Co-sleeping, Bed Sharing & Infant Deaths

A new study reports that infant mortality rates attributable to accidental suffocation and strangulation in bed have quadrupled since 1984. The rates of these deaths increased from 2.8 to 12.5 deaths per 100,000 live births from 1984 to 2004.

Why the dramatic increase? The Washington Post reports that it could be an issue of data shifting.

There are stricter guidelines for sudden, unexpected infant deaths. As a result these deaths are being classified more carefully. Some deaths once classified as SIDS may now be classified as suffocation.

There also may be a link to a recent rise in co-sleeping and bed sharing. Another article in the Washington Post reports that bed sharing in the U.S. doubled from 1993 to 2000.

In one Georgia county three infants recently suffocated in bed. In each case reports indicate that a parent rolled onto the child while sleeping.

A recent study found a bed-sharing rate in the U.S. of 42 percent when infants are 2 weeks old. The rate was 34 percent at 3 months of age and 27 percent at 12 months.

Bed-sharing rates are much higher in some other cultures. In one study about 61 percent of Thai infants shared the bed with their parents.

A common reason for bed sharing is to make it easier to breastfeed. A study found that bed-sharing infants breastfeed longer and more often.

But research also has linked co-sleeping to an increased risk of infant death. One study found that the risk is highest with couch sharing. It also found a higher risk of death for bed-sharing infants who are less than 11 weeks old.

A study in the journal Sleep analyzed the advice provided in 39 parenting books. Forty percent opposed co-sleeping; 28 percent endorsed it; 32 percent took no position.

Different patterns of co-sleeping were recommended in the books. Some promote co-sleeping only during the first weeks or months after birth; others recommend long-term co-sleeping in a “family bed.”

An American Academy of Pediatrics policy statement recommends infant room sharing. It advises parents that infants should sleep in the parents’ bedroom and close to their bed. The baby can be brought into the bed for feeding or comforting.

But an infant should be placed on a separate sleep surface when the parent is ready to return to sleep. The sleep surface should be firm. Soft objects and loose bedding should be kept out of the crib, cradle or bassinette.

Infants always should be placed to sleep on their back.