An interesting safe sleep resource

Cribs for Kids, brought to the public by SIDS of Pennsylvania.

According to one of the press releases on the website (emphasis mine),

Starting in 1998, Bannon and a growing band of volunteers have been working to get cribs out to families who need them in greater Pittsburgh and beyond, and to spread the message that babies are safer in their own crib — as much as 40 times safer, according to some researchers.
“Unfortunately, babies continue to die in our county, but we’ve given out 6,500 cribs since 1998 and we’ve kept track of those families and not one of them has had a baby die in the first year of life.”

Through a special partnership with Graco, the group distributes a special make of the company’s popular portable crib to families referred to from prenatal caregivers and social workers. The cribs are both easy to assemble and pack up to go to a baby sitter or grandparent, and small enough that they can be set up in the parents’ bedroom.

“They sit next to the bed, mom just separated by mesh from the baby, that’s what I consider the safest setting,” Bannon said.

The program started to branch out to other cities just 18 months ago, but already there are chapters of Cribs for Kids operating in 152 communities in 35 states. Many similar efforts have been established by local governments and child-welfare groups seeking to prevent infant sleep deaths.

Another interesting press release has a short interview with Dr. Mckenna, bedsharing advocate, with the following puzzling tidbit:

Although he’s authored scores of articles and a book, “Sleeping With Baby,” on the practice, McKenna is quick to point out that he doesn’t advocate everyone bed-share.

“There are parents who aren’t comfortable sleeping with their infants, and there are some who should not do it. Mothers who are bottle-feeding rather than breastfeeding probably should not. We’ve seen in our studies that there are physical differences in how those women place their babies in the bed with them compared to breastfeeding mothers,” McKenna said.

Maybe it’s just me, but I don’t recall any previous admonitions – by Mckenna or anyone else – not to bother bedsharing if you don’t breastfeed. (there’s more to the article, and I suggest you read the whole link).

The Scripps press releases are the most informative part of the site, in my opinion; I suggest reading them all. Another one of special interest talks about the need for national standardization of infant deaths. A startling finding:

— A small but growing number of coroners who adhere to the most thorough investigation protocols are discovering that most sudden infant deaths are accidental asphyxiations.

First Candle
, a large non-profit SIDS prevention organization, has also received an $11 million grant to provide cribs for safe roomsharing in Indiana, Washington state and DC.


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8 Responses

  1. the april 15, 2008 press release says “In 1992, about 80 percent of 4,895 unexpected infant deaths reported to the federal Centers for Disease Control and Prevention each year were considered SIDS deaths — a determination that’s supposed to be reached only after a thorough death scene investigation, autopsy and medical history review of the baby rule out any other possible cause.

    By 2005, of 4,857 deaths reported, just under 48 percent were considered SIDS deaths, but almost 30 percent were attributed to “unknown causes” and the rest to accidental suffocation or homicide.”

    the number of unexpected infant deaths didn’t really change at all over those 13 years. and from what i can tell from the CDC website, the number of births annually hasn’t changed much (in 1992 it was 4,065,014 and in 2005 it was 4,138,349). so, we can’t really conclude that the “back to sleep” campaign actually prevented any deaths. but i keep reading that SIDS deaths have dropped by half since the back to sleep campaign was launched.

    what do you think about that? did the deaths just get shifted to unknown causes (isn’t that supposed to be called SIDS anyway??) and accidental suffocations? has back to sleep prevented any deaths at all?

  2. I don’t know where the 1992 number of unexpected infant deaths in the article came from, because I’ve seen the figure most often quoted in excess of 6000 deaths. In any case, you’re quite right that some of the decline in SIDS deaths is due to diagnostic shift – calling the death homicide or accidental suffocation after thorough investigation. However, even accounting for that, there was a sharp decrease in infant deaths 1992-9 that can be attributed to the “back to sleep” campaign. See here (.pdf file).

  3. Esther what about cribs that open up to the parents bed. That way the Mom could breast feed the baby and put him back at arms length. That is what I did with my boy. Granted when I had him 10 years ago the Lactation Consultants were telling me I should sleep with my baby. Which was tough because my baby born 13 years earlier, I was told never to fall asleep with her in my arms and to keep her in her crib not in my bed. Wow how things change. Now it seems to be going back to the “Don’t sleep with the baby” camp. I just want to tell folks what is safest.

  4. I’ve said it before – I think sidecar co-sleepers are great. The idea is to have the baby on a separate sleeping surface,with his own mattress and own bedding suited for a baby. Many militant cosleepers are really resistant to that idea and insist the baby needs to be in their bed, in their arms, all night long.

    The Pack n’ Play bassinet with the mesh sides is almost exactly the same thing, with one extra mesh wall.

  5. I think that is silly! Do you have a lot of militant folks in your practice? If so, that must be frustrating.

  6. I don’t have many ideological (militant or otherwise) bedsharers in my practice at all, actually. Most people I know roomshare for the first few months, then move the crib into another room, usually with an older sibling. If there is bedsharing, it’s reactive to a fussy child.

    The ideological bedsharers I know IRL and online are usually those who’ve drunk the ‘cosleeping prevents SIDS and future axe-murdering tendencies’ Koolaid. But thankfully, they’re not patients.

  7. The belief that breastfeeding eliminates the risks of bedsharing is one that I’ve seen expressed often by James McKenna and other AP advocates (although I’ve never before seen them be this upfront about the obvious implication of that belief – namely, that bedsharing would therefore not be advisable for the rather large category of bottle-feeding mothers!)

    It appears to be a somewhat desperate attempt on their part to explain away the fact that the large-scale case-control studies into co-sleeping aren’t coming out the way the AP-ers expected – none of them has shown bedsharing to be associated with a decrease in SIDS likelihood compared to roomsharing in a separate cot, and a few, as you know, have shown that for small babies the opposite is the truth. But, say the AP-ers, it’s all because the studies didn’t differentiate between breastfeeding and bottlefeeding mothers! And this means the studies were hopelessly flawed! And obviously wrong! And if only those biased researchers had had the good sense to adjust for breastfeeding when they did the study, of *course* they’d have found that bedsharing by *breastfeeding* mothers is safer than cot sleeping! (Conspiracy theories about financial kickbacks from crib manufacturers are an optional extra at this point.)

    Unfortunately for bedsharing advocates, there is not only no evidence to support this view, but there is now a study on the subject that didn’t come up with the findings they hoped for (and has – surprise! – been ignored). Ruys JH, de Jonge GA, Brand R, Engelberts AC, Semmekrot BA. Bed-sharing in the first four months of life: a risk factor for sudden infant death. Acta Paediatr 2007; 96(10): 1399 – 1403. This study adjusted for breastfeeding and *still* found SIDS babies were more likely to have bedshared than non-SIDS babies. (They adjusted for very little else, so I don’t regard this as providing evidence in the overall argument re. bedsharing safety; I do, however, think it provides valuable evidence that the specific “But bedsharing must be safer than crib sleeping for *breastfed* babies!” argument is nothing more than wishful thinking.)

  8. Seeing as I am quite an active sleeper (I’ve punched my fiance a few times while dreaming), having the baby in bed with us would be right out. I toss and turn, and fling bedding, so the chances of the baby being smothered by a pillow in the sidecar arrangement would be pretty high too. But putting the crib further from the bed to protect the baby from my nightly gymnastics would make me a bad parent….

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