Co-sleeping death?

co-sleeping, infant mortality, babies, SIDS

A 2-month-old baby died this week while she was sleeping on a couch with her father.

Here's what the Journal Sentinel article says about it:

A 2-month-old girl who was found dead Tuesday after sleeping with her father on a couch could be the sixth Milwaukee infant since March to die as a result of co-sleeping.

The article ends with a list of deaths attributed to co-sleeping. Most of the "co-sleeping" deaths listed involved one or both of these elements: sleeping on a couch or sleeping with a caretaker or parent who had consumed alcohol. They also tended to involve babies that were younger than 3 months old.

For me, a mom who's done some form of co-sleeping with three of our four children, this article raises all kinds of questions:

  • Should this really be called co-sleeping? Co-sleeping advocates recomend never to sleep with babies on couches. 
  • How do infant mortality figures for infants sleeping with adults compare to all infant deaths (including those in cribs) during that time period?
  • What percentage of parents sleep with their infants compared to putting them in cribs? If, for the sake of argument, 1/4 of all parents sleep with their infants, but only 1/5 of all infant deaths occur in babies sleeping with parents, wouldn't co-sleeping be safer?

Nobody wants to endanger their children. Fearmongering doesn't help parents make good decisions. Data does. Until I know the answers to those questions, it's hard to say what's riskier. Even then, it's clear that nearly all alleged co-sleeping deaths seem to be prime examples of unsafe sleep environments.

If a parent piled soft pillows in a crib and and a baby suffocated, would we blame the crib? No. The parent was not following safe sleep practices. A sensible conclusion to draw might not be that co-sleeping itself is the problem. Instead, it might be that safe sleep education does parents a disservice if it focuses only on guidelines for crib-using families.

Co-sleeping can be a confusing term, because some families use it to describe their decision to sleep with their babies, while some use it to describe an arrangement where the baby sleeps in the same bedroom or in a co-sleeper next to the bed.

Most public health departments recommend against bed sharing in no uncertain terms, rather than acknowledging that many families will do so either for reasons of personal choice (breastfeeding and attachment parenting) or poverty (there simply aren't enough beds to go around).

It's an imperfect analogy, but consider this: Most public health departments would never dream of doing abstinence-only sex education, even if they believe that's the best health choice for teenagers. In the same way, why not acknowledge that, even if they are against bed-sharing, some families will do it and might benefit from education on how to do it more safely?

Little infants are more fragile than older children, and babies under 6 months old are at the highest risk for SIDS deaths, no matter where they're sleeping (90% of SIDS deaths happen by 6 months).

Following sleep guidelines such as keeping blankets and fluffy pillows away from infants and making sure they have a safe sleep environment and a firm surface (i.e. not a couch) to sleep on is important. Alcohol consumption also is a big no-no if you're caring for a small infant.

Most parents I know are not solidly in one camp or the other but have tried a variety of sleep options to see what works best for their families. What do you think? Have you ever used a family bed?

Co-sleeping resources:
Dr. Sears online
Milwaukee Health Department
Web MD
American Academy of Pediatrics
Baby Bond

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