Sweet, Safe Sleeping for Babies

Bedsharing and objects in bed increased risk of infant sleeping deaths the most

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) The safest way for infants to sleep is on their backs on a separate sleeping surface, clear of all blankets, pillows and other objects. Other ways of sleeping can increase the risk of tragedy.

A recent study found that the biggest risk factor for younger infants' deaths while asleep was sharing a bed.

For older infants, the biggest risk factor found was infants who rolled from their backs to their stomachs into the way of an object in their sleeping area.

The American Academy of Pediatrics also advises parents to have young babies sleep in a crib or bassinet that is kept in their bedroom and not to have tobacco smoke in the sleeping environment.

"Put infants to sleep on their backs."

The study, led by Jeffrey D. Colvin, MD, JD, of the Department of Pediatrics at Children's Mercy Hospitals and Clinic in Kansas City, Missouri, investigated the risk factors for sleep-related infant deaths.

The researchers used data from 24 states between 2004 and 2012 to study 8,207 sleep-related deaths of children under 1 year old.

When the deaths were analyzed according to the infants' ages, the researchers found that risk factors varied in importance according to whether the babies were older or younger than 4 months.

For example, 74 percent of the deaths involving babies under 4 months old occurred when the babies were sharing a bed with their parents or another adult, compared to 59 percent of the older infants.

A "bed" was defined as an adult bed, a waterbed, an adult mattress, a bunk bed, a children's bed, a sofa bed or an air mattress.

Similarly, 52 percent of younger babies died while sleeping in an adult bed or on a person, compared to 44 percent of older babies who died in this situation.

However, the older babies were more likely to die in sleep as a result of other objects in the sleeping environment or from moving to their stomachs.

While about a third (34 percent) of younger infants died due to an object in their sleeping environment, the percentage for older infants was 39 percent.

Objects included blankets, pillows, bumper pads, sleep-position support items, hard furniture, stuffed or nonstuffed toys, clothing, other soft fabric items, cords, bags or other objects.

Past research has shown that infants sleeping on their backs have a much lower risk of dying from SIDS than babies sleeping on their stomachs.

In this study, 18 percent of the older infant deaths occurred when the child changed from their side or back to their stomach, compared to only 14 percent of younger infants.

The exact cause of death was unknown for 38 percent of the total group of infants studied, even though autopsies were performed in all but a little over 2 percent of the cases.

Among the others, 35 percent of the deaths were classified as SIDS, and 27 percent were classified as accidental suffocation or strangulation.

"The predominant risk factor for younger infants (0–3 months of age) is bed-sharing, whereas rolling to prone [on the stomach], with objects in the sleep area, is the predominant risk factor for older infants (4 months to 364 days)," the researchers concluded.

"Parents should be warned about the dangers of bed-sharing, particularly in 0- to 3-month-old infants," they wrote.

The American Academy of Pediatrics does not advise parents to reposition babies who roll from their backs to their stomachs while asleep.

However, the researchers noted, "parents should be reminded that cribs should be clear of any objects, so that if the infant rolls, there is no risk of rolling into something that may create" an environment in which the infant could suffocate.

The study was published July 13 in the journal Pediatrics. The authors reported no potential conflicts of interest.

The research was funded by the CJ Foundation for SIDS, the National Institutes of Health and the Maternal and Child Health Branch of the Health Resources and Services Administration.

Review Date: 
July 13, 2014
Last Updated:
July 14, 2014