Co-sleeping is key culprit in sudden infant deaths: study

October 13, 2009

More than half of sudden unexplained infant deaths occur while the infant is sharing a bed or a sofa with a parent (co-sleeping) and may be related to parents drinking alcohol or taking drugs, suggests a study published on today.

Although the rate of cot death in the UK has fallen dramatically since the early 1990s, specific advice to avoid dangerous co-sleeping arrangements is needed to help reduce these deaths even further, say the researchers.

The term sudden infant death syndrome (SIDS) was introduced in 1969 as a recognised category of natural death that carried no implication of blame for bereaved parents.

Since then, a lot has been learnt about risk factors, and parents are now advised to reduce the risk of death by placing infants on their back to sleep, placing infants in the "feet to foot" position at the bottom of the cot, and keeping infants in a smoke-free environment.

But it is not clear which risk messages have been taken on board in different social or cultural groups, and little is known about the emergence of new or previously unrecognised risk factors.

So a team of researchers at the Universities of Bristol and Warwick studied all unexpected infant deaths from birth to two years in the southwest region of England from January 2003 to December 2006.

To investigate a possible link between SIDS and socioeconomic deprivation, they compared these deaths with a control group at 'high risk' for SIDS (young, socially deprived mothers who smoked) as well as a randomly selected control group.

Parents were interviewed shortly after the death and information was collected on alcohol and drug use. A detailed investigation of the scene and circumstances of death was also conducted by trained professionals.

Of the 80 SIDS deaths analysed, more than half (54%) occurred whilst co-sleeping compared to 20% co-sleeping rate amongst both control groups.

Much of this risk may be explained by the combination of parental alcohol or drug use prior to co-sleeping (31% compared with 3% random controls), and the high proportion of co-sleeping deaths on a sofa (17% compared with 1% random controls), say the authors.

A fifth of SIDS infants were found with a pillow for the last sleep and a quarter were swaddled, suggesting potentially new risk factors emerging.

The risk factors were similar whichever group the SIDS cases were compared with, suggesting that these risk factors for SIDS apply to all sections of the community and are not just a consequence of social deprivation.

Some of the risk reduction messages seem to be getting across and may have contributed to the continued fall in the SIDS rate, say the authors. However, the majority of the co-sleeping SIDS deaths occurred in a hazardous sleeping environment. The safest place for an infant to sleep is in a cot beside the parental bed in the first six months of life, they write.

Parents need to be advised to never put themselves in a situation where they might fall asleep with a young infant on a sofa. They also need to be reminded that they should never co-sleep with an infant in any environment if they have been drinking or taking drugs.

We have learnt that SIDS is largely preventable, says Edwin Mitchell, Professor of Child Health Research at the University of Auckland, in an accompanying editorial. It is important to monitor parents' knowledge and infant care practices to inform health education and promotion.

Implementing what we already know has the potential to eliminate SIDS, the challenge now is how to change behaviour, he concludes.

Source: British Medical Journal

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not rated yet Oct 13, 2009
Smoking itself during pregnancy can cause SIDS. Co-sleeping had to be made a crime in Victorian England because of the high rate of infant mortality. Mothers were smothering their unwanted babies, it was believed. I wonder if the researchers were aware of this.
not rated yet Oct 13, 2009
I believe it's in here:;sr=8-2
not rated yet Oct 13, 2009
Simply not true.

My wife sleeps with our son since he was born, they still sleep together (he is almost 3, and still breast feeds). It is unnatural and inhumane to place a baby in a different bed to sleep, when babies are so dependent of their mothers for food, warm and comfort.

As otto1923 noted above, most cases of deaths I believe are homicides, they just kill the babies and say "sorry".....
Oct 13, 2009
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5 / 5 (1) Oct 14, 2009
i did not sleep at all as a baby, that's why i am still alive.
not rated yet Oct 14, 2009
@otto there is evidence of smothering in infants just like in adults these according to the article were not the case. It is still rare for a mother to kill their children, actaully rare for any parent to kill their children - thats why when it happens you hear about all over the world.. it's that reminder of the failty of youth and betrayal of implied trust everyone gives their parents.
not rated yet Oct 14, 2009
El Nase
these according to the article were not the case
Sorry- I was implying that some Victorians may have been wrongly accused. Tobacco in England became prevalent about that time.

What is unnatural is babies having to sleep alongside parents and especially mothers who reek of tobacco or drugs. Babies know what moms are supposed to smell like and it's not that. The species begins to deteriorate outside it's natural environment (the tropical savannahs and rainforests it evolved in) and has not had time to adapt to all the odd stopgap behaviors and pathologies which result.
5 / 5 (1) Oct 14, 2009
Infanticide being one of those unfortunate stopgap measures, to compensate for overpopulation and deterioration, whether in Germanic or amerind tribes or on an overcrowded Anglican island 200 years ago. I suppose forensics today can discern between suffocation and cribdeath but accident vs intent is more difficult, especially when alcohol is involved. The authors seem to imply this.

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