Sleeping on the Sofa May Be Dangerous for Infants

SIDS occurred most often in infants who were asleep on a sofa

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Parents often lay infants on the sofa to keep an eye on them while tending to other things. But new research suggests doing so could be dangerous to the baby.

Researchers recently set out to examine the relationship between infants sleeping on sofas and sudden infant death syndrome (SIDS).

They found that more infants died of SIDS from sleeping on the sofa than from any other surface in the home.

The research, by Lauren R. Rechtman, MD, of George Washington University Medical School in Washington, DC, and colleagues, found that 12.9 percent of sleep-related infant deaths occurred on sofas.

The researchers also found that infants were more at risk for SIDS on the sofa if they shared the sofa with another person, if the sofa was a new place for the child to sleep or if the mother had smoked while pregnant.

Parents need to understand “the dangers of placing infants for sleep on sofas and similar surfaces and sharing these surfaces with an infant,” the authors wrote.

According to the study, some couch cushions slope toward the back of the couch, which could create a risk of the infant rolling and becoming wedged between the back and bottom cushions. The authors also wrote that the soft surface of a sofa could pose a risk of suffocation to infants who are not asleep on their backs or who roll over.

"The risk of death when a child sleeps on a soft location is high, as indicated in this latest study. This may be related to increased concentrations of rebreathed air [or] retention of tobacco smoke in the cushions," said Thomas Seman, MD, a pediatrician at North Shore Pediatrics in Danvers, MA. He noted that the higher risk associated with sofa sleep may also be due to how the study was conducted and how many babies were in the study.

The study authors examined data from the National Center for Review and Prevention of Child Deaths Case Reporting System database from 2004 to 2012. At that time, only 24 states gave data on infant deaths.

In the eight years studied, 1,024 infants died on sofas — 12.9 percent of the total sleep-related infant deaths. That's roughly 1 baby for every 8 who died of SIDS.

SIDS is the sudden, unexplained death during sleep of an apparently healthy baby. It usually occurs in the first year after birth. SIDS is the leading cause of death in infants older than 30 days, and 53.9 infants per 100,000 live births die due to SIDS on average, the study authors reported.

The authors reported that an infant who slept on the sofa was 40 to 67 times more likely to die of unexplained infant death than an infant who slept in a bed or crib.

The American Academy of Pediatrics (AAP) recommends that all infants sleep on a flat, firm surface, such as in a crib. To reduce the risk of SIDS, parents should place children on their backs to sleep, the authors noted.

Dr. Seman said that he feels "very strongly about the recommendations from the AAP about proper sleeping position and to eliminate as many of the additional factors [such as another person sharing the sleep surface at the same time] as necessary.  A child depends upon his/her parents to care for and protect them and parents should take that role very seriously. As pediatricians and primary care providers we need to emphasize these factors to the caretakers to make sure that there are no more unintentional deaths."

This study was published Oct. 13 in Pediatrics.

The National Institutes of Health funded the study. The authors disclosed no conflicts of interest.

Review Date: 
October 16, 2014
Last Updated:
October 22, 2014