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RE: additional question on co-sleeping
Lisa,
Have attached an e-mail from the National Child Fatality Review list serv containing an article on this subject... Hope this helps...
Kirsten Nash
Program Coordinator
Center for Child Protection
Austin, Texas
www.centerforchildprotection.org
-----Original Message-----
From: owner-CHILD-MALTREATMENT-RESEARCH-L@cornell.edu
[mailto:owner-CHILD-MALTREATMENT-RESEARCH-L@cornell.edu]On Behalf Of
lfontes@rcn.com
Sent: Wednesday, September 01, 2004 9:23 PM
To: Child Maltreatment Researchers
Subject: additional question on co-sleeping
Is anyone aware of literature on co-sleeping of siblings?
thanks again.
Lisa Fontes, Ph.D.
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Subject: RE: Unsafe sleeping
Date: Tue, 3 Aug 2004 13:10:04 -0500
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Thread-Topic: Unsafe sleeping
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From: "Kristi Howerton" <klh650@eastern.dss.state.va.us>
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Bed Sharing with Siblings, Soft Bedding, Increase SIDS Risk
Infants who share a bed with other children are at a higher risk of
sudden infant death syndrome (SIDS) than are other infants, according to
the most recent analysis of a study of predominantly African American
SIDS deaths in Chicago.
The analysis, appearing in the May, 2003 Pediatrics, also found that two
known risk factors for SIDS-sleeping on soft bedding and sleeping on the
stomach-pose a far greater risk of SIDS when they occur together than
the sum of both risk factors added together would indicate. This
analysis confirms several international studies reporting that SIDS risk
was lower among infants put to bed with a pacifier and reinforced
earlier findings that sleeping on a sofa also increases infants' risk of
SIDS.
The study was supported by the National Institute of Child Health and
Human Development (NICHD) and the National Institute on Deafness and
other Communication Disorders (NIDCD), both at the National Institutes
of Health (NIH), as well as the Centers for Disease Control and
Prevention (CDC). NIH and CDC are agencies of the U.S. Department of
Health and Human Services.
The researchers studied all infants from the ages of birth to one year
who had died of SIDS in Chicago, Illinois, between November 1993 and
April 1996. There were 260 SIDS deaths during that time.
"This study provides important new information regarding SIDS risk
factors," said Duane Alexander, M.D., Director of the NICHD. "The next
step is to get this information to the parents and families who can use
it to reduce the risk of SIDS among their own infants."
"The SIDS rate for African-American babies is more than twice that for
white infants," said CDC Director Dr. Julie Gerberding. "Families need
counseling on ways to reduce the risk of SIDS. For example, they need to
know they should avoid putting an infant to sleep with other children."
The research is part of the Chicago Infant Mortality Study, designed to
identify risk factors for SIDS that place African American infants at
roughly double the SIDS risk of Caucasians. Earlier findings of the
study appear at <http://www.nichd.nih.gov/new/releases/infant_sids.cfm>
http://www.nichd.nih.gov/new/releases/infant_sids.cfm. The Chicago
Infant Mortality Study was directed by Fern R. Hauck, M.D. M.S.,
currently of the University of Virginia Health System.
"Our study found a dramatic increase in SIDS risk for prone sleeping on
soft surfaces, highlighting the need to eliminate these unsafe sleep
practices," said Dr. Hauck. "Additionally, infants should never be
placed to sleep on a couch with anyone or in a bed with other children."
The researchers compared information about each SIDS case to information
about a control infant--a living infant of comparable age, who was from
the same racial and or ethnic group, and who had a similar birth weight.
All of the SIDS deaths were evaluated by the Cook County Medical
Examiner's Office; autopsies had been conducted to rule out other causes
of death. Death scene investigators conducted interviews about
circumstances surrounding the deaths. The researchers used the NICHD
definition of SIDS: "the sudden death of an infant under one year of
age, which remains unexplained after a thorough case investigation,
including performance of a complete autopsy, examination of the death
scene, and review of the clinical history."
Infants who died of SIDS were 5.4 times more likely to have shared a bed
with other children than were the control infants. Sleeping with the
mother alone or mother and father was associated with an increased risk
of SIDS, but this finding was not statistically significant. The study
concluded "the risk was primarily associated with bed sharing when the
infant was sleeping with people other than the parents." The researchers
also reported that sleeping with the mother alone did not reduce
infants' risk of SIDS, as some researchers have concluded on the basis
of earlier studies.
The researchers noted that sleeping on the stomach, and sleeping on soft
bedding-both known to increase the risk of SIDS independently-posed a
much greater risk for SIDS when occurring together than might be
expected. For example, soft bedding appeared to pose 5 times the risk of
SIDS as firm bedding; sleeping on the stomach increased the risk of SIDS
2.4 times. Yet infants who slept stomach down on soft bedding had 21
times the risk of SIDS as infants who slept on the back on firm bedding.
Of the SIDS cases, 15 were found to have slept on a sofa the last time
they were placed to sleep. The researchers do not know why sleeping on a
sofa would increase the risk of SIDS more than would sleeping on a bed,
yet warn that the practice appears to be highly dangerous.
The study authors concluded that physicians should counsel new parents
not only about the benefits of placing infants to sleep on their backs,
but also about the risk their study had uncovered.
"Parents are influenced strongly by their physicians in choosing the
sleep position for their infants," they wrote. "Other infant care
practices, such as bed sharing and use of soft bedding, may also be
influenced by medical providers, particularly if reinforced by the
media."
To reduce the racial disparity in SIDS rates, the authors advised taking
families' economic circumstances into consideration. For example, some
parents may not be able to afford firmer mattresses or to have enough
beds for all their family members. The authors called for research on
how best to meet these needs.
"On the basis of the findings of this study, they [parents] should
receive instruction that emphasizes supine sleeping, firm bedding, not
using pillows, and not sharing a bed with other children or sleeping
with another person on a sofa, while being sensitive to parental
concerns and cultural traditions."
The current study is part of a body of research sponsored by the NICHD
on infant sleep practices and the causes of SIDS. This large body of
research, together with compelling scientific evidence from around the
world, confirmed the safety and effectiveness of placing infants to
sleep on their backs. Based on this evidence, the NICHD formed a
coalition of national organizations to launch a national public
awareness campaign called Back to Sleep in 1994. (See chart at
<http://www.nichd.nih.gov/sids/sidsrates.pdf>
http://www.nichd.nih.gov/sids/sidsrates.pdf.) Since the start of the
NICHD-led campaign in 1994, the SIDS rates for African American infants
and white infants have declined by about 50 percent, but a significant
disparity still remains. To help eliminate this disparity, the NICHD
joined with the non-profit National Black Child Development Institute in
a program to reduce SIDS among African American infants in Chicago and
around the country. The NICHD has also partnered with three African
American women's groups to conduct a series of "Summits" on SIDS risk
reduction training and outreach activities in communities around the
country. The first Summit, held jointly with the National Coalition of
100 Black Women took place in Tuskegee, Alabama,
<http://www.nichd.nih.gov/new/releases/sids_risk.cfm>
http://www.nichd.nih.gov/new/releases/sids_risk.cfm. The second Summit,
held with the Women of the NAACP, took place in Los Angeles,
<http://www.nichd.nih.gov/new/releases/reduce_sids.cfm>
http://www.nichd.nih.gov/new/releases/reduce_sids.cfm. The next summit
will be held May 30-31 in Detroit in partnership with the Alpha Kappa
Alpha Sorority, Inc.
###
The NICHD is part of the National Institutes of Health, the biomedical
research arm of the Department of Health and Human Services. The
Institute sponsors research on development, before and after birth;
maternal, child, and family health; reproductive biology and population
issues; and medical rehabilitation. NICHD publications, as well as
information about the Institute, are available from the NICHD Web site,
<http://www.nichd.nih.gov/> http://www.nichd.nih.gov, or from the NICHD
Information Resource Center, 1-800-370-2943; e-mail
<mailto:NICHDInformationResourceCenter@mail.nih.gov>
NICHDInformationResourceCenter@mail.nih.gov.
CDC protects people's health and safety by preventing and controlling
diseases and injuries; enhances health decisions by providing credible
information on critical health issues; and promotes healthy living
through strong partnerships with local, national and international
organizations.
-----Original Message-----
From: owner-NCFR-L@cornell.edu [mailto:owner-NCFR-L@cornell.edu] On
Behalf Of Megan Weis
Sent: Tuesday, August 03, 2004 1:15 PM
To: NCFR-L@cornell.edu
Subject: Unsafe sleeping
Hello. I work with South Carolina's Child Fatality Advisory Committee.
We have seen a number of deaths that circumstances involved unsafe
sleeping arrangements of infants 6 months and younger (i.e. sleeping
with family members, pillows, soft mattresses, on the sofa as well as
face down.) We are exploring the possibility of working with partners
to initiate a public awareness and parental/caretaker education campaign
that moves beyond "face up to wake up" type prevention. I would
appreciate any direction, resources and/or advice you may share as we
develop our plan.
Thank you for your help,
Megan A. Weis, MPH
SC Violent Death and Child Fatality Coordinator
Div. of Injury and Violence Prevention
1751 Calhoun St.
Columbia, SC 29201
phone: 803-898-0441/fax:803-253-4001
email: weisma@dhec.sc.gov