Bed-sharing deaths of infants persist despite safety warnings

Kakuna Smith, 34, holds a photo of her 11-week-old daughter, Kamilah Gilmore, who died in 2005 while they shared a bed in Dolton, Ill. Ms. Smith still keeps boxes of Kamilah's stuffed animals and toys. CHICAGO TRIBUNE Enlarge

CHICAGO — James Robinson will tell you the hardest part of his son’s death was having to face his fiancee.

The Chicago man blames himself for bringing 7-week-old D’Angelo into bed with him that fateful night. But after spending the day at the hospital with their older son, who had been diagnosed with cancer that day, Robinson feared that if his newborn cried, he’d be too exhausted to hear. So he put his arm around him, as if to form a shield, and the two drifted off to sleep.

When he awoke, the first thing he saw were his son’s bluish lips.

At its worst, the controversial practice of bed-sharing —typically defined as when infants sleep in the same bed as their parents — has stolen babies from their families, usually when a well-intentioned parent rolls over on the baby and suffocates him or her.

At its best, advocates say the practice can strengthen bonds between parent and child, facilitate breast-feeding, and cure sleepless nights.

As the number of parents who choose to bed-share appears to be on the rise, the debate over its safety continues to heat up.

In Illinois between 2008 and 2010, bed-sharing was the culprit in at least 190 infant deaths, according to state data.

In Lake County, Ill., a recent spate of infant bed-sharing deaths — eight between March, 2010, and June, 2011 — caught the attention of Coroner Artis Yancey, who has since sought to educate parents on the issue. He now distributes material on safe sleeping practices and keeps a crib in his office for parents who need one. So far, he said he’s given away three.

"It’s a tragic thing," he said. "It should be the happiest time of [parents’] lives, and it turns out to be the worst time of their lives."

Public health officials, researchers, and distraught parents are also stepping up efforts to spread the word on safe-sleeping practices for infants. Illinois legislators passed two laws aimed at curbing sleep-related infant deaths. One, which went into effect this month. requires additional training for day care providers. The other, implemented last year, mandates that hospitals provide new parents with safe sleeping information.

In an article published last week, a Centers for Disease Control and Prevention senior scientist called for better reporting of Sudden Unexpected Infant Death, including whether an infant died while bed-sharing.

"These deaths seem to be increasing, and we want to understand why. To do that, we need better data," said the scientist, Carrie Shapiro-Mendoza, who previously led a study that found infant deaths blamed on accidental strangulation and suffocation in bed quadrupled from 1984 to 2004.

And in October, the American Academy of Pediatrics released a policy advising against bed-sharing while stating when parents sleep in the same room as a baby — but not in the same bed — the risk of Sudden Infant Death Syndrome can be cut by as much as 50 percent.

Since experts came out in the early 1990s with the recommendation of placing babies on their backs to sleep, deaths from SIDS have dropped dramatically, said pediatrician Rachel Moon, a SIDS researcher at Children’s National Medical Center in Washington and lead author of the academy’s policy. But Dr. Moon said deaths from some of the most common bed-sharing causes, such as suffocation, are on the rise.

Because each circumstance is different, it’s hard to quantify the risks of bed-sharing, so "we can’t say it’s safe. We can’t recommend it for anybody," Dr. Moon said.

Yet James McKenna, director of the Mother-Baby Behavioral Sleep Lab at the University of Notre Dame, maintains that an outright ban on bed-sharing is "a social judgment and not a science."

Barring risk factors like substance abuse, which he said aren’t taken into account in the numbers, Mr. McKenna believes bed-sharing can be done safely and with great benefit to the mother and baby. While he doesn’t recommend bed-sharing for babies who are bottle fed, he believes that mothers who are breast feeding have a greater sense of their babies’ presence and typically sleep in a safer, protective position. He said parents should be allowed to make educated decisions on bed-sharing without feeling like they’re doing something wrong.

"Moms just aren’t these passive, lethal weapons they’re being portrayed to be," he said.

In November, a Milwaukee ad campaign sponsored by a nonprofit showed a baby sleeping in an adult bed next to a knife and words underneath that read, "Your baby sleeping with you can be just as dangerous."

Potential benefits aren’t worth the risk of losing a baby, contends Judith Bannon, executive director of the Pittsburgh-based organization Cribs for Kids.

"If there was anything else killing children at this rate, there would be an outcry from the community," Ms. Bannon said. "You can’t go into people’s home and dictate where the baby sleeps, but you can educate them about safe sleeping for the infant and the consequences of putting them in an unsafe environment."

Kakuna Smith has channeled her devastation into advocacy. Six years ago, the Dolton, Ill., woman’s 11-week-old daughter died in a bed-sharing accident. She now counsels other parents who’ve lost children while bed-sharing and is a SIDS of Illinois board member.

"I’ll tell anyone who will listen," said Ms. Smith, 34. Her daughter Kamilah’s toys, books, and clothes all remain in Ms. Smith’s home as reminders, and Ms. Smith keeps her pink onesie in a zip-lock bag in her dresser.

"I don’t want the [new-baby] smell to go away," she said.

Leanita Williams, whose son Messiah died two years ago this month, finds comfort in seeing his framed picture above the fireplace. That cold night, he was fussy after having his shots, so she brought him into bed.

Nothing could have prepared her for planning his funeral days later. Her words are hushed but direct.

"Put [babies] in a crib," said Ms. Williams, 20, of Chicago’s North Austin neighborhood.

James Robinson had a bassinet in his bedroom, and every day he regrets not having used it. He wonders how things might have turned out if he hadn’t been so emotionally drained that evening. Or if his fiancee hadn’t spent the night at the hospital with their 4-year-old.

Mr. Robinson’s neighbors heard him screaming for help. Later, at the hospital, when the doctors told Mr. Robinson there was nothing else they could do, he said he lashed out, pounding his fists into pictures on the hospital walls. He had to be restrained by a security guard.

Even though a few floors separated him and his fiancee, he couldn’t bring himself to tell her what happened. They sent a nurse upstairs instead. When he saw her across the hospital room, all he could do was cry.

The hospital chaplain found him in a crumpled, sobbing heap, and told him that maybe God took one son’s life to spare the other’s.

"Every time I’m down, I repeat that to myself," he said.

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The American Academy of Pediatrics and SIDS of Illinois advise against allowing infants to sleep in the same bed as parents but offer these recommendations for safe sleeping:

• Babies should sleep alone on their backs, in cribs, bassinets, or portable playpens that meet the most current safety standards.

• Do not use a drop-sided crib.

• Do not use bumper pads, pillows, stuffed animals, or heavy blankets in cribs. Dress babies in wearable blankets for sleep.

• Do not allow babies to sleep on couches, adult beds, or waterbeds.

• Do not allow smoking near babies.

• For more information, ask a medical professional or visit www.sidsillinois.org or www.cribsforkids.org.

Although many in the medical community warn against bed-sharing, some supporters say there are safe ways to do it. The Mother-Baby Behavioral Sleep Laboratory at the University of Notre Dame recommends:

• Babies under 1 should not sleep with other children in the same bed.

• Adults taking sedatives, medications, or other drugs, or those who are intoxicated or excessively tired, should not bed-share with an infant.

• Long hair on the mother should be tied back to prevent entanglement around the infant’s neck.

• Obese adults might not be able to bed-share.

• Bottle-fed babies should not bed-share but can sleep in their own bassinet or crib next to the mother’s bed.

Sources: American Academy of Pediatrics; SIDS of Illinois; Cribs for Kids; Mother-Baby Behavioral Sleep Laboratory, University of Notre Dame