Methodology: The study tracked mortality patterns in the United States over a 20-year period ending in 2004. The researchers collected death-certificate information about all babies who died suddenly and whose deaths were unexpected. For many of the children whose deaths fell into this category, no definite cause could be assigned; these are the children who traditionally have been thought to be victims of SIDS. That number has been dropping dramatically during the 20-year period under study, almost certainly a result of the "back to sleep" campaign, which followed the discovery that the risk of SIDS goes up when babies sleep face-down. But there is another category of unexpected infant deaths, one in which death-scene analysis permits a plausible cause of death to be assigned: accidental suffocation and strangulation in bed. Those numbers have quadrupled in the two decades under study.
Some of those cases obviously have nothing to do with bed sharing—like strangulation in a defective crib. (Among deaths for which the sleeping surface was known, about 15 percent occurred in cribs.) But in cases of sudden, unexpected infant deaths attributed to suffocation or strangulation, more than half occurred in co-sleeping circumstances (and where the sleeping surface was noted, more than 80 percent of the deaths occurred in an adult bed, a sofa, or a couch). A variety of causes were implicated in these deaths, including suffocation by bedding or soft materials and wedging between two objects, but the single most common cause was "overlying," in which a deeply sleeping parent rolled over and suffocated a baby.
Conclusion: This study doesn't really give us the answer about the safety or risk of co-sleeping—it just raises enough questions to make us very nervous. There are some ways that have been suggested to minimize the risk to the baby for those who want to continue co-sleeping, though there are no good studies to back them up. Putting the baby in a little outrigger attached to the side of the parents' bed or in a small canoelike device in the bed itself have been suggested as methods that might decrease the risk. (The sleeping chamber should have a firm bottom and not be filled with loose bedding or stuffed creatures.) Also, don't even think of bed sharing if you have been taking any medication, including antihistamines, which might make you sleep more deeply, or if you have been drinking an alcoholic beverage. But until we have a better study, I think it is important for parents to know that bed sharing, which might have some benefits, could well also have some very significant risks.
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