More and more parents are sharing beds with their infant children, to cement the family bond and facilitate breast-feeding. As a registered nurse, I know how important both of those are for healthy early development in young babies.
But as the coordinator for Safe Kids Fayette County, I am concerned by reports of a fivefold rise in infant deaths from accidental strangulation and suffocation in bed over a 20-year period.
That rise in infant mortality has ignited debate over the growing practice of "co-sleeping" — parents sharing a "family bed" with an infant child.
An analysis of death certificates nationwide found that the rate of fatalities attributed to unintentional suffocation and strangulation in the first year of life quadrupled from 1984 to 2004.
Such deaths remain relatively rare, and the study did not examine what is causing the increase. However, the increase has roughly coincided with the trend in co-sleeping. This practice can result in death — when a sleeping parent rolls on top of a baby, when a pillow falls on an infant's face, when a blanket gets wrapped around a child's neck or when a baby gets wedged between a mattress and a wall.
"There's been a huge increase in the reports of these deaths," said Carrie K. Shapiro-Mendoza of the Centers for Disease Control and Prevention, who led the study published in the February issue of the journal Pediatrics. "Accidental suffocation and strangulation are potentially preventable by providing babies with a safe sleep environment."
Shapiro-Mendoza and her colleagues found that the rate of accidental strangulation and suffocation deaths increased from 2.8 to 12.5 per 100,000 live births during the 20 years. Such deaths increased from 103 in 1984 to 513 in 2004.
Most of the increase occurred after 1996. That was the same time deaths from sudden infant death syndrome appeared to level off after falling by about half. The reduction in SIDS is attributed to a national campaign to encourage parents to put their babies to sleep on their backs.
A 2003 national survey found that the percentage of babies sleeping with a parent or other caregiver more than doubled from 1993 to 2000.
"Co-sleeping still seems to be a very prevalent issue," said Miles White, Fayette County deputy coroner. "This doesn't seem to be so much of a trend, but more of a constant."
Safe Kids recommends:
■ Babies should never sleep on couches, chairs, regular beds or other soft surfaces. Babies should never share a bed or couch with a sibling, parent or caregiver.
■ Remove pillows, comforters, stuffed toys and other soft objects from the crib.
■ Lay babies on their backs.
■ Make sure the baby's crib has a firm, tight-fitting mattress (no more than two fingers of space between crib and mattress) and that it is free of all plastic wrappings.
■ Use tight-fitting bottom sheets made for crib mattresses. Never use adult sheets.
■ For warmth, use infant sleepwear or sleep sacks.
■ Pacifiers should never be attached to strings or ribbons around the baby's neck or to their clothing.
If you have questions about infant sleep safety, call (859) 323-1153.