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This just in…Rise in infant suffocation tied to bed-sharing
Now on the face of it that’s pretty alarming, huh? BUT, and I’m no expert at reading these little science reports, but I spot enough inconsistencies in their logic to go “WTF?” It’s like a Highlights puzzle, what’s wrong with this picture.
FIRST, note that in this article (and most of the other ones, as they were all copies of the same AP-released story) they say that “rates of sudden infant death from suffocation or strangulation have quadrupled in the past 20 years in the United States” yet, I’m hard-pressed to find ANY mention of the rates before or after this increase. Did the number go quadruple from 4? Or did the number quadruple from 400? I’m sure you agree that this bit of information would help us decide whether to be alarmed or not.
SECOND, they associate this increase with more parents sleeping with their babies, yet mention that “black male babies are most affected”. Are they saying that more parents are sleeping with their “black male babies” than any other group? Or could there be another underlying reason for this disparity?
THIRD, the story says that “Most of the deaths that could be determined were by “overlay” — the parent rolling over onto the child.” That’s MOST of the deaths that COULD be DETERMINED. Though they don’t give numbers AND the suffocation/strangulation rates also include “suffocating in soft bedding, becoming wedged between a mattress and frame or wall, or getting a head caught in something.”
So, doing some very limited research this is what I pieced together …The scientists that wrote the study (CDC’s Carrie Shapiro-Mendoza and her colleagues) came to a very different conclusion. Their title was: Recent National Trends in Sudden, Unexpected Infant Deaths: More Evidence Supporting a Change in Classification or Reporting and their basic point was that SIDS rates have gone down due to changes in how we classify deaths, you see, while SIDS rates have gone down (Yay!) they were “offset by increasing rates of cause unknown/unspecified and ASSB (accidental suffocation and strangulation in bed)” The author’s of the study report that “Most of the decline in SIDS rates since 1999 is likely due to increased reporting of cause unknown/unspecified and ASSB”. Hmmmmm, why would the news reports try to make this study sound much more dramatic than it actually is?
ALSO, the classification ASSB (accidental suffocation and strangulation in bed) Which sounds like there was definitely someone else involved, includes babies who were put on their stomach in a crib and suffocated because they couldn’t lift their head off the soft mattress. It includes babies who got their heads stuck in crib slats, it includes babies that slide down in between couch pillows AND cases of overlying. In the cases of overlying, the death certificates rarely report which parent or caregiver or other person caused the suffocation. AND if the death certificates include the mother, they never differentiate between breastfeeding mothers or formula feeding (an important distinction according to James McKenna Why babies should never sleep alone: A review of the co-sleeping controversy in relation to SIDS, bedsharing and breast feeding (the whole thing is very interesting but go to page 45 if you wanna get to the pertinent stuff…) and don’t include other factors such as drug use, and smoking, and other factors.
So, the point is this, the recent stories about the dangers of bed-sharing are being overly-dramatic well and beyond reasonable proof. My theory is that most parents think that babies go into Cribs so they provide the baby with a crib and all the other stuff and THEN when they meet their baby and the baby doesn’t want to go into the crib (the baby wants to sleep beside mommy, NOW! ) they take the baby into their bed. Without coming up with any way to make this a safe place for the baby. Tall beds, overly small beds, no bedrails, couches and recliners, heavy comforters tucked up to the chin, these things have the potential to be dangerous.
Why can’t we stop this silly discussion that says cribs are the only safe place and start putting our heads together and come up with a series of recommendations for SAFE co-sleeping. Oh wait, James McKenna already did ;o) Sleeping with Your Baby: A Parent’s Guide to Cosleeping (Paperback)
and so did I Archive for Co-Sleeping
hope that helps!
xox,
Heather
oh crikey, more ridiculous, biased hoo-ha about bed sharing. in the UK there’s another good book, the only book i read when i was pregnant with my first – ‘three in a bed – the benefits of sleeping with your baby’ by deborah jackson. it’s well researched and just seems very much like common sense. and three contented babies later i’d recommend it to anyone.
More whitewashing from the crib industry…or those who have bought into it.
The number of “cosleeping” deaths that was the baseline is 85 a year in the US. That’s the number that was always cited in articles and I assume that’s what the “old” number was that the current study aludes to. Amazing how many writers on parenting issues get so alarmed by that…yet when it comes to the, what is it? 3000? deaths per year in the US from SIDS (that’s CRIB death), they just say don’t put the baby on her/his stomach.
And of those 85, the vast majority weren’t what you and I would call cosleeping. A lot were the parent falling asleep on the couch with the baby. Sleeping at the same time as a baby that you’re touching is not the definition of cosleeping.
A huge number of the deaths happened when the parent was drunk or under the influence of illegal or legal drugs that affected the ability to wake easily or be aware of her/his surroundings. Others were on waterbeds, a type of bed no informed cosleeper would use.
Yes of course there are some deaths from real cosleeping, including when all the safety precautions are met. But they’re exceedingly rare. Even if the number really has quadrupled, it’s still only a tiny fraction of the deaths due to leaving a newborn unsupervised all night.
But you know what I find most jaw-dropping about the mainstream parents I’ve known, and the mainstream media? The mainstream pediatrics recommendations are for an infant to sleep in a crib or other product that isn’t the parental bed in the same room as one or more parent. But what most people read is “cosleeping is bad, don’t change from the common practice of using a crib in the baby’s room” and not “putting the baby in a room alone is bad, keep the baby near you.”
Alarmist interpretations of studies like this just add fuel to the anti-AP fire. Like you suggest, we have to look deeper.
These new articles about cosleeping infuriate me. I’m glad you’re pointing people towards McKenna, who sometimes seems like the lone rational voice in night. I’m loving all the comics about trying to sign up for baby stuff. Too funny! (And too true!)
I once had a lengthy conversation about such stuff with Other U.S. moms in the country we were living in & how funny these “stories” in the U.S. were. In the local hospitals MOST moms slept with their newborns REGARDLESS of where they came from (wow melting pot doesn’t describe it) & most Moms nursed. In fact when you looked at these “reports” from the U.S. so much was lumped in with co-sleeping that I once commented that if you were sitting next to your baby (properly in a car seat of course) & the car crashed, everyone would be listed as having died in a car accident EXCEPT the baby who would be listed as a co-sleeping death, because Mom & baby were both sleeping & Mama’s hand was resting on the seat at the time of the crash. Got a few chuckles & nods & most of those women were NOT AP moms (Although the Mom we were showering, is, lol, I had a fun time for a change!)
Now I’m wondering- where do James McKenna’s recomendation leave AP moms who need to formula feed for medical reasons?
I guess if you can’t breastfeed, then sharing sleep in the same room but on a different sleeping surface would be the safest option: maybe the baby in a hammock beside the bed, or parents and baby on mattresses next to each other on the floor. Something where the baby and parents are close enough to hear each other breathe and see each other but just that little bit further apart so that the different sleep pattern of a non-breastfeeding carer doesn’t affect the risk.
I did come across this article which isn’t as biased against sharing a bed with your baby. It does of course mention that but it also actually mentions NUMBERS! There are statistics for the years so you can see what the general mortality numbers are.
http://www.cbsnews.com/stories/2009/01/27/health/webmd/main4757556.shtml
I just had my own “baby-registry”-style conversation with a travel agent as we search for a hotel for our family vacation. Gave her all the dets, then said:
Me: Our preference is a King suite.
Travel Agent: Ok, let me just check… I have 2 double beds for xxx, or this 2 double bed for xxx. Or this 2 double bed for xxx.
Me: Ok, but we prefer a King, do you have any Kings?
TA: I thought you said you had children?
Me: Yes, two.
TA: Well, where are THEY going to sleep?
Me: With us, where else?
TA: Oh (nervous laughter).
She really didn’t know WHAT to do with me after that. LOL.
I’m sure if you do a little more research, you’ll probably find another crib/matress/bedding company sponsored study! I know for us, co-sleeping was MUCH safer than me actually getting up and feeding my daughter sitting up in a glider. I almost ALWAYS started nodding off while holding her, and finally figured out (by the time she was around 3-4 months) that I was much better off LAYING DOWN feeding her than I was falling asleep holding her in a chair with nothing but a boppy pillow underneath her! Those breastfeeding hormones can make you fall asleep at the drop of a hat while you’re nursing, BUT they also keep you from falling into TOO DEEP of a sleep and therefore you’re never too asleep to know where your baby is in relation to where you are.
This kind of stuff makes me absolutely livid! Lord forbid you should ever do what YOU think is best for YOUR child because obviously the “experts” know it all here. I am 19yrs old and I just had my first child and I remember all the stuff the “experts” told me during my whole pregnancy (BACK TO SLEEP, PUT YOUR BABY IN A CRIB, BACK TO SLEEP!!!!!!) and it was scary. When my son was born he wanted to nurse all the time and didn’t want to sleep in his own bed so I would put him in bed with us but I was so afraid of him DIEING (because that’s what they told me would happen) , that I did not get any sleep for the first 3 weeks. Thank God my mother is an awesome researcher and found a bunch of studies and reports that showed co-sleeping is an option and it can be a safe one. But they never tell you that stuff….
Personally I believe all these “experts” can’t be trusted 100% because a lot of them are getting paid off by product companies. I couldn’t even believe some of the care I received during my pregnancy and even some the medicine they were trying to give me while I was in labor (Hospital birth = worst experience of my life).
You know, I got a little book on caring for one’s baby from a local program for pregnant and nursing mums. I was pleased to see them say there is no “right” way to sleep with your baby. I would have liked it even more if they had mentioned the benefits of co-sleeping. But that they weren’t fear mongering was pretty awesome.
Maybe I’m a princess with a pea, but I know that I wake up any time I roll onto something uncomfortable at night, whether I’m breastfeeding or not. And I’m quite sure that rolling onto my baby’s hard little elbows and knees would be uncomfortable enough to wake me up!
As for the hotel- what the heck business of theirs is it how you want to sleep?!? Tell the woman to shut up and give you what you asked for! Also- I’ve heard of parents who actually get a separate room for their kids at the hotel. Yipes. I can understand a separate bed, or a separate room at home. But at a hotel? Where the rooms are designed so that you can’t hear what’s going on next door? Surrounded by strangers? I don’t think so!
I will shout this from every soapbox people are dumb enough to let me climb on… SIDS and suffocation are NOT the same thing! Why do these stupid researchers keep saying that these babies who died from SIDS were suffocated by their parents rolling on to them. By it’s very nature, SIDS is an UNIDENTIFIABLE death! If they know the baby died from being suffocated – intentionally or unintentionally – it’s not an unknown cause!
I HATE stupidity in the media! Especially when the whole purpose is to come across as experts in a field in which they have no experience!
The gizmo that friends of mine had when co-sleeping was kind of like a little platform-cot thing that sat between the two parents in bed. The sides were about 2-3 inches, and it helped stop either parent accidentally roll onto the baby when it was a newborn – both had major weight issues, and the mother couldn’t direct breastfeed for physical reasons. (tongue-tie I think, and then the baby wouldn’t touch the breast for food so she pumped for most of a year)
It had its own thin mattress, on top of webbing, so that there weren’t any issues with inhaling things from parental mattress, but got the benefit of parental mattress.
Made co-sleeping quite a bit safer, until they’d adjusted.
(I don’t recall if I’ve commented here before, but I’m a big fan. Pre-med in college, so maybe soon to become an ally in the medical field.)
Miriam, my mom had something similar for me when I was an infant 20 years ago.
I wanted to take issue with the comment about having major weight issues. Unless drunk and/or stoned, fat people aren’t going to be any more of a danger to another person in the bed than a normal sized person. Heck, my ex-boyfriend would be able to avoid rolling on top of a stuffed animal that shared the bed, and at the time he was around 360lbs. The only problem would be room in the bed, and that can be solved by a bigger bed. (Sorry, Fat Acceptance blogger, heh)
[quote]I wanted to take issue with the comment about having major weight issues. Unless drunk and/or stoned, fat people aren’t going to be any more of a danger to another person in the bed than a normal sized person. Heck, my ex-boyfriend would be able to avoid rolling on top of a stuffed animal that shared the bed, and at the time he was around 360lbs.[/quote]
I agree. I’m a bit overweight and co-slept with my 4 children. When they were infants, I would lay my arm out straight and lay the baby on top of it (it’s not the most comfortable position, but after sleeping while pregnant, anything seems more comfortable.
) This made if physically impossible for me to roll over on the baby.
I would also think this would work for co-sleeping, but not breastfeeding. Some of the studies I’ve seen showing that co-sleeping reduces the risk of SIDS, I would think it would be best to co-sleep regardless of whether or not one breastfeeds.
I also don’t understand the argument about not co-sleeping, if one smokes? Since smoking seems to increase the risk of SIDS, I would think one would want to co-sleep to decrease the risk.
“major weight issues” was their phrase to describe their concern about the relationship between their weight and the weight of their child. It had as much to do with body perception/experience as actual physical weight.
HomeOfLove: There are a bunch of studies clearly showing that co-sleeping with a smoking parent is *much* more risky for a baby than being in a crib next to the bed of a smoking parent. Smoking increases SIDS risk in your baby across the board, but much more so if you sleep with them. It’s theorised that this is due to smoke particles remaining on the parent’s body/in their lungs, for the baby to breathe in during the night. The evidence is quite clear on this one.
Unfortunately, the idea that co-sleeping reduces SIDS is a myth. Because McKenna showed that co-sleeping could help regulate the baby’s heart rate and temperature and so forth, and because many societies who co-sleep have low SIDS deaths, everyone hoped that this was a way to reduce SIDS deaths, and lots of people will still state this as if it were a proved fact. Unfortunately, not only do those studies not prove anything about what would happen to SIDS rates in practice, but we also now have a bunch of studies that directly compare SIDS babies and healthy babies from the point of view of all sorts of factors, that show us what factors are risky and what factors are protective (this is how we know, for example, that sleeping on the back or sleeping in the same room as the parents is protective against SIDS). None of those studies have ever shown an advantage with co-sleeping. None of them. Doesn’t matter what else they controlled for – smoking, alcohol, sleeping on beds rather than sofas, breastfeeding. No improvement in SIDS deaths with co-sleeping. And three studies have shown an increase in SIDS deaths in co-sleeping with babies in the first few months, so that may be extra risky. (Of course, you’re looking at a very small risk overall, but it still seems to be there.)
BTW, another problem with McKenna’s research (apart from the fact that he wasn’t actually looking at any cases of SIDS, so we’re really limited in how far we can extrapolate his studies) is that, in his studies, the babies who weren’t co-sleeping were sleeping in a separate room. He didn’t compare co-sleeping with sleeping next to the bed (the safest, and recommended, form of crib sleeping). So, of course, that automatically biases his research – if you compare co-sleeping to a riskier form of crib sleeping, it’ll artificially make co-sleeping look safer by comparison. But, of course, the real question is how co-sleeping as safely as possible compares to crib sleeping as safely as possible. There is now a lot of evidence that it does *not* reduce the risk, and may increase it in the case of very young babies.
Oh Sarah, Sarah, Sarah, long time no hear!
I KNEW you’d be leaving a comment on this post ;o) For all of those that haven’t debated Sarah on this topic yet, on the Hathor the Cowgoddess blog we (myself and some others) tried all sorts of tactics, we found studies, talked until we were blue in the face, but our studies were always ‘flawed’, our point of view always wrong. Sarah, (please forgive me for speaking for you) doesn’t agree that the work of James McKenna has any merit, or that the work of Linda Palmer is scientifically proven, or that any other studies, or writings or essays that we might want to introduce into the discussion are worth anything at all. I think, I may be wrong, that the last discussion was about crying it out? I’m going to go search and see if I can link to it for the edification and amusement of us all…
Here’s some prior discussions:
http://www.thecowgoddess.com/2006/06/11/my-response-to-rosa-brooks/
http://www.thecowgoddess.com/2006/06/13/heres-some-studies
http://www.thecowgoddess.com/2008/01/14/cribs-for-kids
I recently had my site hacked and had to upload another version of wordpress, it looks like some of the comments and posts have some gobbledy-gook in them, I’m going to see if it’s possible to fix that short of editing every post…hope it’s readable!
If a debate ensues, remember play nice!
xox,
Heather
Good heavens – I’m flattered you remember me after all this time! Thanks for linking back to the previous discussion we had on co-sleeping (the third link you gave). I’d forgotten how much I wrote in the comments there about the co-sleeping research and the limitations of McKenna’s work. It would be great if people read it and if it starts up more discussion.
You put ‘flawed’ in quotes. I did think the articles you linked to were flawed, and did my best to explain why in detail. If you disagree with the reasons I gave, I’d love to hear why and to discuss it further.
We didn’t actually discuss Linda Palmer in that debate, but I do think her analysis of the data is very poor indeed, for several reasons. I’ve actually been discussing this with her recently on another blog, at http://northtexasnaturalfamily.com/index.php/2009/01/12/sleeping-safely-with-your-baby (my discussion with her starts at the fourth comment down).
Congratulations on your fourth little one in the making!
Sarah V
I’m really interested to know what your background is? Are you a healthcare professional? Or just very interested in this topic…don’t want to pry, I was just wondering.
Mum-raa: Hi! Yes, I’m a GP (general practitioner) in the UK.
sarah v – thanks for making things a bit clearer – i suspected you might be involved in the nhs! just wondered if you have ever read ‘three in a bed’ and what you think of it? and also why you’re subscribing to hathor / mama is when all you seem to want to do is cause a kerfuffle?!
mama – you think you’re a luddite – i’ve only just realised that if the name is in pink you can click on their website and consequently found sarah v’s blog. sorry sarah v – i could have found out who you were without asking if only i’d been clever enough!
I live in Jacksonville Fl, and I have wanted to tear my hair out. I have driven past two “A.B.C. sleep” billboards. Anyone heard of this one? It means “Alone, Back, Crib”, and touts that this is the ONLY safe way for your baby to sleep. My college had an expo and a baby/family rep was there. She almost yelled at me when I challenged her on the subject. These “A.B.C.” people haveheld two “seminars” here that I’ve noticed. Sadly I have found that people who put on blinders and refuse to see the advantages of co-sleeping instead of just the eliminatable risks are not going to change their mind and often get grumpy when presented with a contrasting viewpoint. I just try to remember that the workers that went on strike for better, safer working conditions in the early 1900′s were savagely beaten, arrested, and sometimes shot (LEGALLY) for daring to challenge the established. We as a human race are slowly moving toward the more humane. I know that breast and bed will be accepted eventually, but only when the “professionals” begin to view babies as individuals with the same emotions as adults. Hell, it wasn’t until the 80′s that doctors finally realized that newborns feel pain. Until then, and for a bit after, newborns had no anaesthetic for surgery of any kind (open heart, abdominal, etc). Hell, the babies being circumcised usually don’t get pain relief other than tylenol and a sugar water dipped pacifier. And my husband will tell ya, his foreskin is pretty much the most sensitive part of his body and he would KILL anyone trying to make an incision, mush less cutting it completely off. “Humanity” is NOT a human trait, but we’re getting there, even if the snail pace is driving me BONKERS.
Sorry to go off in a bunch of directions there, it just ticks me off to be told I’M the dangerous one (for sharing a bed for pete’s sake!!), when the medical field (which I am entering, hoping to change) has perpetually throughout history broken it’s vow to do no harm with insane policies and unsound reasoning. (Um how the HELL did “babies don’t feel pain” become accepted by ANYONE!!!!!!!!!!)
Mum-raa: Goodness – what gave away the fact that I’m in the NHS? Do my comments exude a general aura of monolithic inefficiency and pointless red tape interspersed with occasional flashes of life-saving brilliance, or something?
I’ve skimmed through ‘Three in a Bed’, though I don’t think I’ve ever sat down and read it from start to finish. As I recall, I rather liked it as a book making parents aware of an alternate way to do things – thought-provoking, and not too preachy as such things go. I remember I read the second edition, in which she’d changed the subtitle from ‘Why You Should Sleep With Your Baby’ to ‘The Benefits Of Sleeping With Your Baby’, which I thought was a subtle but important change. The last edition was a few years ago, so the latest studies won’t have been discussed.
I don’t subscribe to Hathor’s blog, but do read it occasionally (more regularly at the time that those discussions took place). I don’t try to cause kerfuffle for the sake of it, but I do think it’s important not to misrepresent facts for the sake of an agenda, and Hathor’s is one of the blogs that’s quite prone to do that. When I see someone claim something that’s not actually true, I speak up.
Mama She, I know what you’re talking about. At 22 when I left the hospital, I was scared to death by the videos they made us watch. My mom came to see us was Bug was only a week or so old, and the first night I was just sobbing. Bug wasn’t sleeping in the bassinet, and I was exausted. I was terrified that if I layed down to sleep, she’d be dead in the morning. My mom took her and co-slept with her. I didn’t know till morning. And after that.. it was not as big of an issue for me.
Like HomeOfLove, I found a way to sleep that prevented me from moving without waking.(with my arm out, over Bug’s head so she could nurse). She would mostly sleep in the bassinet, but would often join us for nursing as well.
The stress from the terror the hospital put on me was one of the worse contributing factors to my postpartum depression. It’s still the only negative to my very hands off hospital birth of awesomeness…. but it is a BIG negative. Since when is putting a mom in a state of terror a good thing???
” Since when is putting a mom in a state of terror a good thing???”
It’s a good thing for doctors ever since they realized that terrified mothers visit their doctors more often.
My boyfriend worried so much when our daughter was in bed with us. He was terrified that he would accidentally roll over on her. I assured him that A)He would notice and that B) I would notice an extra 200lbs on my arm which was always wrapped around baby, and push him off. It of course never happened. I knew everything would be fine since my older three survived being in bed just fine as well.
Some people are sheep, and they happily gobble up what the media feeds them. Then they ask for seconds. *shrugs* Sad, but true.