Arms Reach® NewsBaby in Parents’ Bed in Danger? September 30 1999
by Erica Goode, National Desk – The New York Times Company
Parents should never sleep in the same bed with infants or toddlers under the age of 2, the Federal Consumer Product Safety Commission warned yesterday, because sleeping together poses a significant risk of accidental smothering or strangling.
"Don't sleep with your baby or put the baby down to sleep in an adult bed," Ann Brown, the commission's chairwoman, counseled parents.
The agency presented data from a study it had conducted indicating that over an eight-year period 515 children under 2 – an average of 64 a year – died as a result of sleeping in adult beds.
But the recommendation prompted outrage from some pediatricians and many mothers and fathers, who argue that sharing a bed is part of child-rearing in many cultures and that it is beneficial, promoting breast-feeding and strengthening bonds between parent and child.
"There is no way on this earth that a U.S. Government official should make pronouncements about child-care practices based on a single study," said Dr. Abraham B. Bergman, a professor of pediatrics at the University of Washington.
Dr. Bergman and other critics said that while parents did need to know about safety hazards associated with adult beds, an across-the-board warning against bed sharing was unwarranted. The commission's recommendations, they said, smack of cultural bias and will frighten parents unnecessarily.
The new study, released yesterday in New York at a news conference sponsored by the American Medical Association, was based on data from the death certificates of infants, coroner's reports and news accounts for the years 1990 to 1997. The A.M.A. publishes The Archives of Pediatrics and Adolescent Medicine, which will carry the study in its October issue.
In 121 of the 515 deaths, the study found, a parent, sibling or other adult sleeping in the bed had inadvertently smothered the child. More than three-quarters of the children who died from "overlying" were younger than 3 months.
In the other 394 deaths, children suffocated or were strangled after they became entrapped in the bed structure, ending up, for example, wedged between mattress and wall or between mattress and headboard. Older-style waterbeds presented a particular hazard to children, who could suffocate while lying face down on the bed's surface, reported the researchers, led by Dr. Suad Nakamura, a physiologist at the commission's directorate for health science.
Dr. Nakamura said the 64 infant deaths linked to adult beds contrasted with 50 deaths a year on average tied to cribs, most of which did not meet Federal standards.
"Placing children younger than 2 years to sleep in adult beds exposes them to potentially fatal hazards that are generally not recognized by the parent or caregiver," Dr. Nakamura and her colleagues concluded.
A Safer Option For Parents Who Want To Keep Their Infants Close To Them At Night, She Said, Is A "CO-SLEEPER®" brand Bassinet, Which Is Attached To The Bed, But Allows The Child To Sleep In A Separate, Protected Space.
Critics of the commission's report say the study's methods were flawed. For example, Dr. Bergman said, because no one knows exactly how many babies sleep with their parents in adult beds the study gives no indication of relative risk, a weakness noted by the study's authors in their report.
Death certificates, Dr. Bergman said, may also be misleading. They often contain little information about the circumstances of the deaths - whether the parents were using drugs or alcohol, smoked, or suffered from depression, for instance. And in some regions, he said, coroners may be more likely to attribute the deaths of infants in poor families to "overlying," while attributing infant deaths in higher-income families to sudden infant death syndrome.
Only 2 of the 121 overlying deaths in the study were related to alcohol, according to coroner reports and other data. But the researchers conceded that the data were sometimes scant and that other deaths might also be alcohol related.
Bed sharing is the norm in many countries, anthropologists say, and is common in Hispanic, Asian and African-American families. It is also gaining popularity among young working couples, who are loath to be separated from their children at night.
Historically, American pediatricians have discouraged the practice in the belief that it fostered bad sleeping habits, made children dependent and raised the risk of suffocation. But in recent years, some specialists have revised their views.
Dr. William Sears, a pediatrician in San Clemente, Calif., who with his wife, Martha, has written 25 books on parenthood, endorses the practice, saying it is "the nighttime parenting style of the millennium."
"My concern," Dr. Sears said about the commission's recommendation, "is that every night, millions of responsible parents go to bed with their babies and their babies wake up just fine."
But Dr. Sears also includes in his books a list of cautions. For example, he warns that parents should never share the bed with children when they are under the influence of alcohol or drugs, or when they are highly fatigued. Obese parents, he said, also need to be "very cautious."
Studies by Dr. James McKenna, a biological anthropologist at the University of Notre Dame, indicate that infants who sleep with their mothers cry less and breast-feed longer and more often than children who sleep in cribs.
"Cosleeping and breast-feeding are basically one and the same adaptive system," Dr. McKenna said.
In response to criticism, Ms. Brown said in an interview that the safety commission's recommendation "is not an anti-breast-feeding diatribe in any way."
She said that the issue was one of safety and that there was no safe way for parents and infants to sleep together.
"The safe sleeping environment for a baby," she said, "is in a crib that meets Federal safety standards, on a firm, flat mattress, with the baby on its back, and no soft bedding in the crib."
For their part, Jennifer and Aaron Wright of Fremont, Calif., have put their daughter, Alice, to sleep in their king-sized sleigh bed ever since she was born eight months ago.
"Having our baby in our bed feels right, and we don't have to worry about her being cold or lonely," Mrs. Wright said.
"I understand that they're looking out for the safety of the babies," she said about the commission, "but I think my husband and I are smart enough to make our own decisions."
© 1999, The New York Times Company.