Co-Sleeping Infant Deaths From Suffocation on the Rise

Co-Sleeping Infant Deaths From Suffocation on the Rise October 23, 2018
Photo Credit Flickr

October is Sudden Infant Death Syndrome (SIDS) Awareness Month. The purpose of the month is to educate and promote safe sleeping habits for infants to prevent sleep-related deaths. According to the Centers for Disease Control, 3,500 sleep-related deaths occur each year in the United States. In 2016, the CDC reported that 1500 deaths reported were classified as SIDS, 1200 deaths had unknown causes, and 900 deaths were related to accidental suffocation and strangulation. As SIDS education has decreased the SIDS related deaths, strangulation and suffocation deaths of infants have increased by 184% between 1995-2015. During this same period, co-sleeping with infants became more popular for infants and parents. Co-sleeping is an alarming and dangerous trend in the parenting world that leads to preventable deaths.

One of the largest organizations that promote co-sleeping is La Leche League. On their website, La Leche League says, “Bedsharing, when breastfeeding is a traditional way of caring for a baby at night – breastfeeding at night, can be a whole lot easier when you take your baby into bed with you and feed laying down.”

Because La Leche League feels so passionately about bedsharing for breastfeeding, they designed a guideline for all parents to follow with bed sharing.

In the breastfeeding world, LLL is well-respected. Doctors refer mothers to LLL for help with lactation issues related to breastfeeding. Because many mothers respect LLL, they also follow the safe sleep guidelines for breastfeeding.

While their guidelines certainly help to eliminate some aspects in accidental suffocation. Their guidelines do not address numerous factors that can lead to suffocation of the infant.

Adults often sleep with blankets and pillows in their beds. Mothers move and shift in their sleep. Infants under six months old often can’t roll over on their own. The result is that if a mother rolls over she can easily smother the infant with her body, blankets, or a pillow while she is asleep.

In recent years several infant death related to co-sleeping have made the news. A Pennsylvania woman pleaded guilty to third-degree murder in the co-sleeping suffocation death of her 2-month old son. A Florida mother was charged in the co-sleeping death of her newborn son in 2016.

Perhaps the most startling aspect in both cases is both women had previously killed other infants due to co-sleeping before their arrests. Co-sleeping can be a hard habit to break.

As the number of accidental suffocation deaths of infants increased, the American Academy of Pediatrics released new guidelines for safe sleep in 2016.

AAP recommendations on creating a safe sleep environment include:

  • Place the baby on his or her back on a firm sleep surface such as a crib or bassinet with a tight-fitting sheet.
  • Avoid the use of soft bedding, including crib bumpers, blankets, pillows, and soft toys. The crib should be bare.
  • Share a bedroom with parents, but not the same sleeping surface, preferably until the baby turns one but at least for the first six months. Room-sharing decreases the risk of SIDS by as much as 50 percent.
  • Avoid baby’s exposure to smoke, alcohol and illicit drugs.

The APP also says:

 Breastfeeding is also recommended as adding protection against SIDS. After feeding, the AAP encourages parents to move the baby to his or her separate sleeping space, preferably a crib or bassinet in the parents’ bedroom.”

“If you are feeding your baby and think that there’s even the slightest possibility that you may fall asleep, feed your baby on your bed, rather than a sofa or cushioned chair,” said Lori Feldman-Winter, MD, FAAP, member of the Task Force on SIDS and co-author of the report.

“If you do fall asleep, as soon as you wake up be sure to move the baby to his or her own bed,” she said.

“There should be no pillows, sheets, blankets or other items that could obstruct the infant’s breathing or cause overheating.”

Breastfeeding mothers may feel confused receiving the conflicting information from two sources they believe are reliable in infant care. Despite the suggestions provided by LLL, co-sleeping of any kind increases the infant’s risk of dying from accidental suffocation or strangulation.

All parents make mistakes and learn painful lessons. However, the choice of not co-sleeping can be a life or death decision for your baby. In honor of SIDS awareness month, we recommend all mothers follow the guidelines outlined by the AAP.

All babies deserve the opportunity to make it to their first birthday.

After you finish breastfeeding, place the infant in a crib or bassinet.

If you are co-sleeping, consider the risks and reconsider your choice to protect your babies future.

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TRENDING AT PATHEOS Nonreligious
What Are Your Thoughts?leave a comment
  • Kevin K

    My cousin posted a video of his first grandchild rolling over at one week! I find that terrifying.

  • that is so scary!

  • Tawreos

    Was the vid followed by a video of the kid skittering across the ceiling at 6 months? =)

  • Jennny

    My daughter has had 2 babies in 2yrs in the city in the Uk that has the highest incidence of SIDS. Mums-to-be get ante-natal check-ups at clinics, at their GP’s surgery, but in this city there is a network of them, like drop-in centres. This is to encourage poorer inner-city folk to attend one near them without making appointments first and the clinics’ walls are all plastered with the advice you gave. 10days after the birth, all mums are visited regularly by the Health Visitor attached to their GP surgery and she will be very firm with anyone not obeying these guidelines. Here, cellular cotton blankets are permitted, but never above the baby’s armpits. That was the one thing I found hard not to be able to do with my g/babies, I swaddled my 3 babies and found it soothed them so much, but I appreciate very much the push this city is giving to reduce SIDS.

  • TinnyWhistler

    I’m now picturing Jack Jack.

  • swbarnes2

    Talk of SIDS prevention should include the effectiveness of pacifiers.

    https://www.ncbi.nlm.nih.gov/pubmed/21505778

    Also, since this is Patheos, see 1 Kings 3:19

  • this is the atheist channel

  • What percent of suffocation deaths occurred in bed sharing or cosleeping situations? And what percent were in unsafe co-sleeping situations? I followed these rules for co-sleeping safely with my girls AND their father did not share the bed with us at all.

    https://cosleeping.nd.edu/safe-co-sleeping-guidelines/

  • I cringe when I see pics online of babies in positioners, sleeping with loose blankets, on pillows, on a parent’s shoulder, etc. These are all situations where baby can very easily suffocate to death.

  • Jim Jones

    I’d love to see some research on primitive peoples such as those in the Amazon river area, or maybe the Bantu in Africa. What are their stats? How do their babies sleep?

  • persephone

    I did what the APP recommended, although it wasn’t out at the time my kids were born. Having them in our room made life so much easier. I had to quit breastfeeding early with both of them, so I would prepare a bottle before bed, then set an alarm for a little earlier than they would wake up. I’d get the bottle warmed up, jostle them enough to feed, burp them, and, when they were soundly back to sleep, they went back to the bassinet or crib.

    Avoiding crying, unhappy babies in the middle of the night made for a much better situation all around.

  • Christina

    I agree completely! We bed share following those recommendations and we didn’t till my husband agreed. It’s so taboo and maybe we should look at other reasons for SIDS such as the amount of vaccines given at there 2 month old well check.

  • Vaccines are associated with a 50% reduction in SIDs. They are one reason SIDS rate is at an all time low in all western countries, including USA.

    https://www.ncbi.nlm.nih.gov/pubmed/17400342

    https://vaccinesworkblog.wordpress.com/2017/12/29/vaccines-save-lives/

  • It is hard to compare indigenous peoples stats to western countries because their sleep conditions are different and there are so many other variables, like lack of access to clean water and vaccines.

  • Jim Jones

    Sure. but it’s still a data point. Does this happen? If they sleep in hammocks, does that prevent it?

  • I think we need to study it more, to be sure. More babies die in cribs than in cosleeping situations because more babies sleep in cribs, in USA. So, we need to study the issues more.

  • It is useful to point out that overlaying has been known already before the “vaccine injury awareness month” brigade come in.

    Vaccine Injury Awareness Month would be a great idea. The trouble is, that it’s actually “vaccine injury” e.g. autism awareness month.

  • Actually deaths in cribs related to SIDS are about 1/3 of the deaths – followed by suffocation deaths. So it’s not really that we need to examine it. the safe sleep guides by the AAP have reduced the number of SIDS death immensely. The only reason the death sleeps are increasing is because bed-sharing is becoming so common

  • there is NO safe way to bed-share. If your children survived, you were lucky.

  • Kevin K

    Ha! No. She’s still not 6 months old. I don’t have a way to de-identify it, or I’d post it.

  • Anat

    OK, as an older person I need an explanation: I need to understand the whole ‘the crib should be bare’ thing. How are infants supposed to stay warm? What temperature do you keep an infant’s room? What about the temperature of the rest of the house?

  • swbarnes2

    You can swaddle a child too young to roll over, and footed pajamas really help keep heat in. (Of course, too warm is a problem too…)

    Blankets are a suffocation hazard. That’s why they aren’t allowed.

  • swbarnes2

    Well, start with 1 Kings 3:19. Not “primitive”, but ancient.

  • swbarnes2

    I cited an ancient story about a co-sleeping death, of a totally unvaccinated baby (likely breastfed too)

  • persephone

    There are a lot of heavy sleeper pajamas and sacs that work very well for young babies.

  • Kepi

    ^^ What an αsshole.

  • we do not use ad homies here. Sorry. First and last warning.

  • I agree with you persephone

  • While I like your blog a lot, I completely disagree with you here.

  • Can you link me to that data, please?

  • Upvoted except for the 2nd sentence, OOPT.
    The very idea of “Vaccine Injury Awareness Month” is ludicrous as the rate of serious injury from vaccines is extremely low, as you know. It is just Propaganda Kabuki Theater invented by rabid anti-vaccine death cultists Babs Low Fisher and her financier Joe Merde-ola.
    .

    You may as well have a “Rattlesnake Injury Awareness Month” as they cause many, many more serious injuries than vaccines.

  • Absolutely. All of the data is available on the CDC website. There are around 3500 sleep-related deaths annually. The CDC classifies them as Sudden Unexpected Infant Death. In 2016, there were 3600 deaths. They were broken down as:

    In 2016, there were about 1,500 deaths due to SIDS, 1,200 deaths due to unknown causes, and about 900 deaths due to accidental suffocation and strangulation in bed.

    They provide a graph. In 1990, there were nearly NO deaths related to strangulation or suffocation in the bed, by 2016 there were 900.

    Accidental suffocation and strangulation in bed (ASSB) mortality rates remained unchanged until the late 1990s. Rates started to increase beginning in 1997 and reached the highest rate at 23.1 deaths per 100,000 live births in 2015. In 2016, the rate was 21.8 deaths per 100,000 live births.

    During that same time SIDS cases dropped considerably -Sudden infant death syndrome (SIDS) rates declined considerably from 130.3 deaths per 100,000 live births in 1990 to 38.0 deaths per 100,000 live births in 2016.

    Unknown cases remained around the same for several years and trended upward slightly – but not as much as the strangulation and suffocation. No matter what way you look at it the reason for the increase in deaths is bed-sharing. So the idea that bed-sharing in any capacity is safe is simply untrue. As parents and mothers, we have been given information that is no longer accurate, and science via studies, data, and statistics are proving that bed-sharing is not safe. Even if you remove EVERYTHING – adult beds are simply TOO soft for infants.

    I do not fault anyone for believing the information they have been given. My goal in sharing is that people realize that as we evolve and learn – we need to improve our practices. I appreciate you and your comments here.

    https://www.cdc.gov/sids/data.htm

  • lady_black

    Infants are to be kept warm by the clothing they wear. An infant doesn’t sleep in the nude, so extra coverings aren’t necessary (other than for swaddling when they’re young… mine slept better when swaddled). I had some footie pajamas for mine in the winter, made from warm materials such as flannel or actual blanket material. If the room is very cool, a cap can be worn.
    An infant’s room should be kept at the same temperature as the rest of the home, which, when sleeping, should be on the cooler side. Infants that are kept too warm, will perspire, just as you do, and that’s uncomfortable for them. I can remember when my middle son was an infant, and we visited my then-husband’s grandparents. They used a wood stove for heat, and being elderly, they kept it up as high as possible. I asked if they had a cooler room where my son could nap in his carrier, because the heat was clearly making him uncomfortable (me, as well).

  • lady_black

    I didn’t want mine in the room with me. I’m a light sleeper who doesn’t appreciate hearing every little noise a baby makes. I kept them in a nearby room.

  • lady_black

    Your husband should be in your bed. Your baby should not. Unless you have a bed-box which completely separates the infant from sleeping adults.

  • lady_black

    “maybe we should look at other reasons for SIDS such as the amount of vaccines given at there 2 month old well check.”
    NO!

  • Anat

    The temperature that is comfortable for sleeping under a winter comforter is much lower than the temperature that is comfortable for sleeping in pajamas with no extra covers. (But then we had a summer baby in one of the hottest summers in decades, so we slept without covers with the AC on, but that is unusual.

  • lady_black

    Do you wear footie pajamas made of blanket material? Probably not. A good rule of thumb is, if you would be comfortable, your baby would be, too.

  • I’ve never thought of this – but my son has hypothyroidism and dysautonomia – so he always needed extra layers to keep him warm

  • lady_black

    Hmmm. I have hyperthyroidism, and I also have cold intolerance. I also have heat intolerance. But I prefer a very cool room for sleeping. I just use a comforter, because I don’t like pajamas (they get all twisted up). If it’s too warm, I can’t sleep.

  • My son sleeps in a T-shirt and with a fan. Otherwise he sweats through the sheets

  • PistachioGecko

    They make little sleeper suits now, with the leg portion being all one piece and the attached top portion looking like a coat vest. You zip the baby into this in their pajamas. The material can be quilted for cold climates/winter or a thinner fleece or flannel for warmer climates. Summer and hot climate babies don’t really need anything extra beyond their pajamas.

  • PistachioGecko

    Not usually on soft mattresses for starters.

  • My husband did not want to be woken up by a crying baby. It was his choice to sleep in another room and have the baby sleep with me so as to minimize crying and minimize disruptions to his sleep. He put his sleep first, not I. I would have gladly included him in the bed. In fact, first baby started out in crib, in her room, but was too disruptive to husband’s sleep.

    Maybe ask questions before you judge?

  • Can you account for vaccinated kids having a halved risk of SIDs? Yep, thanks for reminding us to look at that.

  • We should. But that won’t take too long since we’ve already established the answer is “something else.”

  • Huh. Interesting. When my brother (late 1985) and then I (late 1990) was born, the rule of thumb mum was given was “Baby should be wearing one more layer than the adults” but a)England and b)that may or may not have been related to some mild disabilities my brother and I had.

  • lady_black

    You missed the point. Was that deliberate?

  • Your point was that husband and wife should share the bed, not mother and baby. What if husband does not want to be near the baby and does not want to be woken up by mother when she gets up to nurse baby in the wee hours? What if it was his idea to sleep separately? Did that occur to you?

  • lady_black

    The point: Adults sleep with other adults, not with babies. An adult bed isn’t suitable for a baby.
    Now as far as getting up in the night and waking the other person, there’s nothing wrong with married people occupying different beds for sleep. With the way my husband snores, there’s no way our marriage would have survived without it. That doesn’t equal bringing an infant into an adult bed.
    When mine were infants, I didn’t even want them in the same ROOM with me, because I would hear every snort, sigh or other sound they made. So I can sympathize with your husband as a light sleeper.
    Maybe you were focusing on the wrong thing about my comment. Co-sleeping is dangerous. One of the women mentioned in the blog post is from my town, so that story has been in the news here. After one baby smothered to death, she went on to sleep with the next one. That one died, too. That’s a tragedy. And, it landed her facing charges.
    I can’t recommend it as a practice. One country in Europe hands out baby boxes to prevent co-sleeping. You can use almost anything as a baby box. An empty dresser drawer will do. A corrugated cardboard box. Anything to physically separate an infant from an adult in a bed.

  • She practiced dangerous sleep sharing. I did not. Thank you for your concern.

  • shay simmons

    Or cows.

  • Dr Sarah

    That’s a major exaggeration. While studies do show a slightly increased risk of SIDS with even safe bedsharing in the early months, and of course there is also going to be some suffocation risk, both risks are very low if precautions are taken. I agree it’s well worth trying to settle babies in a separate cot or bassinet by the bed if at all possible, but, realistically, the majority of the ones who bedshare will be fine, especially for people who take care with precautions. You might as well say that because some babies get killed in car accidents even when in a car seat, we’re all lucky that our children survived driving in a car.

  • we follow the guidelines of the AAP and since you don’t – you can move along

  • Dr Sarah

    One big point that’s being overlooked here, however, is that quite a few babies just flat-out will not settle in a separate crib. There have been cases when a mother becomes so exhausted trying to get her baby to settle that she ends up falling asleep with her baby in the bed in a completely unprepared and unsafe situation or – worse – on a sofa or armchair. (I can remember doing this myself, in fact; luckily, everything was fine, but my son dodged a bullet there.) Those babies would have been safer if their mothers had had safe bedsharing guidance as a back-up.

    I completely agree that it’s a terrible idea for groups such as LLL to be actively promoting bedsharing (they do this out of dogma, and I’ve seen them flat-out misrepresent evidence when it suits them) and that it’s always better to have your baby in a separate cot or crib by your bed where possible. However, realistically, sometimes it isn’t possible. Sticking to a flat-out don’t-ever-bedshare line is like giving teenagers abstinence-only education; yes, if everyone stuck to it all the time it would be the safest thing, but the reality is that many people won’t stick to it, and those people are going to be at much higher risk if they don’t also have ‘and if you do need to do it, here’s how to keep your risk as low as possible’ backup advice.

  • Dr Sarah

    While most suffocation and SIDS deaths associated with bedsharing are going to be with people who don’t follow the guidelines, studies have nonetheless shown an increased SIDS risk in younger babies who bedshare even when higher-risk situations are accounted for. It’s a tiny overall increased risk, but it is there.

    As for suffocation, as far as I’m aware there are no studies that compare guideline-adherent bedsharing risks to cot-sleeping risks, but, given that cots are designed specifically with babies in mind and adult beds aren’t and that the overall extra suffocation risk associated with bedsharing is massive, I think the onus of proof does need to be on the people claiming that following guidelines can reduce the overall extra risk to zero, not on the people who advise caution.

  • Dr Sarah

    The problem with that is that these groups have high infant mortality anyway, and it frequently isn’t possible to determine a cause, so we don’t know how many deaths are due to SIDS. The figure probably is low, because smoking rates are low, babies are all breastfed (or else starve to death so SIDS isn’t a factor), and adults don’t have mattresses or pillows, so even a bedsharing situation is likely to be very low risk but in ways that aren’t fully comparable to a Western situation where people are unlikely to be setting up the kind of sleeping surface that a member of a hunter-gatherer tribe would use.

  • well talk to the CDC, Dr. Sarah. or contact the American Association of Pediatrics. They are the authorities on safe sleep. We will not endorse any bed sharing at all

  • Dr Sarah

    You… do realise you just wrote that as a reply to a comment in which I pointed out to someone else that there was an increased risk of SIDS/suffocation with bedsharing, don’t you?

  • Dr Sarah

    Sorry; that last was snarkier than I meant it to be, for which I apologise. However, since my comment was pointing out statistics that agreed with your point in reply to someone who was disagreeing with you, so trying to shut that down isn’t terribly helpful.

  • Dr Sarah

    Excuse me, but it isn’t helpful to make assumptions about people’s beliefs just because they disagree with you on one point. I have said nothing about not following AAP guidelines, and I stated that there is a slightly increased risk with bedsharing and that it’s better to settle babies in a separate cot where possible. I was disagreeing solely with your implication that the risk is high (not just present, but high) even with precautions. Making claims that are obviously incorrect is counterproductive; it just makes people more likely to ignore what’s being said altogether.

  • I would love to see those studies. Can you link me? Are there studies which compare safer bedsharing to other sleep environments? Why does the onus need to be on the people making the claim? Can you not find data on SIDS cases and compare?

  • Dr Sarah

    Sure. I’ll get the links when I have a few minutes to go over my notes (can’t promise it’ll be today, so didn’t want you to think I was ignoring you).

  • kilda

    it’s interesting that starting in 1997, SIDS cases start going down and accidental suffocation cases went up. Does anyone know if they changed the way they classified cases around that time? I’m wondering if criteria changed so that cases that previously would have been classified as SIDS before 1997 starting being classed as suffocation.