Sudden infant death risk greater when parents share bed with babies
The controversy over whether parents should share a bed with newborns has been reignited by research showing that babies who do are five times more likely to die suddenly than those who sleep in a cot.
Ministers have asked health advisers to urgently reappraise official guidance on co-sleeping and cot death to see if it needs to be updated to recommend that parents never let their child sleep beside them, as is already the case in the Netherlands and the US, which advise against bed-sharing until a child is at least three months old.
The professional body representing doctors specialising in children’s health supported a change that would extend NHS advice not to co-sleep from mothers or fathers who smoke, drink or take illegal drugs to all parents. But other experts, including the National Childbirth Trust, cautioned against any switch and warned that a blanket policy against co-sleeping could end up increasing the risk of sudden infant death syndrome (Sids) by parents falling asleep while caring for a baby on a sofa or chair, which is riskier than a bed.
The study, reported in the medical journal BMJ Open, found that parents who slept with their children ran a five-fold extra risk of their baby suffering a cot death than those left in their cots, even if they did not smoke, which is the main risk factor for such deaths.
The findings, of research led by Professor Bob Carpenter of the London School of Hygiene and Tropical Medicine, are significant because they relate to babies aged under three months whose parents are thought to be at low-risk of their newborn dying because they do not smoke, and the mother has not been drinking alcohol and does not take illicit substances.
About half of parents sleep with their baby sometimes or regularly, either deliberately or because they have unintentionally fallen asleep beside them, other research shows. Cot death used to cause about 2,000 deaths a year but changes in behaviour, especially parents putting their child to sleep on their back, have seen fatalities fall to 287 across the UK in 2010. About half those deaths occur in cases when the parents and baby are sharing a bed, Carpenter said.
His team looked at the results of five previous Sids studies, which involved 1,472 cases of cot death and 4,679 normal babies. They conclude that 81% of cot deaths among babies under three months, and whose parents do not exhibit the normal risk factors, could be avoided if parents always ensured their child slept separately. Doing so could prevent about 130 of the UK’s annual toll of sudden infant deaths, Carpenter added.
“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 because many of the bed sharing deaths involve these factors”, the paper says. Doctors, nurses, midwives and health visitors should “take a more definite stand against bed sharing, especially for babies under three months”. If parents heeded their call then a substantial further fall in deaths could be achieved, the authors add.
Bringing a baby into bed temporarily to feed or comfort it is acceptable, but only if it is put back into its cot immediately afterwards, said Carpenter.
The Department of Health has asked the National Institute for Health and Care Excellence to urgently examine its guidance. “The death of any baby is a tragedy,” it said. “Putting babies to bed in a safe way reduces the chances of them getting hurt. We know that for the first six months of life, the safest place for a baby to sleep is in a cot, lying on his or her back, in the parents’ room.”
Nice also advises parents never to sleep on a sofa or armchair with their baby to reduce the risk of suffocation. “Sleeping alongside a baby increases the risks to the child – including death. We currently recommend that doctors, midwives and nurses should warn parents of the risks of sleeping alongside a baby in a bed”, said a spokesman.
Dr Simon Newell, a vice-president of the Royal College of Paediatrics and Child Health, said most babies who sleep with parents will come to no harm. But, he added: “If a simple measure could significantly reduce the risk of death, then we should follow in the paths of the US and Netherlands and recommend parents do not to share a bed with their baby if he/she is under three months old.”
But the NCT, the childbirth and parenting charity, disagreed. “It could lead to an increased likelihood that a parent or carer inadvertently falls asleep while holding the baby, in a chair or on a sofa, which is much less safe for the infant,”, said Rosemary Dodds, its senior policy adviser.
Sids deaths in the UK occur mainly in more disadvantaged families and in places where smoking, drinking or drug-taking occurs, she added.
Unicef UK said Carpenter’s advice was unhelpful to parents who bring their baby into bed for cultural reasons., and endorsed the NCT’s warning about parents feeling forced to adopt riskier practices, such as using sofas and armchairs.
Anita Tiessen, its deputy director, also cast doubt on the evidence and methodology behind the new study and argued that better evidence was already available.
[An infant baby via Shutterstock]