Federal health experts report a disturbing four-fold increase in infant deaths from accidental strangulation and suffocation. To blame, they say: parents sleeping in bed with their babies.

The rise in deaths, charted over the last 20 years, has coincided with increased bed-sharing, say experts at the U.S. Centers for Disease Control and Prevention, which released the report. Between 1984 and 2004, deaths attributed to accidental infant strangulation or suffocation climbed from 2.8 to 12.5 per 100,000 live births. That translates into an increase from just 103 deaths in 1984 to 513 deaths in 2004. The risk was highest in African-American families, which experienced a death rate of 27.3 per 100,000 live births, compared with only 8.5 percent among white families.

Why more parents are sleeping with their babies isn’t known. Experts suspect many parents may choose to share a bed with their infants to make it easier to breast feed or bond. 

Of course families without the luxury of buying cribs or bassinets may have no choice. “There’s something we call chaotic bed-sharing,” Rachel Moon, a spokesperson for the American Academy of Pediatrics, told the Washington Post. “You share a bed not because you make a conscious choice to bed-share, but because you have no other options.” To give all parents that option, a growing number of nonprofit groups offer cribs to poor families.

But many parents believe their babies are safer sleeping with them. And some experts agree.

According to the official advice from the American Academy of Pediatrics, babies should sleep in the same room with their parents but in a separate bed, such as a crib or bassinet, adjacent to the parents’ bed to make breast feeding more convenient. Infants should sleep on their backs on a firm mattress with no pillows, stuffed animals, or other objects that could suffocate them.

But not everyone agrees that’s the best advice. James J. McKenna, PhD, an anthropologist at the University of Notre Dame and director of the Mother-Baby Behavioral Sleep Laboratory there, served as a consultant for the committee that drafted the AAP recommendations. But while he applauds the room-sharing guidelines, he thinks there are many reasons why mothers should share a bed with their infants. “When done safely,” he writes in an article on site of the Natural Child Project, “mother-infant cosleeping saves infants lives and contributes to infant and maternal health and well-being.”

One practice that isn’t safe under any circumstances is falling asleep with an infant on a couch or sofa. The design of the furniture makes it too easy for babies to be pushed against the back cushions and suffocate. Experts also warn that parents who smoke or have consumed alcohol or drugs that impair their judgement or alertness should not sleep with their babies in the same bed.

As McKenna points out, UNICEF, the World Health Organization, and the Academy of Breast Feeding Medicine, among other health agencies, promote bed-sharing.

Even the CDC experts who sounded the alarm admit that they can’t say for certain that bed-sharing is responsible for the surge in accidental suffocation and strangulation. The numbers may simply reflect more thorough death-scene investigations or revised methods for classifying sudden infant death syndrome fatalities.

For now, the alarming new numbers–and the contradictory advice from experts–are certain to cause many parents more than a few sleepless nights.

© 2009 PDQhealth

Tags: accidental suffocation, American Academy of Pediatrics, bed-sharing, infant deaths, Natural Child Project