A interesting study published on bmj.com yesterday reports that more than half of unexplained sudden infant deaths occur while the infant is sharing a bed or a sofa with a parent (co-sleeping). In addition, it may be associated to parents drinking alcohol or taking drugs.
The term sudden infant death syndrome (SIDS) was introduced in 1969. It is supposed to be a recognized category of natural death that carried no implication of blame for the parents.
In June of 1994, the Back to Sleep campaign was launched to “educate the medical field, parents, grandparents, and care givers about the importance of putting babies to sleep on their back to significantly reduce the risk of SIDS.” In addition to back sleeping, the SIDS Alliance has pointed out that soft bedding and overheating were also significant risk factors for SIDS and accidental infant deaths.
But it is unclear which risk messages have been taken on board in different social or cultural groups. Moreover, little is known about the coming out of new or previously unrecognized risk factors.
In order to find out more, a team of researchers at the Universities of Bristol and Warwick studied all unexpected infant deaths from birth to two years in the southwest region of England from January 2003 to December 2006.
They examined the potential link between SIDS and socioeconomic deficiency. They compared these deaths with a control group at ‘high risk’ for SIDS which were young, socially deprived mothers who smoked, as well as a randomly selected control group.
Shortly after the death, parents were interviewed. Information on alcohol and drug use was collected. Trained professionals conducted a detailed investigation of the scene and circumstances of death.
They analyzed a total of 80 SIDS deaths. More than half (54 percent) occurred during co-sleeping compared to a 20 percent co-sleeping rate among both control groups.
The authors say it appears that much of this risk may be explained by the combination of parental alcohol or drug use prior to co-sleeping with 31 percent compared with 3 percent random controls. The high proportion of co-sleeping deaths on a sofa with 17 percent compared with 1 percent random controls.
- 20% of SIDS infants were found sleeping with a pillow when they died
- 25% were swaddled
The researchers also found:
“Some of the risk reduction messages seem to be getting across and may have contributed to the continued fall in the SIDS rate.” However, the majority of the co-sleeping SIDS deaths occurred in a hazardous sleeping environment.
They recommend that:
- the safest place for an infant to sleep is in a cot beside the parental bed in the first six months of life
- parents never put themselves in a situation where they might fall asleep with a young infant on a sofa
- parents never co-sleep with an infant in any environment if they have been drinking or taking drugs
In an associated editorial, Edwin Mitchell, Professor of Child Health Research at the University of Auckland comments:
“We have learnt that SIDS is largely preventable. It is important to monitor parents’ knowledge and infant care practices to inform health education and promotion.”
He says in closing: “Implementing what we already know has the potential to eliminate SIDS, the challenge now is how to change behavior.”
The biggest issue that most new parents don’t understand is that someone who is sleep-deprived will not realize they have rolled onto their baby if they are in a deep sleep.