Bed sharing and reducing the risk of cot death

Posted on Thursday, May 23rd, 2013

From The Times 21.5.2013

“Should I sleep with my baby?” is a question that has polarized opinion since research revealed that just over half of all cot deaths occur when babies sleep with their parent(s). And the debate has been stoked today by new research revealing that the parental bed doesn’t just pose a threat when mum and/or dad has been smoking, drinking or taking sedative drugs. Any shared bed can be dangerous to a young baby.

Opinion on the subject may be polarized, but it is not divided equally. While most doctors and parents are happy to heed cautions about sleeping with their baby, there is a small but vociferous group who remain convinced that the benefits outweigh the risks.

We live in a free world and I have never advocated a dictatorial approach when guiding parents. They must decide for themselves, but the stand out finding for me in this latest study is that there is a 5-fold increase in the risk of cot death among young babies (under 3 months) who share the parental bed, even when they have everything else going for them (they are breastfed, both parents are non smokers, and mum hasn’t been drinking or taking drugs).

The absolute risk may be small – 5 times not very much is still not very much – but the consequences are so devastating that even the most hardened sceptics are likely to concede that, lovely though it is to sleep with your baby, he or she is safest in their own cot.

It is thanks to ongoing research like this that we are winning the battle against cot death (or sudden infant death syndrome as it is know in the textbooks). When I first qualified there were more 30 cot deaths every week in the UK; today that number is closer to five. But that is still 5 too many, so here is an overview of what parents can do to minimize the risk, based on the latest evidence.

• Always put young babies to sleep on their back (see below)

• The safest place for them to sleep during the first 6 months of their life is in a cot in your bedroom.

• Place them with their feet at the bottom of the cot (“feet-to-foot position”), and try and maintain a steady room temperature between 16 and 20 degrees C.

 

• Don’t overdress your baby; no more than two light layers of night-clothes. Use a sheet and blanket and tuck them both in firmly at the foot of the cot, making sure the head remains uncovered.

• Avoid sleeping with your baby in a sofa, bean-bag or armchair – however briefly. And never sleep with them in any situation if you have been drinking, taking sedative drugs or medicines, or are exhausted.

• Give up smoking (ideally before pregnancy and trying for a child). If both parents smoke, their baby is at least five times more likely to succumb to cot death – and don’t let anyone smoke in your house

• Breastfeed. A number of studies have shown that the risk of cot death is lower in breastfed babies, even after adjusting for confounding factors like parental smoking.

• Consider giving your baby a dummy at night and when they are napping during the day (studies suggests it halves the risk of cot death). Don’t force them to take it, and don’t worry if it falls out when they do go to sleep. If your child is breastfed, don’t offer a dummy until they are four weeks old by which time breastfeeding should be well established. Use it until the child is at least six months old, and then withdraw gradually.

• Last, and perhaps most importantly of all, always seek medical advice promptly if your baby is unwell.

 For more advice and information on protecting your child visit The Lullaby Trust website (formerly the Foundation for the Study of Infant Deaths) at www.lullabytrust.org.uk or call their helpline on 0808 802 6869 (10am – 5pm).

 

  •  Babies who sleep on their fronts are six times more likely to succumb to cot death than those who sleep on their backs.

 

  • The introduction of the Back to Sleep campaign in 1990 /91 more than halved the number of cot deaths in the UK.

 

  • It is estimated that putting babies to sleep on their backs has saved 20,000 lives in the UK since the early nineties, and as many as half a million around the world.

 

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