Valerie Telio has heard the warnings again and again: The safest way for a new baby to sleep is on the back, in a crib.
But when her third child, born last summer, turned out to be a terrible sleeper, the Montreal mother brought the baby into her bed. And after nursing, she settled her daughter by placing her on her tummy in the bed.
She's not alone in her nighttime desperation.
Debra Mawas let her son Sean sleep in his swing all night; otherwise he woke every 90 minutes.
Arwen Hunter relied on the bouncy chair to get a few hours' rest during her daughter Sophia's first months.
"I had heard it was bad," says Ms. Hunter, who lives in Toronto. "But I didn't care. I was exhausted."
On other issues, they are the kind of mothers who follow public-health advice to the letter. They breastfeed and make organic purees. They seal off electrical sockets in their homes with safety plugs. Ms. Telio even put a safety gate on her own bed.
But when it comes to getting through the first few months with a new baby, some of the most vigilant mothers admit to ignoring their doctors' advice and doing whatever it takes to get their babies to sleep.
"You are so horribly sleep-deprived, you would do anything," Ms. Mawas says.
"You can't judge until you've been through it."
A Quebec coroner's report, released earlier this month, found that a two-month-old baby died last year of asphyxiation after his mother put him to sleep in a car seat after a restless night. The coroner, Jacques Robinson, explained that the head of a baby sleeping in a car seat can bend far forward, restricting the upper respiratory passages and cutting off oxygen.
Dr. Robinson is recommending that health and social service agencies make new parents aware of these potential risks.
But parents of sleepless newborns say yet another public-health warning is likely to result in more guilt and anxiety.
Ms. Telio, for example, says she would regularly wake "in a cold sweat," convinced she had rolled over on her daughter - a risk associated with co-sleeping.
Tracey Ruiz, a birthing and postpartum specialist who is known as the "sleep doula," says parents are already under tremendous strain from sleep deprivation.
She has a roster of clients who do everything from driving their babies around in car seats for hours to climbing into the crib with their newborns to get them to sleep.
"The desperation you see in these families is ridiculous."
Ms. Ruiz says her clients often lack community support to get them through the first few difficult months of caring for a newborn.
Many new parents live far away from their families. Many are discharged quickly from the hospital after giving birth and get little assistance during the postpartum period.
As a result, many new mothers do not tell their health-care providers that they are not going completely by the book when it comes to their babies' sleep.
"They aren't honest because they know they are going to get heck for it," Ms. Ruiz says.
When Natalie Morales, an anchorwoman at NBC's Today show, recently posted on a parenting website that she put her colicky son to sleep on his tummy, her message was met with cheers from other parents in the same situation. "We can both sleep better at night because of it," Ms. Morales wrote. "Is that such a bad thing?"
Ms. Hunter, who co-slept with her daughter and let her sleep five to six hours in the bouncy chair, says she "rolled her eyes" when she heard the chair may be bad for her daughter's physical development.
"It's hard to remember all the rules that I broke." Ms. Hunter says.
The Canadian Pediatric Society attempted to take a "harm-reduction" approach by creating a set of guidelines for safer co-sleeping. The practice is associated with suffocation and sudden infant death syndrome, but can be made more safe if parents remove pillows and duvets, make sure there is no possibility of entrapment between the mattress and wall, and do not take drugs or drink, says Denis Leduc, a Montreal-pediatrician who co-authored the CPS position on creating a safe sleep environment for infants.
"If you eliminate all those things and you are breastfeeding, chances are you are going to be okay," Dr. Leduc says.
The problem is also being addressed by several U.S. jurisdictions in which low-income parents are given training in soothing methods outlined in Harvey Karp's bestseller The Happiest Baby on the Block. According to Dr. Karp, while back sleeping is the safest position for babies, it is also the least comforting.
Dr. Karp's book and DVD describe how to combine swaddling, swinging, sucking, positioning and shushing sounds to soothe newborns.
He says infant crying and sleeplessness are the top causes of postpartum depression, shaken-baby syndrome and breastfeeding failure.
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