Cosleeping &SIDS Fact Sheet

The Crib Industry wants you to know that 60 “accidental” infant deaths have occurred in the United States per year, in adult beds, for age birth to 2 years. The implication is that these are co-sleeping deaths,

but many of these infants are sleeping alone in adult beds. Why did they forget to mention that safe cosleeping actually reduces bed deaths? … especially after the first several weeks.

Linda Folden Palmer, DC
Author BABY MATTERS and BABY POOP

FOR REVIEW OF NUMEROUS STUDIES THROUGH 2005, CLICK HERE

In 2005, the crib industry (JPMA) provided a large forum for the Consumer Product Safety Commission (CPSC) to announce this report. Unfortunately, no comparative statistics are provided in their announcements, and even the statistics they report are admittedly anecdotal and irregular. While the report supposedly left out the adult bed deaths that were diagnosed as SIDS (versus accidents), the determination between suffocation and SIDS is often a judgment call. Suffocation in a crib is more often reported as SIDS, while suffocation in an adult bed is reported as “death by adult bed.” Whether suffocation or other undetermined cause, all parents want to know is what is safe and what is not. Today, studies are not complicating this issue as much.

The actual SIDS statistics were not measured. Why? Several well-designed research studies demonstrate that SIDS is actually reduced in babies cosleeping along with an aware, protective (non-smoking, non-drug-impaired) mother in a safe bed. Such an announcement would not sell cribs. The numbers in the largest study on cosleeping around the world suggest that safe cosleeping reduces SIDS!  (See graph at bottom). International Child Care Practices Study  

Another large study on SIDS shows 1/5th the risk of death for sleeping infants simply sharing the room with non-smoking adults. This includes many sleep variations. The rate for sharing bed was not measured directly. New Zealand Cot Death Study.

While SIDS can be greatly reduced by breastfeeding, no one ever mentions this.

The Chicago Infant Mortality Study reveals that Breastfeeding Infants have 1/5th the Rate of SIDS. They report a nearly doubled SIDS rate for cosleeping, but this study does not remove the powerful effect of smoking parents from their statistic. When other studies remove this behavior, they find the remaining infants enjoy a greatly lower rate of SIDS for cosleeping versus isolated crib sleeping.There are two kinds of cosleeping, that conscious decision made by highly attentive parents, and that coming from factors such as fatigue from partying or drinking. When sofa sleeping and wedging dangers are also removed, the family bed shines as safest.

Some numbers:

Number of U.S. births year 2000: 4,058,814

Total infant deaths year 2000: 28,411 – age birth to 1 year (6.9 per thousand)

Number SIDS deaths year 2000: 2,523  Defined as death with unexplained cause, birth to 1 year.

Total suffocation deaths year 2000: 1,000

Number of crib-related “accidents”/yr: 50

Number of playpen-related deaths/yr: 16

Number deaths/yr attributed to overlying: 19 Most are only “suspected.”

Number of babies (0-2) dying in night fires/yr: 230 Many of which may have been retrievable if next to parent, not in another room of home. This is true for abductions and other night dangers as well.

Number of deaths/yr in adult beds reported as entrapment/suffocation between bed and wall, headboard, or other furniture, on waterbed, in headboard railings, or tangled in bedding: 18    

With side-rail: 1 That’s 19 of the 60.

Number of deaths/yr reported as suffocation of unknown cause in adult bed: 13 These would be SIDS if in a crib. Remember, these do not necessarily involve cosleeping.

Number of deaths/yr in adult beds from prone sleeping: 5 Again, these are considered SIDS in cribs, and they are preventable in adult beds, as in cribs.

4/yr died not from falling out of adult bed, but from suffocating (pile of clothes, plastic bag) or other danger (such as drowning) after falling out.

13% of U.S. infants are routinely cosleeping with nearly 50% sharing bed for part of the nights. National Institute of Child Health and Human Development 2000 Survey,

Number of U.S. infant lives that could be saved per year by exclusive/extended breastfeeding: Thousands  Exclusive/extended breastfeeding cuts SIDS risk and may cut overall infant death risk in half.

Why does our nation rank only 36th in infant survival?* in the industrialized world (some non-reporting nations are thought to rank better than us as well)? Our difference from the best-ranking nations is a high predominance of formula feeding, isolated sleep, and medical intervention.   *(The ranking number is lowered by 6 by statisticians to adjust for an assumption that the U.S. has more live premature births, leading to more infant deaths. The statistical impact factor is only slight.)

The highest cosleeping/ breastfeeding nations rank with half or LESS of our overall infant death rate (and with negligable SIDS rates).

Remember we rank #1 in medical intervention.

The SIDS/Suffocation Risk Factors for Co-Sleeping:

# Bed sharing not being the accustomed sleep arrangement

# Sofa sleeping

# Smoking parent

# Unsafe space between mattress and headboard or wall # Prone sleeping

# Parent compromised by drugs or alcohol  # Overly heavy or fluffy bedding

# Sleeping with sibling (for tiny infants) or non-interested adult

and additionally for parental bed sleeping: 

                      # Sleeping without protective parent in room

Clearly cosleeping and adult beds can be made to be safer. This would be a much more appropriate service for the Consumer Product Safety Commission to provide, rather than their thoughtless suggestion against cosleeping. Also, clearly, responsible parents consciously creating a safe cosleeping environment are safely providing the best of all worlds for their baby.

When crib deaths were much higher than they are now, the decision was to make the crib safer, not to throw out the baby. Most of the improvement in the crib death rate occurred from the “Back to Sleep” campaign. Babies can sleep supine in adult beds as well, although there’s no evidence that side sleeping with mother, as may occur after nursing, is a risk.

Co-sleepers and side-beds that attach firmly to the mattress are good options for preventing falling out, suffocation, and entrapment, whether baby is in the co-sleeper or in the adult bed. Adjustments should be considered for the space between headboard and mattress, especially for “creepers.” Some just put mattresses on the floor, eliminating entrapment concerns.

GRAPH:

I have taken numbers from the “International Child Care Practices Study,” Nelson, et al. to create the above graph. The Sudden Infant Death rates for each studied area are plotted against the percent of infants in that area who are cosleeping for over 5 hours per night (percent bed sharing X percent over 5 hours). One more point could be placed at 88% cosleeping for Chongqing, China, with negligible (<.1) SIDS. I have not plotted this point in the graph, as the study authors did not assign an exact SIDS value, and I do not wish to be distorting the graph in favor of conclusions. The report supplies 1995 statistics. The U.S. was not included. In 1995, the U.S. SIDS rate was 1.0 per thousand. Cosleeping was a little lower than today’s estimated “20% for half the time or more.” The authors of the study did not propose any graphs. They did not wish to weigh too much conclusion on their study findings as there were many variables, such as fashion of bedsharing and diagnostic criteria for SIDS.

The material in this website is provided for information purposes only. No part of this text should be taken as, or considered a substitute for, medical diagnosis, medical advice, or medical treatment prescription.