Bed sharing: A silent killer? Debate amps up over infants in parents’ bed

Like all mothers, Jessica Gordon wanted to do everything right for her baby. She read magazines and books and talked to other mothers about the best way to keep her firstborn son, Payton, safe.

But on Sept. 13, 2011, she awoke to every mother’s worst nightmare—Payton, then 10 weeks old, motionless in her bed.

Gordon says she got up that night to nurse him but fell asleep as he ate. About three hours later, she awoke to find his face pressed against her stomach.

“I realized Payton should have woken up, too,” she says. “His lips were blue.”

Gordon panicked, calling 911. Her neighbor, a state trooper, began performing CPR, and emergency responders rushed Payton to a nearby hospital.

It was too late.

Even before she learned from medical staff that all hope was lost, Gordon says she knew in her heart that Payton was gone.

“I completely lost it,” she says tearfully, recounting the worst day of her life. “I started screaming, ‘It’s all my fault! It’s all my fault! I fell asleep! I did this! I did this!’”

Preventing accidental suffocation

Payton’s death is one of about 200 each year in Illinois classified as sudden infant death syndrome—the unexpected death of a child under 1 where the cause cannot be determined.

Roughly three to four dozen of those are due to accidental suffocation, many involving an adult sleeping with an infant, according to the nonprofit Sudden Infant Death Services of Illinois.

The Illinois Department of Child and Family Services says accidental suffocation as a result of bed sharing or co-sleeping with an infant is the leading cause of child death in the state.

Rollover suffocation is such a problem that DCFS has launched a public awareness campaign, declaring October Safe Sleep Awareness Month for children under 1.

Central to the campaign is the message that babies should not sleep in a bed, couch or chair with anyone, including other children.

The public awareness campaign—The ABCs of Safe Sleep—also advises that parents:

Place the baby on his or her back during sleep.

Keep cribs free of toys, pillows, blankets, stuffed animals, quilts, crib bumpers and sleep positioners.

Not smoke before or after the baby is born or let others smoke around the baby.

Try using a pacifier when putting the baby to sleep. Don’t force a pacifier, though, and if the baby is breastfeeding, wait until he or she is a month old or is used to breastfeeding.

Provide supervised “tummy time” during waking hours to help build strong neck and shoulder muscles, and limit time spent in car seats, carriers and bouncers.

Safe sleep not one-size-fits-all

Although the state says SIDS rollover deaths can be drastically reduced by separating adults and babies during sleep, some argue that parents can sleep safely with their newborns if done the right way.

Diana West, a spokeswoman for La Leche League International and co-author of the recently released book, Sweet Sleep: Nighttime and Naptime Strategies for the Breastfeeding Family, argues that the one-size-fits-all message of never sharing a bed runs counter to a mother’s biology.

She says mothers are inclined to fall asleep while nursing because of hormones released in their bodies during the breastfeeding process. Warning them against bed sharing can prompt mothers to breastfeed in much more unsafe places such as a chair or sofa, she says.

West also notes that research shows that sharing a bed and breastfeeding can synchronize sleep-wake cycles between mother and baby and reduce stress for both.

In Sweet Sleep, West and company recommend what they have dubbed the Safe Sleep Seven, a checklist of behaviors to be avoided that will reduce the risk of SIDS and accidental suffocation.

The checklist states that if the mother is a non-smoker, sober and breastfeeding, and her baby is healthy, on his or her back, lightly dressed, unswaddled and they share a safe, flat surface, then the baby’s risk of SIDS is no greater than in a crib.

West notes that about a third to a quarter of all mothers will share a bed with their baby at some point.

Wendy Middlemiss, co-chair of Attachment Parenting International Research Group and associate professor of educational psychology at the University of North Texas, says the important thing for mothers to know is they take care to ensure their baby has a strong arousal response and that their airway is clear.

That arousal response to awaken them if their breathing becomes obstructed can mean the difference between life and death, she says.

She says public awareness campaigns that “focus so narrowly” on bed sharing miss an opportunity for what to watch for and what is essential for a baby’s safety.

“When we don’t talk about that, we haven’t provided any of the important information that (parents) need; that generates much more risk,” Middlemiss says.

Agreeing to disagree

Although experts agree that at least six of the Safe Sleep Seven recommendations are crucial to providing infants with a safe sleep environment, the state maintains its position that bed sharing is always risky.

Paula Jaudes, professor of pediatrics at the University of Chicago and medical director for DCFS, says rollover suffocations are thought of as accidents, but they are preventable if families understand the basics.

“We want to save children; it’s that easy,” she says.

Keeping children in a crib in the parents’ room can be a good compromise to having them in the bed, she says. And Jaudes, like every other expert, says it is never safe to sleep with a child on a sofa or in a chair because they can easily get wedged between the parent and a cushion.

Gordon, who now serves as a board member of SIDS of Illinois, says if it happened to her, it can happen to anyone.

She says she now tells mothers who do late-night breastfeedings to “do what it takes to stay awake. Turn on the television, set an alarm on your cellphone or wake up another member of the family to make sure you stay awake while breastfeeding,” she says.

Gordon says disagreeing with her “doesn’t make you a bad parent,” but she hopes her story convinces families that bed sharing is unsafe.

“Even if you do everything right and make the mistake that I did, you can still lose your child,” she says.

Timothy Inklebarger is an award-winning veteran reporter and staff member at Chicago Parent’s sister newspaper, The Wednesday Journal.

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