed all night) will make sleeping in a bed a real challenge. If you transition to a bed before age 3, you can plan on waking up to a little visitor next to your bed pretty much every night.
When the time comes, however, you need to help your child transition smoothly to sleeping in a bed. For that, you need to follow certain steps. These are:

1.	Create a safe environment: Safety proof your child’s room and any adjacent areas he may be able to visit into the middle of the night. Secure windows, tops of stairs, and any stepstools that can be tripped over. Even better, you can install a safety gate at your child’s door. You can even install a small night-light in his room to help him orient himself and avoid hurting himself.
2.	Pick the mattress: Go to the mattress store – or any other store that sells mattresses – and let your child help you choose the mattress or bed. With safety in mind, all you need is a twin-size mattress and box spring and some safety rails for the side. You should adjust the height of this new bed accordingly, as it will need to sit low on the floor for some time until your child gets used to it. Get some fun new sheets, some special pillowcases and you’re set to go.
3.	Disassemble the crib (together): Once the new bed comes home, ask your child to help you to take down the crib. This way, your child will feel part of the transition process and will also be able to say good-bye to the crib.
4.	Set up the bed: Put the bed in a corner of your child’s room so that the head and side of the bed are flush against the wall for protection. Add a safety rail to the exposed side of the bed. Your child will feel safe this way, just as he did in his crib.
5.	Explain the rules of bedtime: If your child is verbal before the first night of sleeping in the bed, go over the rules of bedtime with him. Tell him that he is a big boy now who needs to understand that when we go to sleep, we only wake up when the sun is nice and bright.
6.	Do your bedtime routine: During the first few nights your child is sleeping in his new bed, take an extra 10 minutes of reading time together to make him feel comfortable in his new environment. The idea here is to make your child feel safe. If your child seems excited about the new bed from the very start, you’re one of those luck people who has made this transition easily.

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Early morning wakings are one of the toughest sleep problems to fix, if not the toughest. If you’re wondering why, it’s because after a decent night’s rest your child has got more energy to fight sleep in the morning. And the truth is, all of us come up into lighter sleep phases in the last hour of our sleep, preparing to take up for the day.
Remember, however, your child is waking early only if he is not getting the right amount of night rest for his age and his body. In other words, if your child sleeps from 7 PM to 6 AM, it’s a perfectly reasonable schedule for him, even though it might feel early to you.
We can’t ask our children to sleep more than 11 hours at night. Their bodies are usually rested after this much sleep, and they won’t be able to do more.
Also keep in mind the following fact: if your child is waking even at 10/½ hours, if he is rested and energetic in the morning and makes it easily till his naptime, then he’s getting enough rest for his body.
Problems arise if your child sleeps from, say, 7 PM to 5:30 AM. In this case, you’ll need to push the bedtime later by 15-minute increments, then watching to see if your child can sleep later in the morning,
A word of caution, though: Making the bedtime later can often have the opposite effect of causing your child to wake up earlier. This is the reason why things need to be done in small steps.
Here are some other ideas to try if your child is an early bird:
•	Make sure that your child’s room is very, very dark.
•	If there are any sounds that could be waking him – such as garbage trucks, barking dogs, sprinklers – put white noise in the room and make the volume loud enough to protect him from these sounds
•	Remove all stimulating toys from your child’s crib or bed, which can be distracting once the sun enters his room.
•	If you are checking in on your child within the last hour before his wake time, your interaction may prevent him from returning to sleep. Don’t check on him if it’s less than one hour till his wake time.
•	Make sure the bedtime is not too late for your child’s age. Adjust the bedtime earlier by 15-minute increments, and watch what happens in the morning. In doing so, you will allow your child to sleep later, as he is less overtired at bedtime. If he does wake earlier, return to your previous bedtime. If moving the bedtime earlier has no effect on the wake time, you may want to consider using the earlier bedtime anyway to help your child get the right amount of night sleep for his age.
•	Make sure your child is not hungry. If you have a child under 12 months and have newly begun to wean feedings, you may want to slow the process down to give him more time to adjust. Moreover, be careful to ensure that you are offering the breast or bottle more often during the day to help him transition his previous nighttime feeds to the daytime, so he won’t be hungry going down for sleep at night.

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Seeing your baby cry is perhaps the most heartbreaking moment of all. You don’t want him to cry. You want him happy. And of course, you want him healthy. But for all that to happen, he needs to sleep properly.
It would be nice if your child could learn how to sleep without any crying or frustration whatsoever. Every parent would sign up for that. Unfortunately, the truth is that all children, regardless of the method you use to help them sleep, inevitably do shed some tears in the process. Let’s see why.
First and foremost, children cry when learning to sleep because they are protesting – they don’t like change. In fact, they hate change. Just think about it.
Do you remember what your favorite book was as a kid? Do you remember wanting to read that book over and over again, even though you knew every word of it?
We all resist change, children and adults alike. It’s normal to do so, and it’s normal for your child to express his resistance by crying. After all, crying comes before words – not the other way around.
Second, as children begin to learn how to sleep but haven’t yet figured out how to do so, they are understandably frustrated. They no longer have Mom and Dad on their side to help them get to sleep, and they don’t yet know what to do differently. They will eventually.
What’s really interesting about falling asleep is that although each of us is born with the inherent ability to do so, it is considered a learned behavior. And yet you can’t teach anyone else how to do it – you can’t simply say to your child to close his eyes and sleep. Instead, each of us has to learn for ourselves what to do to settle into sleep.
Of course, there are children who seem to learn how to sleep almost magically, with very little effort on the parent’s part. However, children are different. Everyone is unique.
Your child, along with many others, hasn’t learned this essential skill yet, which is why he needs you to take a step back, so he has the opportunity to achieve that on his own.
How will he do it?  He might kick his legs around a bit, he might gently rock his head from side to side, or he might grab his lovey. Or maybe he’ll suck on his thumb. If he’s a bit older, maybe he’ll play with his hair.
The truth is, each of us has different things we do to soothe ourselves into sleep, and your child will surely find a way that’s perfect for him. But he won’t discover those things nearly as easily with you standing right next to him or picking him up – he won’t have the motivation to do so.
Simply put, if you “help” him, he will cry even harder because the touching feels like a tease that serves to reinforce the crying.

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Although your baby may give up regular nighttime feedings on his own by the time he’s three months old, do not expect – or insist – that such a young infant give them up altogether, all of a sudden.
But if your child is at least three months old, still nurses or requires a bottle at bedtime, and needs to eat again several more times during the night, then the extra feedings may well be causing the extra wakings. If that is the case, you may be able to help him sleep better by decreasing the number of these feedings.
However, if your baby takes in a substantial amount of food – from extended feedings at the breast, or bottles adding up to more than eight ounces over the course of the night – then he has learned that certain times of night are mealtimes. To eliminate these feedings suddenly wouldn’t be wise or nice.
The amount of milk or juice your child drinks during the night may be considerable. If he finishes four full eight-ounce bottles, that is a large amount for even an adult to consume overnight.

Solving The Problem
If you have concluded that excessive and unnecessary feedings at night are disrupting your child’s sleep, you will be relieved to learn that although such feedings can lead to severe sleep disturbances, the problem is also one of the easiest to fix.
Two things need to be addressed. The first is to reduce or eliminate the nighttime feedings to avoid their various sleep-disrupting effects. The second is to teach your child new sleep associations so that he can fall asleep without being held, without eating, and without sucking on the breast or bottle. You can do these things at the same time, or one at a time.
To fix the problems caused by the feedings, start by gradually decreasing the number of nighttime feedings, their size, or both. Just don’t stop the feedings suddenly. A program designed to allow new patterns to develop will be easier for him to follow.
Your goal is to gradually move your child’s feelings of hunger out of the nighttime and into the daytime. Once there is only a single remaining nighttime feeding left, you can choose to stop that feeding right away – instead of gradually – if you prefer, since the total amount of ingested food during the night is now fairly small.
If you are working on sleep associations and hunger patterns simultaneously, put your child in bed as soon as each feeding is over, even if he wakes and begins to cry. If you nurse him and he sleeps next to you, move him off of you when the feeding is done so that he can learn to fall asleep without using your breast as a pacifier. You’ve just fed him, so he is not hungry – now you are only changing his expectation of what happens while he falls asleep.
Within a week, if all goes well, you will have finished cutting down or even eliminating the nighttime feedings. After that, continue applying the technique of progressive waiting at any waking at night (except for feeding times) until the wakings stop. It should not take more than another few days.

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A leading researcher on temperament in infants and young children once said in despair, “When I raised my first child, I believed behavioral theories claiming that what I do as a parent molds my child’s character. With my second child, I was already a geneticist and believed that a child is born with characteristics that are passed on through heredity and that environmental influence is minimal. I barely knew my third child at all...” 
This analysis was, of course, exaggerated, but it demonstrates the ongoing quest of parents and scientists to answer this question: what determines the personality and personal characteristics of the child? 
The question of heredity (“She got her shyness from her dad’s family”) versus environment (“If his mother were more strict with him, he would be calmer”) underlies parents’ attempts to understand the range of influence they have in molding their child.
Up-to-date research points to a complex picture: the influence of heredity and environment on the child. Much evidence suggests that the baby is born with genetic baggage that not only determines how he looks, the color of his eyes, and his chances of suffering from various diseases but also significantly influences the character traits that he or she will develop.
Physical activity level, shyness or sociability, openness to new situations, and anxiety are among the traits that are related to the genetic predisposition with which babies enter the world. Many parents discover that their child has traits that are undesirable to them—especially if they remind them of qualities they dislike about their parents, their spouses, or themselves. 
Parents frequently try to fight these traits, but they often discover that it is a losing battle. 
It seems that the most important variable that influences the quality of the relationship between parents and children is the “goodness of fit” between the child’s traits and the parents’ expectations. 
A very active child, for example, may be adored by a father who appreciates and identifies with this trait but merely tolerated by a father who expects a calmer child. 
On the other hand, a quiet, calm child may be considered depressive or lifeless by the first father, while the second father sees her as perfect. 
Incompatibility between parental expectations and the child’s traits may lead to frustration and stress in the relationship, particularly if the parents try to “correct” the child to conform to their expectations.

	The Relationship Between Temperament And Sleep
Every parent is familiar with the situation in which her child demonstrates by his behavior that he “is up past his bedtime.” 
When scientists asked parents to describe this situation, some said that the child calms down, seems sleepy, falls asleep on his own, or asks directly or indirectly to go to bed. Other parents said that their child in this situation “climbs the walls,” “is a crybaby,” “is nervous and unhappy with everything,” “doesn’t respond to what he’s told,” or “simply does annoying things.”
Clearly, young children react to tiredness in significantly different ways. 
A state of fatigue is not necessarily expressed by decreased activity and obvious sleepiness.
Sometimes the symptoms can be just the opposite. 
Some of the typical “negative” behaviors of the tired child are compatible with general patterns that characterize behavior disorders.
Much evidence points to a strong correlation between sleep and the development of the child’s personality traits. 
Studies have shown that a baby who suffers from sleep disorders (difficulty falling asleep, for example, or many awakenings during the night) tends to be “more difficult” in other behavioral domains. 
In a study conducted in several sleep laboratories, scientists compared a group of nine- to twenty-four-month-old babies whose parents had come for a consultation about their children’s sleep problems with a control group of babies without sleep disorder – not surprisingly, what they found is significant differences in the traits that the mothers attributed to babies. 
The mothers completed a temperament questionnaire, which is a sort of “personality” test for young children.
The mothers rated their degree of agreement with such sentences as “The child agrees to be dressed and undressed without protesting,” “The child responds strongly (screams, yells) when frustrated,” and “The child sits quietly when waiting to eat.” 
In general, the mothers of babies with sleep problems described them as more demanding, complaining, annoying, negatively sensitive to different stimuli, and difficult to adapt to different situations, as compared with babies without sleep problems.
One of the traits measured in the temperament questionnaire is the degree of sensitivity or responsivity of the baby to different sensory stimuli (noise, temperature, taste, smell). 
Some babies are very sensitive to any kind of sensory stimulus, and others are sensitive only to a specific type of sensation—for example, those who recoil from skin contact. 
A wide range of babies do not respond in an outstanding way to sensory stimuli.
One of the hypotheses that the researcher William Carey examined in 1974 was that babies who suffer from hypersensitivity to sensory stimuli would tend to develop sleep difficulties.
Carey’s findings supported the hypothesis, and he claimed that the heightened sensitivity to sensory stimuli is hereditary. 
In order to fall asleep, the baby has to disassociate himself from the external environment and stop responding to people, noise, light, and temperature, and to disassociate from internal signals as well, such as pain, discomfort, and hunger. This ability to disassociate is most critical for maintaining uninterrupted sleep and for preventing awakenings in response to various stimuli. 
A baby who is sensitive from birth to any internal or external stimulus will have trouble disassociating from environmental stimuli, which will interfere with his ability to relax and fall asleep easily and will cause him to awaken easily and frequently over the course of the night. 
This correlation between sleep and behavior continues throughout later childhood. 
Studies that examined school-aged children found a correlation between sleep disorders and problems with behavior and more general adaptation. 
Actually, sleep disorders serve as a sensitive barometer of general adaptation problems among children and adults. 
Sleep disorders are a prominent sign of stress and anxiety, depression, and adaptation problems. Sleep problems are so prevalent in some behavior or emotional disorders that they have been included in diagnostic criteria.
One factor that strengthens a diagnosis of anxiety disorders in a child, for example, is the presence of a sleep disorder.
The close correlation between sleep disorders and behavior problems in children can be explained in a number of ways. 
Perhaps a child born with a tendency toward problematic behavior develops sleep problems as well, as a result.  At the same time, it is reasonable to believe that significant sleep problems will lead to insufficient sleep or sleep deprivation, which may cause the child to be nervous, impatient, and harder to manage. 
In addition, a third cause, such as incompatible parenting patterns, may provoke or aggravate both behavior problems and sleep difficulties. 
In treatment centers, scientists frequently come across babies or young children who are described by their parents as hyperactive. 
The parents use this term casually, but professionals use it to diagnose a condition—the professional term is attention deficit hyperactivity disorder— that occurs only in older children. 
These babies are described as especially active and restless and are said to demand attention and seek stimuli constantly. 
Often parents associate their child’s sleep difficulties with his wakeful restlessness. Occasionally a parent says something like, “This boy has a turbo engine and he cannot shut it down at bedtime,” or “He is like the Energizer bunny; he keeps going and going and going.” 
Although hyperactivity is diagnosed at a later age, there is evidence that most hyperactive children were overactive, restless babies, with difficult temperaments.
Again, we face a chicken-or-egg question: are these babies unable to sleep like “normal” babies because they are unusually active, or does their sleep problem underlie their “hyperactivity”? 
In many cases sleep disruption appears to lead to “hyperactive” behavior patterns, even though no research has directly confirmed this fact.
More and more evidence demonstrates that lack of sleep may bring on behavior that resembles that of a hyperactive child. 
From an intuitive perspective we can all recall methods we use to keep ourselves awake when we are tired. 
These methods include increasing our activity, fidgeting, fiddling with our hands or our facial muscles, and similar strategies. 
This pattern contradicts the expectation that the tired child will relax and slow down. 
The clinical literature has documented certain cases in which significant sleep problems have been found to lead to “hyperactive” behavior patterns and later to a wrong diagnosis and treatment.
It is of utmost importance to examine the possibility that the sleep disorder is the source and not the outcome of the “hyperactivity.” 
In the event that a sleep disorder exists, it should be treated before treating the disorders that result from it. 
In some cases treating the sleep disorder may spare the child from receiving unnecessary medication like Ritalin, which is the most prescribed chemical response to children’s behavioral problems.
An erroneous interpretation of a child’s behavior can also result when she responds to a sleep disorder with heightened tiredness, indifference, and lack of interest in the environment. This pattern may be interpreted as depression, and sleep difficulties can be seen as the result of that condition. 
As the professional literature reveals, such an erroneous diagnosis can result in a failure to detect and treat a primary sleep disorder, as well as mistaken treatment for depression. 
Case studies have shown that when the problem is diagnosed correctly as a primary sleep disorder and treated accordingly, there is a parallel improvement in sleep and disappearance of the “depressive” symptoms.

	Intellectual Development
Assessing intelligence in infancy is a very complex task. 
Tests used on infants to assess early mental abilities that could be considered components of intelligence have generally failed to predict intelligence or cognitive abilities and achievements in later ages. 
The research on the relation between sleep and intellectual development has been hampered by our limited capacity to assess intelligence in infants. 
Efforts to study this issue have failed to provide a clear picture of the situation, and we need to call upon additional studies on older children and adults to help us consider the issue more systematically.
Scientists from the University of Connecticut in Evelyn Thoman’s group, which has contributed significantly to the field of the study of infant sleep, examined this question. They followed sleep of newborns over the course of their first two days of life and examined their development at the age of six months. 
Special recording devices documented the babies’ sleep in hospital bassinets after birth. 
The scientists then tested the mental, motor, and perceptual abilities of the babies at the age of six months, using the Bayley Test. 
They found a correlation between sleep measures of the newborns on their first day of life and their development six months later. 
Some scientists found a correlation between sleep disorders in infancy, especially those that are caused by respiratory problems, and possible shortfalls in intellectual development and academic achievements at a later age. 
Other studies, however, found no comprehensible correlation between sleep and later mental function.
Studies on older children and adults have shown that sleep disorders or insufficient sleep primarily interfere with cognitive abilities associated with attention and concentration. 
That is to say that the ability to focus on certain stimuli for extended time deteriorates. 
People who don’t get enough sleep react more slowly and make more mistakes on tasks that demand attention and continuous concentration. Although the question of sleep and attention has not been directly studied in infants, some support for their correlation comes from indirect approaches. 
For example, mothers described their babies (aged nine to twenty-four months) who suffered from sleep problems as having trouble concentrating on play or a particular activity for an extended length of time, and as easily distracted by other stimuli.
In another recent study, sleep scientists examined the relationship between sleep patterns and learning skills, concentration, and attention among school-aged children. 
The sleep patterns of the children were examined objectively by using sleep watches, and their learning functions were examined by computerized tests. 
Similar to the results in studies of adults, they found that children whose quality of sleep deteriorated (as manifested by many or lengthy awakenings from sleep during the night) also had decreased attention abilities. 
These findings support the assumption that these critical functions for learning and academic achievement are adversely affected by sleep disorders among children. 
Furthermore, recent studies have shown that if “normal” children are requested to shorten their sleep for experimental purposes, they suffer negative consequences, and their learning and attention abilities are significantly compromised.
On the basis of what we have learned about older children and adults and from the limited information on infants, it is fair to conclude that the intellectual abilities of infants are challenged by disrupted or insufficient sleep.