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Bed sharing link to cot death

Tuesday May 21st, 2013

Parents of babies were being urged today not to share beds with their babies.

A new study has linked bed-sharing to a five times increased risk of cot death.

The increased risk of sudden infant death syndrome (SIDS) to breastfed babies under three months old remains the same, regardless of whether or not the parents are non-smokers and the mother does not use illegal drugs and has not drunk alcohol.

Writing online in BMJ Open, Professor Bob Carpenter, of the London School of Hygiene and Tropical Medicine, UK, and colleagues estimate that about 88% of all SIDS cases that happened while the parents and babies bed shared would not have happened if the babies had slept alone.

Professor Carpenter said today: "If parents were made aware of the risks of sleeping with their baby, and room sharing was instead promoted in the same way that the 'Back to Sleep' campaign was promoted 20 years ago to advise parents to place their newborn infants to sleep on their backs, we could achieve a substantial reduction in cot death rates in the UK.

"Annually there are around 300 cot death cases in babies under a year old in the UK, and this advice could save the lives of up to 40% of those. Health professionals need to make a definite stand against all bed sharing, especially for babies under three months."

The researchers say: “The current messages saying that bed sharing is dangerous only if you or your partner are smokers, have been drinking alcohol or taking drugs that make you drowsy, are very tired or the baby is premature or of low-birth weight, are not effective."

Midwives today said there might be circumstances when parents had a baby in bed with them - but they should ensure they do not fall asleep.

Janine Stockdale, of the UK Royal College of Midwives, said the safest place for a baby was in a cot in the parents' room.

She said: "The RCM is not against parents taking their child into bed with them, for example, for breastfeeding and to comfort the child. However, even when doing this parents need to be organised and very sensitive to how tired they are when they do this, for example it is easy to fall asleep when breastfeeding especially in the middle of the night."

Combining individual data from five published data sets from the UK, Europe and Australasia, this is the largest individual level study of SIDS, including data on 1,472 SIDS cases and 4,679 controls.

The results showed that even when neither parent smoked and the mother did not drink alcohol or take drugs, breastfed babies under three months old had a five times higher risk of SIDS than babies who had slept in a cot next to their parents’ bed.

The risk of SIDS decreased as baby grew older, but if either parent was a smoker or the mother had drunk more than two units of alcohol in the previous 24 hours or had used illegal drugs at any time since the child was born, the risk was greatly increased.

Prof Carpenter’s study found that of the 22.2% of babies who had died from SIDS, both parents had been sleeping with their child at the time of death, while 9.6% of the parents in the control group had awoken the morning of the interview in the same bed as their child.

Over the past 10 years, there has been an increase in bed sharing and the authors believe about half of SIDS cases occur while bed sharing – more than double the figure found in the study.

“88% of the deaths that occurred while bed sharing would probably not have occurred had the baby been placed on its back in a cot by the parents’ bed,” write the authors.

Even in very low-risk breastfed babies, where there were no risk factors for SIDS other than that they had slept in their parents’ bed, 81% of SIDS deaths in infants under three months of age could have been prevented by not bed sharing, they add.

SIDS is still one of the major causes of death among babies from 28 days to their first birthday in developed countries.

Carpenter C, McGarvey C et al. Bed sharing when parents do not smoke: is there a risk of SIDS? An individual level analysis of five major case–control studies. BMJ Open Online First. doi:10.1136/bmjopen-2012-002299

Tags: Childbirth and Pregnancy | Drug & Alcohol Abuse | UK News | Women’s Health & Gynaecology

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