‘Co-sleeping’ infant deaths a persistent problem

Child and adolescent death rates from unintentional injuries dropped 29 percent from 2000 to 2009, the CDC reports.

But child death rates from suffocation are on the rise, according to the same report. There was a 54 percent increase in reported suffocation among infants less than 1 year old.

The study, released Monday, didn’t break down the circumstances of suffocation, but many of those infant deaths are almost certainly the result of ‘‘co-sleeping,’’ in which parents and infants sleep in the same bed.

Co-sleeping is a problem in Georgia, state officials tell GHN.

In 2009, 141 of 199 deaths among Georgia infants less than 1 year old were sleep-related, according to a statewide review of fatalities among children, Marcie McClellan’s GHN article reported last year.

Tonya Boga, the director of the state Office of the Child Advocate, said Tuesday that of the 896 reviewed Georgia sleep-related infant deaths from 2006 through 2010, 43 percent involved co-sleeping. The co-sleeping deaths increased over that time frame, she said.

The Georgia Division of Children and Family Services reported recently that among deaths of children from Dec. 1 through Feb. 12 who had some DFCS contact over a five-year period, six of the 35 were from co-sleeping.

“There’s not a week gone by at DFCS that there hasn’t been a death of some child related to sleeping,’’ said Ron Scroggy, acting state director for DFCS. Besides co-sleeping, children have suffocated from being caught in crevices of couches and chairs, and being caught under pillows, he said.
The Georgia Department of Public Health said it has joined other state agencies, including Human Services, in a campaign to increase public awareness of safe sleeping practices.

Katie Jo Ballard, executive director of the Governor’s Office for Children and Families, said she believes the official increase in these sleep-related deaths reflects more accurate reporting of a longstanding problem.

The American Academy of Pediatrics (AAP) advises against co-sleeping, which can put an infant at risk of suffocation and strangulation. It recommends that babies sleep in the same bedroom as their parents, but in a separate crib or bassinet, for the first few months of life.

Other AAP recommendations include that infants sleep on their backs, with no loose bedding or soft toys.

Georgia is one of seven states in a pilot project collecting data on sudden, unexpected infant deaths. The goal is to produce better information on those deaths that require an investigation, said CDC health scientist Lena Camperlengo.

Experts agree that a crib is the safest place for an infant to sleep, not every family can afford one. In that case, the AAP recommends substituting a dresser drawer that has been removed from the dresser.

The Office of the Child Advocate is distributing brochures on safe sleeping and encouraging participation in crib distribution programs.

Since 1998, infant deaths that once would have been called SIDS — sudden infant death syndrome — have increasingly been attributed to unsafe sleeping conditions.

SIDS still exists as a diagnosis. When there is no clear evidence of a definable cause of death — such as unsafe sleeping conditions, negligence, foul play or a medical problem — the death is ruled SIDS.

Dante McKay of the advocacy group Voices for Georgia’s Children said, “We are studying the extent of the [co-sleeping] problem in Georgia to see how and where we can make the most impact in reversing the trend.”

Some parents still advocate co-sleeping. They say sharing a bed with their infant allows for bonding and convenient feedings.

Doctors say this is understandable but shouldn’t be taken too far.

Dr. Michael Goodstein of York, Pa., a neonatologist at York Hospital and director of York County Cribs, told GHN last year that “mothers can cuddle and nurse their babies in the adult bed.”

“But they need to be aware that when the parent is getting drowsy, it’s time for the baby to be put back in a proximate but separate safe-sleep environment.’’

Some parents choose to co-sleep because of tradition or family pressure.

But Goodstein emphasized, “Infant sleep safety requires a consistent and repetitive message in the community to prevent accidental deaths.”

“I’ve never seen a baby come back to my emergency department who has died because their bath wasn’t perfect and they had some dirt behind their ears,” Goodstein said. “But I’ve seen lots of babies come back dead because parents didn’t know how to ‘sleep’ their babies safely.”