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Dilemma after Dark: Balancing Sleep and Breastfeeding

In her newly published book, author Cecília Tomori explores a major challenge for new parents, the nighttime balance of sleep and breastfeeding. Nighttime Breastfeeding: An American Cultural Dilemma, published in October, is the result of her long-term ethnographic study alongside new parents and how they cope with the pressures of parenthood. Following, the author gives insight into this in-depth study which eventually became her book.



As an anthropologist seeking to learn about breastfeeding, I had the privilege of visiting new parents who had just returned home from the hospital after the birth of their first child. During these visits, the joy of becoming parents was visible in the way parents gazed upon one another and held their newborns in their arms. Their joy, however, was often complicated by exhaustion and uncertainty over some fundamental concerns: breastfeeding and sleeping at night.


Like most middle-class parents in the United States, those in my study had been preparing for their babies’ births for many months. They participated in lengthy childbirth preparation courses with additional classes on breastfeeding and infant care, purchased items they would need for the baby, and set up a nursery. They were committed to breastfeeding, which they viewed as important and beneficial for their babies. They also planned to follow medical recommendations to have their babies sleep separately from them, usually in a bassinet next to their beds, with plans to move their babies to the nursery after a few weeks.


Very quickly, however, many new parents found their expectations for breastfeeding on a collision course with their plans for sleeping separately. Their babies would fall asleep in their mothers’ arms, often after a lengthy breastfeeding session, but as soon as the infants were put down they would awaken and cry until they were picked up and breastfed again. Most mothers, with the support of their spouses, ultimately brought their babies to their bed and all three ended up sleeping in the same bed for the rest of the night. This arrangement made breastfeeding and sleeping easier, but raised other doubts: Would bed-sharing put the baby at risk of dying from Sudden Infant Death Syndrome? Would it hinder the baby’s independence? Ruin the parents’ relationship? On the other hand, how would parents handle the exhaustion without bed-sharing? These dilemmas and how families navigate them are the subjects of my book.


When I first set out to study American practices of breastfeeding, I did not know that I would focus on nighttime breastfeeding. Yet the topic arose constantly in conversations during my preliminary research. As an anthropologist familiar with a wide range of cross-cultural, historical, and evolutionary perspectives on infant care, I was drawn to explore why decisions about where and how infants breastfed and slept during the night were so fraught for many parents in the U.S.


I invite readers to join me on a journey to pursue this question through close ethnographic study of middle-class families’ experiences and anthropological analysis. Weaving together sociocultural and biological anthropology, historical studies of medicine, and feminist scholarship, I show that parental decisions about nighttime breastfeeding and sleeping are not simply pragmatic ones. Rather, in making these decisions parents must confront dominant concepts of health, medical authority, and cultural expectations for babies and their relationship with parents that are bound within the frameworks of a profoundly unequal society.




Cecília Tomori is a medical anthropologist who has worked as a health services researcher at Northwestern University’s Feinberg School of Medicine and the Jesse Brown VA Medical Center and is currently a Research Associate at the Johns Hopkins Bloomberg School of Public Health.


Series: Volume 26, Fertility, Reproduction and Sexuality