"Babies sleep safest alone."
If you're in New York state, you've probably seen or heard the TV or radio ads put out by the Office of Children and Family Services declaring this. If you're elsewhere, chances aren't bad that your county has launched a similar effort, trying to warn everyone not to sleep next to their babies no matter what.
They're well intentioned, trying to prevent tragic deaths of infants. But by applying a scientific double standard and by refusing to differentiate between safe and dangerous ways to cosleep these public health campaigns are promoting distortions of the more complicated truth that may have the side effect of increasing SIDS and accident deaths, both still much more common causes of death.
As I write in today's Metroland article "Babies Sleep Safest Where?," here are two of the central problems with saying "babies sleep safest alone":
(1) Babies who actually sleep alone, as in without an adult sleeping in the same room, have twice the risk of SIDS, according to the 2006 Sudden Unexpected Deaths in Infancy study. Even the American Academy of Pediatrics specifically recommends against putting infants to sleep in their own room. (If asked, OCFS isn't against room sharing, but they don't mention that not doing it is dangerous, and it doesn't bother them that their campaign slogan could easily be misconstrued as being against it.)
(2) The "Babies Sleep Safest Alone" campaign, and most of the other groups fighting bedsharing, are relying on numbers that don't sort out drunk babysitters who smoke next to infants face down on couches from breastfeeding mothers on a bed that has been carefully set up to remove safety hazards (or, of course, any of the shades of gray in between). They also don't have accurate numbers for how many people bedshare, meaning they can't translate numbers of deaths into meaningful, comparable death rates. And yet, they insist that sleeping next to an adult is always more dangerous than sleeping a crib, which is as silly as blaming crib sleeping per se for the deaths of infants who strangle on badly made cribs or suffocate on unsafe crib bedding. In fact, a case can be made that if done following all safety precautions, bedsharing actually has a protective function against SIDS, by regulating immature infant respiratory response. (In countries with low smoking rates and high breastfeeding and cosleeping rates, SIDS is nearly nonexistant.)
In the end, there are so many factors to weigh and so many different
kinds of risks and benefits to balance that only parents can make the
call. They should be helped with information about what makes infant
sleep safe or not safe—in all locations—without being bullied into what what mother called "an uninformed choice." To be fair,
campaigns like New York's do list some of these risk factors in their
print materials, but on TV and radio and in headlines, they only say
you shouldn't sleep next to your baby at all.
There are definitely times and contexts (a fair number of them even) when bedsharing isn't safe and a cosleeper crib or crib near the bed makes more sense. But there are also huge number of benefits to safe bedsharing, including increased breastfeeding success rates (which itself saves infant lives), so there are real losses to jumping to these extreme and inaccurate soundbites.
Unfortunately, the debate is getting so polarized and oversimplified that some child protective
workers are being instructed to charge parents with neglect for
cosleeping, period—while not being taught anything else about sleep risks, including SIDS. Way to drive bedsharing families underground and away from safety information they could use.
To come down off my high horse for a moment: I understand the passion here. The prospect of smothering your baby with your body* is more distressing to think about than the knowledge that babies sometimes die quietly and mysteriously in the other room. It's like how it's scarier to contemplate being the victim of violence than to think about car crashes, even though car crashes are the much greater risk. But the thing is, basing safety behaviors and public health campaigns on what's more emotionally wrenching to contemplate doesn't actually save more lives. You need to actually look at all the facts for that.
(Image from Babies Sleep Safest Alone video PSA.)
For more on the evolutionary history of human sleeping arrangements, and the social history of our belief that babies should sleep alone, check out the work of Dr. James McKenna.
*Which is itself overstated; most deaths in adult beds are from entrapment in the frame or by the wall, not by rollovers.
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