Erie County Department of Social Services Disproportionate Minority Campaign (DMR) Safe Sleeping Campaign
Babies Should Sleep Alone/Co-Sleeping is Unsafe
The risks of unsafe sleep environments and conditions are well documented both in New York State and across the nation. There are a concerning number of fatalities that involve unsafe sleep environments in the fatalities reviewed by the NYS Office of Child and Family Services.
2009- 50% of the 117 fatalities of infants involved reports alleging unsafe sleep conditions
2008- approximately 84% of the 151 infant fatalities involved reports of unsafe sleep conditions
Included in the issue of unsafe sleeping conditions is bed sharing. Bed sharing means an infant and one or more other persons are sleeping together on any surface, not necessarily a bed.
“The issue of bed-sharing by infants and adults is one that is especially fraught with social, cultural, and personal implications, with strong adherents arguing for and against the practice. It is clear, however, that when bed-sharing occurs in conjunction with certain other factors, risk to the safety of the infant is increased. Added risk factors include the following:
- The bed-sharing occurs in unsafe sleep conditions, such as with soft bedding on surfaces such as a
couch or armchair.
- A person sleeping with the infant is under the influence of alcohol or drugs (including legal, illegal, prescription,
and over-the-counter drugs), or is overly exhausted. These increase the likelihood that the person will not wake
up during a dangerous situation (for example, rolling over on the infant).
- There was maternal smoking during pregnancy and/or smoking in the environment after birth.
- The infant shares the bed with a person who is obese; this increases the danger of the infant being smothered by
the person’s body.”
The same policy also cited a recent study that examined 251 SIDS cases in New Jersey, which found that 244 of those deaths were associated with one or more risk factors, with only 44 having a single risk factor. The study identified the percentage of times that each of the following risk factors were associated with the deaths:
Not placed on back – 70%
- Smoking by one or both parents – 60%
- Upper respiratory infection – 44%
- Bed-sharing – 39%
- Scene risks (for example, use of soft bedding or presence of other children) – 31%
- Under 37-week gestational age – 27%
On the subject of risk, OCFS has provided a guide to best practices for safe sleep in its publication “Helpful Tips to Keep Your Baby Safe”, which includes the following recommendations: always place a baby on his/her back to sleep and make sure that all caregivers know to do this, make sure the baby’s face and head remain uncovered, use a firm sleep surface free of any soft objects or loose bedding and that will not allow the baby’s head to become wedged between two surfaces, keep the temperature moderate, no smoking around the baby, be careful about sleeping with infants - especially when sleeping on small surfaces, and understand the risks of sleeping with an infant after having used alcohol or drugs or when overtired. While the issue of safe sleep could apply to a child of any age, the focus of this public service announcement is on infants since they are at greater risk.
The U.S. Consumer Product Safety Commission (CPSC) warns parents not to place their infants to sleep in adult beds, stating that the practice puts babies at risk of suffocation and strangulation. And the American Academy of Pediatrics (AAP) agrees. In Erie County at least 31 deaths were linked to infants and toddlers under 2 years of age sleeping with adults from January 2006 to June 2011:
- 20 of the deaths were attributed to a parent, caregiver, or sibling rolling on top of or against a baby while sleeping
- more than 70% of the deaths involved infants younger than 3 months old
Hidden Hazards – 11 infant deaths between January 2006 and June 2011 were attributable to hidden hazards for babies including:
- suffocation when an infant gets trapped or wedged between a mattress and headboard, wall, or other object
- suffocation resulting from a baby being face-down on a air mattress, a waterbed, a regular mattress, or on soft bedding such as pillows, blankets, or quilts
- strangulation in a bed frame that allows part of an infant's body to pass through an area while trapping the baby's head
- strangulation in a bed near draperies or blinds where your child could be strangled by cords.
Most medical experts say the safest place to put an infant to sleep is in a crib that meets current standards and has no soft bedding.
 Barbara M. Ostfeld, Linda Esposito, Harold Perl and Thomas Hegyi; Concurrent Risks in Sudden Infant Death Syndrome, Pediatrics 2010; 125, 447-453. http://pediatrics.aappublications.org/cgi/content/abstract/125/3/447