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Commission recommends against children sleeping in adult beds

Two dummies illustrate how a baby can suffocate when an adult accidently rolls over the child in bed  

September 29, 1999
Web posted at: 11:26 AM EDT (1526 GMT)

By Laura Lane

(WebMD) -- The warm and cozy family bed may not be without hazards, a new study suggests. Researchers are reporting that infants and children under the age of 2 could be in a precarious position when sleeping with their parents in an adult bed.

An article published in this month's issue of the Archives of Pediatrics and Adolescent Medicine reports that researchers at the U.S. Consumer Product Safety Commission found that 64 children die each year in the United States while sleeping in the same bed as their parents.

According to the researchers, this study is the first to examine the number and kinds of deaths that result from the practice -- also called "bedsharing." They conducted their study by poring over death certificates from all 50 states and reports of deaths resulting from consumer products from January 1990 through December 1997.


During that time, 515 children younger than 2 died while bedsharing. Of that number, 121 died as a result of suffocation after a parent or other adult rolled onto the children. The remaining 394 children died of suffocation, asphyxia or strangulation after becoming trapped in bed structures, including the mattress, bed frame and side railings. Children sleeping on water beds accounted for 79 deaths.

With such results, commission officials are urging parents and caregivers to place children in cribs rather than adult beds.

To avoid strangulation, cribs should have locking sides that fit securely into the frame  

"It's extremely important that people understand the danger that putting a baby in bed puts them at risk for strangulation and suffocation," said Ann Brown, chairman of the commission. "Don't sleep with your baby or put the baby down to sleep in an adult bed."

Brown added that parents should only place their children in cribs that meet commission standards; such a crib has appropriately spaced side rails and a mattress that is flat, firm and free of soft bedding and pillows.

Some pediatric sleep experts, however, are saying that the commission's recommendations may have gone too far.

"It's not appropriate for a government agency like the commission to make recommendations on child-care practices on the basis of a single study," said Dr. Abraham Bergman, a pediatrician at the University of Washington in Seattle.

"There's no scientific basis to claim that bedsharing and use of an adult bed is a hazard to infants," said Bergman, who has studied sudden infant death syndrome for nearly 30 years. "It's a classic example of garbage in and garbage out."

"Sudden infant death syndrome," also known as SIDS, is a term used to describe an unexplained cause of death in an infant under a year old. Because many cases occur while the baby is sleeping in a crib, SIDS is commonly called "crib death." In 1997, the most recent year for which statistics are available, 2,991 children died of SIDS in the United States, according to the National Center for Health Statistics.

Bergman said that the chief flaw in the study was that the researchers did not compare the number of deaths to the total number of infants who actually bedshare.

Dr. Joel Steinberg, a pediatrician at the University of Texas Southwestern Medical School, agreed, pointing out that 64 deaths per year is a low number compared to the total number of babies born annually. Thus, he believes the study's authors should not have drawn conclusions about how risky bedsharing is.

But Suad Nakamura, lead author of the study, said that numbers shouldn't matter. "A death of an infant is a death of an infant," said Nakamura, who is a physiologist at the commission.

Both Bergman and Steinberg also pointed out that information on death certificates isn't completely reliable, mostly because investigations into the causes of death aren't always thorough and vary by state. Nakamura said she is confident in the reliability of the information and that variation doesn't impact the number of deaths.

"The bottom line is that sleeping should be done in a safe environment," said Steinberg, who is also a spokesman for the American Academy of Pediatrics, which does not discourage bedsharing as a means of preventing SIDS.

The commission should also issue guidance to parents who will continue to bedshare either because of cultural tradition or because they can't afford to buy a crib, said Angela Mickalide, campaign program director of the National Safe Kids Campaign Program. According to her, the commission's recommendation may help to reduce the number of SIDS deaths in the country.

Copyright 1999 WebMD, Inc. All rights reserved.

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