Babies' deaths spur city warning

Sharing bed with parents linked to 50 fatalities

`Extremely high' correlation

July 02, 2002|By Jonathan Bor | Jonathan Bor,SUN STAFF

As many as 50 infants in Baltimore may have suffocated since 1998 while sleeping with a parent or older sibling, city officials said yesterday.

Noting that bed-sharing was a factor in about half of the 99 sudden infant deaths during the past 4 1/2 years, Dr. Peter L. Beilenson, the city's health commissioner, issued a warning to let babies sleep alone.

"We were so taken by this serious problem that we wanted to alert parents to the danger of sleeping with their very young infants," Beilenson said yesterday.

Parents or siblings may have rolled over the infants in many cases, resulting in accidental suffocation, he said. Bed-sharing also puts parents at risk of trapping babies against the wall or against bedding that may cut off their air supply, he said.

Dr. Charles Shubin, a pediatrician from Mercy Medical Center who is a member of a city task force on infant deaths, said it is difficult to determine exactly how the infants died. Suffocation is hard to determine in an autopsy, he said, so doctors and police are left to infer the cause of death from circumstances.

"We don't have absolute proof that the babies died" from being smothered by an adult, Shubin said. "What we have is a statistical correlation that is extremely high."

Since January, the state medical examiner identified 11 cases of sudden and unexplained infant deaths in Baltimore among babies less than a year old. Six of the babies were sharing a bed with an adult, while four others were in cribs with soft bedding, including comforters, pillows and large stuffed toys that could cause suffocation.

Members of a city task force studying infant deaths were so alarmed by the finding that they ordered a review of sudden infant deaths over the preceding four years. This involved an examination of reports by police, social service agencies and the medical examiner.

The incidence of sudden infant death syndrome has fallen substantially in the past decade, thanks in part to a national "Back to Sleep" campaign in which experts urged parents to place infants on their backs, not their stomachs. The campaign was launched after an Australian report showed that infants placed in the face-down position were more likely to die unexpectedly, presumably when their faces press against bedding. Experts have also advised parents to avoid soft mattresses and bedding materials.

In Maryland, the SIDS rate fell 22 percent over the decade. Last year, 49 were reported statewide. Though they could not cite a percentage decline, city officials said sudden infant deaths seem to have fallen in Baltimore as well.

Even so, experts who examined the sudden deaths in Baltimore said they were struck by the fact that so many were preventable.

"The harder we looked, the more we saw, and we didn't like what we saw," said Shubin.

Officials found the case of an infant who slept with a parent and died after being wedged between the mattress and wall. In another case, a mother sleeping with the baby on a sofa inadvertently pressed the infant against the back of the sofa.

Beilenson said he does not want to discourage mothers from breastfeeding, noting that some mothers may fall asleep while nursing their babies. Some experts contend that babies nursing on mother's milk might be at lower risk for sudden death.

But he said mothers should try to place their babies in a crib or bassinet after breastfeeding. Those who can't afford a separate infant bed can purchase a plastic storage container -- selling for about $10 at discount stores -- that can be outfitted with a firm mattress and fitted sheet.

Dr. Maureen Edwards, medical director of the state's Center for Maternal and Child Health, said many of the SIDS deaths statewide involve babies sleeping in adult beds.

"Whether it's co-sleeping or the circumstances under which co-sleeping occurs is unclear," Edwards said, noting that the soft bedding probably plays a significant role.

Last month, the Consumer Product Safety Commission warned parents not to place babies in adult beds, citing the cases of 180 babies younger than 2 years old who died in 1999 and 2000.

The commission said the practice poses the hazard of entrapment, falls or "overlaying of the baby by another child or adult in bed."

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