Thursday, 23 September 2010

Infant sleep safety

By Ellie Bogue
An upcoming infant-sleep symposium will explore views on co-sleeping – parents sleeping with infants – that local officials find alarming.

Birth Matters, a local educational service for expectant families, is organizing the Oct. 2 symposium to give parents information to make safe choices about where their infants sleep. The group acknowledges that not all experts agree on the safest practices for sleeping infants, so Birth Matters is bringing in three guest speakers to address some of these issues. What surprised Hallie Greider and her sister Jordan Saalfrank, founders of Birth Matters, was the lack of support from the local medical community in being a part of the symposium.“Why wouldn't you at least want to educate yourself on this?” Greider said. The idea of having the symposium came to Greider after seeing a public-service commercial that showed a mother and infant sleeping on a couch with fatal results for the child. They felt a responsibility to inform the public on what they believe is safe protocol if a parent chooses to sleep with an infant. According to Greider, sleeping on a couch with an infant is something they would never condone as a safe sleep practice.In 2009 the Allen County Coroner's Office investigated nine infant deaths that involved shared sleeping space. Greider says, judging from the few details released to her from the coroner's office, that none of the circumstances surrounding the deaths were something they would ever recommend as safe co-sleeping practices. But Deputy Coroner Patt Kite maintains co-sleeping isn't safe, no matter how you practice it.“No one in Allen County or Fort Wayne involved in the Coroner's Office, Department of Health or Child Fatality Review Board would ever promote co-sleeping, based on what we have seen while investigating these cases and because of the medical research we have seen on this topic,” Kite said.In 2009, 11 infants died in Allen County, Kite said. Of those 11, nine had documented histories of co-sleeping. Of those nine, three had a cause of death ruled as positional asphyxia. One was ruled positional asphyxia and hyperthermia. Of those four positional asphyxia cases, one infant became wedged between the wall and bed in which she was sleeping with a relative; the other three were not in a bed. One was on a sofa next to his mother where they were sleeping together, another got her head wedged between the back cushions and the sofa while the girl's father had been sleeping on another sofa in the room, and the last child died while sleeping in a reclining chair with his 10-year-old sister.“There is no benefit so important from co-sleeping that it outweighs the risk of killing your child,” said Allen County Prosecutor Karen Richards, adding, “I have been to enough scenes with dead infants, I don't ever want to go to another one again.”Connie Kerrigan, manager of Community Nursing for Parkview, agrees.Kerrigan, who serves on the Child Fatality Review Board, said there is at least one co-sleeping-related death a week in Indiana. She said with the small size of the nose and mouth of an infant, it doesn't take much to block them. She has also seen studies that suggest when a very young baby breathes in carbon dioxide, it can cause the baby to stop breathing.None of these sleep situations would be considered good practice by Birth Matters or by James McKenna, an anthropology professor who specialized in infant sleep. McKenna, one of the speakers at the safe sleep symposium, runs a sleep-study laboratory at Notre Dame to examine the interaction between mother and child during co-sleeping on a shared surface.In a 1995 article published in Horizons magazine, McKenna wrote, “Is it safe to sleep with your baby? Under most circumstances, co-sleeping is likely to be very safe and beneficial; but it depends on how it is done. If the parent(s) smoke or take drugs, co-sleeping is risky. Sleeping with an infant on a waterbed, couch, soft bed, or any bed that has gaps or ledges, into which the infant can fall, can be risky for the infant. It is more ideal to sleep on a firm mattress and to limit the use of pillows and blankets.”In McKenna's 2007 book “Sleeping with Your Baby: A parent's Guide to Cosleeping,” McKenna describes ideal bed-sharing as “when neither parent smokes, are sober, have chosen to bed share and are breastfeeding their baby.” He also suggests, “the mattress should be placed without a frame in the center of the room away from walls and furniture. No older children, no pets or stuffed animals should be allowed in the bed.”First Candle describes itself as a “national nonprofit health organization uniting parents, caregivers and researchers nationwide with government, business and community service groups to advance infant health and survival.” It suggests having the crib in the parents' bedroom and bringing the baby into the parents' bed only to breast-feed or bond, but the baby should be put back in “his or her own separate, safe sleep space” when it's time for the baby to fall asleep.Worldwide organizations such as UNICEF have guidelines for co-sleeping. Like McKenna, they stress a firm, flat mattress, no waterbeds, beanbags or sagging mattresses. They even suggest a safe sleeping position for mother and child. Still other organizations, like a study cited by the American Academy of Pediatrics, suggest bed-sharing infants can be at higher risk for Sudden Infant Death Syndrome if the baby is under 11 weeks old.“We are not advocating this is for everyone,” Greider said.Besides McKenna, area physicians Dr. Robert White, a neonatologist, and Dr. Christopher Tallo, a pediatrician, will speak at the symposium. Greider said she hopes people will be open to hearing what their guest speakers have to say so parents can gather as much information as possible, including safe ways for your child to sleep in a crib. That way parents can make a choice having heard all their options, she said.

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