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Let Sleeping Babies Lie in Their Cribs

Infants who slumber elsewhere at much higher risk for suffocation, study finds

MONDAY, Oct. 6, 2003 (HealthDayNews) -- When it comes to bedtime for baby, stick with the crib.

That's the message from a Saint Louis University School of Medicine study that found infants sleeping in adult beds or on furniture are 40 times more likely to suffocate than those sleeping in cribs.

In assessing whether the incidence of babies' suffocation deaths in cribs, adult beds or other furniture has increased in the past decade, doctors found that almost 80 percent of babies now sleep in cribs and the number of suffocation deaths in cribs has decreased by more than half. But the number of suffocation deaths in adult beds and furniture more than doubled.

"These are real and alarming numbers. The risk of the baby dying of suffocation if the baby sleeps with you is markedly increased," says study author James S. Kemp, an associate professor of pediatrics at the Missouri university.

The finding appears in the October issue of Pediatrics.

The researchers found 192 babies suffocated while sleeping in their cribs from 1980 to 1983, compared to 107 babies between 1995 and 1998. During the 1980s, 152 babies were reported to have suffocated while sleeping on an adult bed, and 33 babies suffocated while sleeping in sofas or chairs. From 1995 to 1998, those numbers increased: 391 babies suffocated in adult beds; 110 babies died from suffocation in sofas or chairs.

The main causes for suffocation in adult beds were getting wedged between the bed and the wall, stifled by soft bedding, or overlying, which is when an adult lies on top of the baby, the study reports.

"Babies lack the motor skills to deal with environmental risks. They can't roll over or push things off their face," Kemp says.

While these statistics are significant, some of the large differences between the two decades could be due to diagnostic shifts in the way babies' deaths were reported, Kemp adds.

"The data from the 1990s is better. There is more attention to the details of the scene at death. And the more information there is from the scene, the more likely it is to find an accident has happened, that there was something in the environment that caused it," he says.

That being said, Kemp says, the data clearly indicates a risk that should be paid attention to: From 1995 to 1998, the risk of suffocation for babies in cribs was .63 deaths per 100,000 babies, compared to 25.5 deaths per 100,000 babies who suffocate in adult beds.

Betty McEntire, executive director of the American SIDS Institute, applauds the study. It's the first, she says, that breaks down the data about suffocation by location of death.

"Sadly, almost all the calls we get from parents are about babies who were in bed with their parents," she says. "Now that we've got people to follow the other recommendations about safe sleeping in cribs, the next campaign is to focus on deaths in adult beds."

Complicating the issue of babies sharing beds with parents, she says, are strong opinions by advocates of breast-feeding who say breast-feeding a baby in bed fosters important bonding between a baby and its mother.

"As a pediatrician, I encourage breast-feeding and worry that this campaign could discourage breast-feeding," says Carl E. Hunt, director of the National Center on Sleep Disorders Research.

"While we know that infants sleeping on sofas and chairs is very dangerous, there are limitations to the bed-sharing data in the study," he says.

Among the questions, he says, is whether the babies were bed-sharing or sleeping by themselves in the beds, and whether there were other factors that could have caused the suffocation, such as parental smoking or the size of the babies, especially if they were pre-term.

Kemp acknowledges the study data isn't perfect, but emphasizes the risk is real.

"It would be very hard for anyone who knows about risk analysis to say you could go out and buy a bed which would be acceptable to a parent and accommodate a baby safely -- one with a hard mattress, no pillows or blanket. It doesn't exist out there. I'm in favor of bonding between parents and babies, but just not in the same bed," he says.

More information

An explanation of Sudden Infant Death Syndrome can be found at the National Institute of Child Health & Human Development. For information about reducing the risk for SIDS, you can visit SIDS.

SOURCES: James S. Kemp, M.D., associate professor, pediatrics, St. Louis School of Medicine, Mo.; Betty McEntire, Ph.D., executive director, American SIDS Institute, Marietta, Ga.; Carl E. Hunt, M.D., director, National Center on Sleep Disorders Research, National Institutes of Health, Washington, D.C.; October 2003 Pediatrics
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