BANGOR, Maine — Public health officials in Maine, spurred by three infants who died while sleeping with their parents last week, raised the alarm Tuesday that bed sharing puts babies at increased risk of death from suffocation.
While numerous state and national medical organizations support that position, there is also a strong countermovement that contends that the more than 75 percent of nursing mothers who sleep with their babies at some point are doing nothing wrong.
According to a press release from the Maine Department of Public Safety, three infants died unexpectedly in a four-day period last week. On Oct. 4, a 2-month-old girl in Madison perished in her father’s bed after being placed there by her mother. The next day, a 2-month-old Canaan boy died while sleeping with his mother, and on Oct. 7 a 5-week-old Windsor boy was found unresponsive after sleeping through the night with his mother. He later died at MaineGeneral Medical Center in Augusta.
The State Medical Examiner’s Office has performed autopsies on the infants but will not determine causes of death until additional studies are performed.
“The infants may have suffocated,” reads the press release. “No foul play is suspected.”
Bed sharing between adults and infants is condemned by numerous groups, including the Maine Center for Disease Control, the American Academy of Pediatrics, the National Institutes of Health, the U.S. Department of Health and Human Services, and the U.S. Consumer Product Safety Commission, among others.
Dr. Stephen Meister, the medical director for the Maine Center for Disease Control’s family health division, said Tuesday that there are myriad reasons some babies go to sleep and never wake up. While many of those reasons are shrouded in mystery, Meister said, there are ways to reduce the risk, including putting babies to sleep in their own bed, crib or bassinet — even when parents are exhausted from the rigors of caring for an infant.
“If it’s safer, it’s worth it,” said Meister. “It’s really not that much more work.”
Dr. Jennifer Hayman, a pediatric hospitalist at Maine Medical Center in Portland, helped the State Medical Examiner’s Office conduct a study that found at least 30 cases of Maine babies dying while bed sharing between 2001 and 2006.
“All of them were found on autopsy to not have a specific cause of death,” said Hayman. “Less than 4 percent of the babies in that category had safe infant sleep conditions.”
Those conditions include babies sleeping on their backs on a firm surface in their own crib or bassinet, free of loose bedding, toys and stuffed animals.
Dr. Colette Sabbagh, an Eastern Maine Medical Center pediatrician who practices at Husson Pediatrics in Bangor, agreed.
“We ask our patients at every visit about the sleeping situation,” said Sabbagh. “We also inquire about toys, soft bedding, stuffed animals and even blankets that can impair the baby’s ability to breathe. These things should not be kept in the baby’s crib.”
Dr. James McKenna is a professor of anthropology at Notre Dame University and director of the school’s Mother-Baby Behavioral Sleep Laboratory. In 30 years of research on this topic, he has published more than 140 articles and a book called “Sleeping With Your Baby.” He agrees with many of the safety precautions listed above, but not with the notion that there is anything wrong with bed sharing between parents and their infant children, especially while mothers are breast-feeding.
“It’s a complicated issue,” McKenna said during a telephone interview Tuesday. “What you don’t hear ordinarily in cases like this are the specific circumstances in which these babies die.”
Contributing factors could include a mother who smokes cigarettes, the baby being placed on a pillow, other children in the bed or a parent “desensitized” because of drugs such as a sleeping agent, said McKenna.
“For the most part, these public announcements, however well-intentioned, can prove to be very disturbing misrepresentations,” he said. “It isn’t the practice [of bed sharing] that is inherently dangerous. It’s the conditions under which the practice takes place.”
McKenna said for many cultures, such as in Japan, bed sharing is practiced by nearly 100 percent of parents and Japan has one of the lowest sudden unexplained infant death syndrome rates in the world.
Jan Hunt, director of The Natural Child Project, a national parenting advocacy organization, agreed with McKenna.
“Unless the parent is a smoker, it’s almost always the case that bed sharing is not a related factor,” said Hunt. Children in smoking households are more susceptible to sudden unexplained infant death syndrome whether they sleep with a parent or not.
So what are parents to do? Dr. Hayman at Maine Medical Center said the best prevention is education.
“You need to have a strong relationship with your child’s doctor,” she said. “Find someone you trust. Ask questions.”
For tips on safe sleeping practices for infants, visit the National Institutes of Health’s Web site at: www.nichd.nih.gov/sids. For more information on Dr. McKenna’s research, visit the Notre Dame Mother-Baby Behavioral Sleep Laboratory’s Web site at: www.nd.edu/~jmckenn1/lab/.