Cultural Influences on Infant and Childhood Sleep Biology, and the Science That Studies It: Toward a More Inclusive Paradigm II

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Abstract
We try to keep in mind cultural influences on the advice we give. We remind ourselvesthat 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 askfor parental attention, or who continue to nurse at night-is problematic only in relationto 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 oftheir 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 issocial practice, like burying the dead or expressing gratitude for gifts or eatingmeals 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 aperson’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 developmentsas regards research into mother-infant cosleeping in the form of bedsharing, andhave contributed a new last section that critiques recommendations against anyand all bedsharing. But mostly, we provide here (without modification) a culturalbackground to our thinking about what constitutes ‘‘normal, healthy, anddesirable’’ infant sleep and show the interconnectedness between scientificresearch, cultural values, concerns for morality, and sleeping arrangements thatare characteristic of Western society. Specific biological and psychologicalevidence 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 thebasis of the overall social and physical context within which it occurs.

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