Apr 29 2009

Is bed-sharing cause of crib death?

Is bed-sharing harmful to babies?  According to experts, it may be.  There has been much concern about crib dead and they blame some of it on bed-sharing or sofa-sharing.  They point out that the babies at greatest risk are those of low birth weight, have respiratory problems, or if the parents smoke or drink alcohol.  Of course, their advice does make sense.  However, the babies at highest risk of crib death from bed-sharing also seem to be those at highest risk for crib death in any sense.  So, does bed-sharing really make a difference?

I will not go against medical advice in suggesting that it is OK, but even the experts say that a blanket warning to parents is not appropriate.  I will say that we shared our beds with our babies and they did not suffer from it.  Of course, they were and are healthy babies and we do not smoke or drink.  Therefore, we were at low risk to begin with.  I will not say that it was the most comfortable situation all the time, but we are no worse for wear.

There is still no explanation for much of sudden infant death.  When it first came to light, there was suggestion of child abuse.  Later, it was found to be much more mysterious, but sometimes showed signs of abuse from suffocation or “shaken baby”.  As it received more coverage, attention turned towards diagnosing some undetected physical problem.  So, we ended up with some heart and lung defects that can cause babies to suddenly stop breathing – called apnea.  Other causes came to light, such as reflux.  However, reflux came about (sometimes) due to medications given to treat apnea.  But, people forget that many of these physical conditions had been around even before SIDS or crib death came to attention.  Children born with birth defects were monitored carefully and if they did suffer negative consequences, it was not classified as crib death because there was a known cause for it.  SIDS was a diagnosis given to those babies who died under mysterious circumstances. 

Those circumstances remain mysterious, although multiple hypotheses have been forwarded.  Some say that babies sleeping on their stomachs may accidently suffocate when they roll their heads into their pillows and cannot roll them away again.  Or, when they roll their heads they compress arteries in the next that supply the brain.  Prior to this, it was recommended that babies sleep on their stomach because they breathe better that way.  The current recommendation is to keep them on their sides.  Other hypotheses include the presence of bacteria due to a change in the manufacturing of crib mattresses, excessive mucous in the nasal passages.  Other hypotheses include many medical conditions.  But, again, if there is a medical explanation for the death, it would not be classified as SIDS.  Until they can connect all the crib deaths with some distinct explanation, we will never know the real cause of SIDS.  Perhaps, what is classified under the umbrella of SIDS may be more than one condition.  But, surely, we should be able to start grouping these deaths into categories.  Statistics suggest that thousands of babies die of crib death every year.  Could there be that many different diagnoses to explain all these deaths in the end?

So, if we do not know the cause of crib death, what can we do to prevent it?  Really, there is nothing that can guarantee our children’s safety.  However, if expert advice does not sound harmful in any way, then it would be appropriate to follow it. If it goes against any of our fundamental beliefs, then it might be best to discuss it with the doctor before going against medical advice.  But, what about bed-sharing?  It is an individual decision and should be discussed with the doctor or midwife.  Of course, if a parent crushes their child, causing suffocation and death, it really is not crib death, is it?  It would be accidental death or neglect.