Rise in infant suffocations renews bed-sharing debate

Infant deaths blamed on accidental strangulation and suffocation in bed (ASSB) have increased dramatically in the United States, quadrupling since 1984, a new study says.

Although the reason for the increase isn’t clear, the study is sure to ruffle feathers among parents who sleep with their babies, as experts note that the increase coincides with the rise in bed-sharing, which has gained popularity as a way to help mothers bond and breastfeed.

ASSB deaths can occur when a sleeping parent rolls onto a baby, the baby becomes trapped between the mattress and a wall, a pillow falls on the infant’s face, or a blanket gets wrapped around the baby’s neck.

The study’s results have some experts calling for stepped-up efforts to discourage bed-sharing, and the authors say that prevention efforts should target those at highest risk (especially African-American male infants younger than 4 months old) and focus on helping parents provide safer sleep environments.

At the same time, the rate of sudden infant death syndrome (SIDS) declined, which is largely credited to the national "back to sleep" campaign that urges parents to put babies to sleep on their backs.

Co-sleeping supporters say it isn’t inherently dangerous and that parents won’t roll over onto a baby because they’re conscious of the baby’s presence – even during sleep.

But in addition to the potential safety risks, sharing a bed with a baby can prevent parents from getting a good night’s sleep, and infants who co-sleep might learn to associate sleep with being close to a parent in the parent’s bed, which may become a problem at nap- or bedtime.

If you do choose to share your bed with your baby, make sure to follow these precautions:

• Always place your baby on his or her back to sleep to reduce the risk of SIDS
• Always leave your child’s head uncovered while sleeping
• Make sure your bed’s headboard and footboard don’t have openings or cut-outs that could trap your baby’s head
• Make sure your mattress fits snugly in the bed frame so that your baby won’t become trapped in between the frame and the mattress
• Don’t place a baby to sleep in an adult bed alone
• Don’t use pillows, comforters, quilts, and other soft or plush items on the bed
• Don’t drink alcohol or use medications or drugs that may keep you from waking and may cause you to roll over onto, and therefore suffocate, your baby
• Don’t place your bed near draperies or blinds where your child could be strangled by cords

(Source: Nemours Foundation: Pediatrics: March 2009)