Infant deaths spur co-sleeping warning

The chief medical examiner's office plans to send a letter to 3,500 pediatricians across Massachusetts within the next two weeks urging them to warn new parents against sleeping with their infants.

The action comes after 31 infants died in the state last year while sharing a bed with an adult or sibling.

``There are 31 kids who could have been alive today," the state's chief medical examiner, Mark A. Flomenbaum, said.

The American Academy of Pediatrics, the nation's largest organization of pediatricians, recommends that infants sleep in a crib for safety. Yet a simmering controversy continues regarding bed-sharing. Many medical professionals and researchers say the practice can be done safely and can even benefit infants. And despite warnings, many mothers still co-sleep with their infants for at least part of the night, citing emotional closeness, better sleep, and easier nightly breast-feeding among their reasons.

According to the 2003 National Infant Sleep Position Study led by the National Institutes of Health, at least 45 percent of infants spent at least some time in an adult bed over a two-week period. The number of parents sleeping with their infants more than doubled between 1993 and 2000, the study found.

Rachel Mosteller, a staff writer for bloggingbaby.com, frequently co-sleeps with her 4-month-old son and said he sleeps better when in bed with her.

``You know what the expert stance is, but they're not the ones here at 4 o'clock in the morning," she said. ``I read all the articles about things like co-sleeping and all they do is make me feel guilty."

Bed-sharing fatalities are often difficult to distinguish from those due to Sudden Infant Death Syndrome, the unexplained death of an infant that results from the stoppage of breathing.

Some research has suggested that bed-sharing may increase the incidence of SIDS, particularly in the presence of other risk factors -- such as putting the baby to sleep on his stomach or on soft bedding. However, bed-sharing has dangers of its own. Babies may be smothered by an adult or by tangled bedsheets.

Flomenbaum said babies should always sleep in a crib. ``When the kid is asleep, or especially when the parent is asleep, they should not be in the same bed," he said.

Six of the bed-sharing deaths last year were in Bristol County, representing 20 percent of all infant deaths in that county. That was up from two bed-sharing deaths, out of 22 infant fatalities, in 2004.

Today, the Bristol district attorney's office will announce a campaign to educate parents about the dangers of this practice and to provide free bassinets for parents who cannot afford a crib.

``These are the saddest things you could possibly imagine," said Bristol District Attorney Paul Walsh. ``The mother is in an extremity of anguish, and we have to go in and investigate. We almost have to treat them as suspects, because the child is dead."

The district attorney's office will collaborate with hospitals in Fall River, New Bedford, and Wareham to provide educational material to new parents.

``I highly support the Bristol County DA doing this," said pediatrician and former American Academy of Pediatrics president Maurice Keenan of Newton-Wellesley Hospital. Keenan, a member of the academy's Task Force on Infant Sleep Position and SIDS, helped develop the recommendation against co-sleeping.

University of Notre Dame professor James J. McKenna, whose research has identified benefits to co-sleeping, cautioned that anti-bedsharing campaigns could have hidden dangers. If parents are afraid to admit to pediatricians that they sleep with their infant, they may not receive information that would help them share a bed more safely, he said.