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New Findings on Co-Sleeping and SIDS

This just out.  An international team of researchers have analyzed 11 studies on bed-sharing
and sudden infant death syndrome in an attempt to clarify what is known about the risks of
the family bed. The studies were selected from all studies published on the topic since 1970. 
The debate will continue since some studies indicate that bed sharing does not increase the
risk of SIDS for infants of non-smoking parents.  Currently some countries advise parents simply
not to bring their baby into their bed. Other counties, and Beginnings Parents Guide, advise
not to share their bed in certain circumstances.

These are the circumstances in which bed-sharing is a major risk for SIDS:

·      Parents who smoke: Among babies whose mothers smoke, an infant sharing the mother’s
bed is more than 6 times as likely to die of SIDS than if s/he sleeps separately.  In comparison,
an infant who sleeps with a non-smoking mother is no more likely to die of SIDS than if sleeping
alone.
 
A 2011 study not included in the meta-analysis found a further increased risk if both parents
smoke, and demonstrated that fathers’ smoking also is a risk.  When one parent smoked,
compared to none, the risk of SIDS with bed sharing increased two and half times, and slightly
more if the smoker was the father. When both parents smoked, the risk increased four and
half times.  
 
·      Baby under 3 months old.  Bed sharing with infants <12 weeks old was investigated by
three studies. Combined findings showed a greater than 10-fold increase in the risk of SIDS
when babies slept with another person. In contrast, for older infants, there was no significant
increase.
 
·      Only occasional bed sharing. For babies who shared a bed on the night they died, but
routinely slept separately, the special-occasion bed-sharing doubled the risk of SIDS.  This may
be partly explained by the infants’ illness that was the reason for bringing the baby into the
parents’ bed. Notably, for babies who routinely shared the bed, there was no significant
increase in risk.  Further, babies who are returned to their own bed during the night are not at
increased risk. This suggests that temporary bed-sharing to  breastfeed or comfort the baby
adds no risk of SIDS and may be beneficial.
 
·      Inappropriate surfaces Sharing a sofa, waterbed or other very soft surface creates excess
risk of SIDS. Further the US Consumer Product Safety Commission reports the majority of sleep-related
infant deaths are attributable to suffocation involving pillows, quilts, and extra bedding. So the
guidelines for safe crib bedding also apply to the family bed. 
 
·      Parents using alcohol and drugs   Less conclusive emerging evidence shows the risk of bed
sharing is increased when parents’ responsiveness is reduced by alcohol or drugs.
 
In light of the evidence, the 2012 fourth edition of the Beginnings Parents Guide will continue to
warn against bed sharing if either parent smokes or has consumed alcohol or drugs.  It will continue
to emphasize use of tight-fitting bedding and no pillows, loose blankets, or stuffed animals. It will
add a warning against parents sharing their bed with a baby under three months of age, whether
or not they smoke.
 
References
Vennemann MM, Hense HW, Bajanowski T, Blair PS, et al. (2012) Bed Sharing and the Risjk of Sudden Infant Death Syndrome: Can
We Resolve the Debate? Journal of Pediatrics 160: 44-48. Available online at www.jpeds.com
 
Liebrechts-Akkerman G, Lao O, Liu F, et al. (2011) Postnatal parental smoking: an important risk factor for SIDS. European Journal
of Pediatrics 170:1281-1291
 
Chowdry RT. (2010) Nursery Producut-related Injuries and Deaths Among Children Under Age Five. Washington, DC: US Consumer
Product Safety Commission
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