Sleeping on Sofa a Risk Factor for SIDS

Number of infant deaths linked to the practice is rising, study finds

WEDNESDAY, Jan. 18, 2006 (HealthDay News) -- Parents who doze off with an infant while on the sofa may be putting their baby at increased risk for sudden infant death syndrome (SIDS).

That's the finding from a British study which found that while SIDS deaths in the United Kingdom have fallen over the past two decades, the number of infants who've died while sleeping on couches has actually risen in the past few years.

"Although the reasons for the rise in deaths when a parent sleeps with their infant on a sofa are unclear, we strongly recommend that parents avoid this sleeping environment," lead researcher Peter Fleming, of the Royal Hospital for Children, Bristol, said in a prepared statement.

The report appears in the Jan. 18 online edition of The Lancet.

The rate of SIDS has declined in the United States, especially since the introduction of the "Back to Sleep" campaign, which encourages parents and caregivers to have babies sleep on their backs. But it remains one of the leading causes of infant mortality, claiming the lives of about 2,500 babies each year in the United States.

Known risk factors for SIDS include being male, pre-term, low birth weight and sleeping on the side or front. In addition, the risk of SIDS is increased by smoking during pregnancy and exposure to secondary smoke after birth.

In their study, Fleming's team looked at how Britain's own "Back-to-Sleep" campaign, begun in 1991, had affected the number of SIDS deaths in that country.

The researchers compared data on 369 unexpected infant deaths occurring between 1984 and 2003 in Avon, England, with 'control" data on 1,300 babies from a study done between 1993 and 1996.

They found that the number of deaths among infants sleeping with a parent in bed did fall over the period covered by the study. However, the number of SIDS deaths from sleeping with a parent on a sofa increased fourfold, they noted.

The British team also found that SIDS deaths among poorer families rose from 47 percent to 74 percent over the study period. In addition, the prevalence of mothers who smoke during their pregnancy increased from 57 percent to 86 percent. The number of preterm infants also rose -- from 12 percent in 1984 to 34 percent by 2003. And the prevalence of breast-feeding mothers dropped from 50 percent to just 26 percent.

"Our data clearly show that SIDS is now largely confined to deprived families, and if we exclude deaths on sofas, the numbers of babies dying whilst in bed with their parents has fallen by 50 percent over the past 20 years," Fleming said.

But one expert doubts that the findings are relevant outside of the specific group the researchers studied.

"I do not doubt the findings of the present study or the trends in that particular district," said Toke Hoppenbrouwers, a clinical professor of pediatrics at the University of Southern California in Los Angeles. "But in the details, I cannot embrace the idea that the specific findings are universal."

Overall, Hoppenbrouwers agreed that trends in baby sleep positions seem to have caused a decrease in SIDS. "Any interventions need to be targeted to the cultural groups in the various locales," she said. "Sleeping habits such as bed-sharing may well be peculiar to culture as well. The authors demonstrate an important trend that warrants further study in different locales."

Another expert believes the findings are important because they provide long-term evidence that sleep position is important in reducing SIDS deaths.

"The greatest thing that came out of this data is that it positively supports the success of the 'Back to Sleep' campaign," said Dr. Seema Csukas, director of community health development and advocacy at Children's Health Care of Atlanta.

The increase in SIDS deaths from sleeping on a couch might result from infants getting caught in a corner of the sofa, Csukas said. "SIDS deaths in a bed against a wall can result if the infant gets trapped between the bed and the wall," she noted.

"If you have an infant, you need to make sure that it's sleeping on its back," Csukas advised. "This significantly reduces the risk of SIDS." Csukas also advised not smoking during pregnancy as a way to reduce the risk of SIDS.

More information

For more on SIDS, head to the First Candle.

SOURCES: Toke Hoppenbrouwers, Ph.D., clinical professor, pediatrics, University of Southern California, Los Angeles; Seema Csukas, M.D., director, community health development and advocacy, Children's Health Care of Atlanta; Jan. 18, 2005, The Lancet
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