The same doctor who made SIDS known to the American public believes that bedsharing with your baby is not dangerous. You heard that right. Dr. Abraham B. Bergman was the first president of the National SIDS Foundation. He got SIDS research into federal programs in the 70’s. He helped pass the national Sudden Infant Death Syndrome Act in 1974. His latest paper was released in 2013 and didn’t go mainstream then, which is a tragedy for American families. This latest article in JAMA Pediatrics, “Bed Sharing per se Is Not Dangerous” calls out the American Academy of Pediatrics in making unfounded claims against bed-sharing with babies. Baby sleeping close to her mother, holding her finger Bergman lists the many reasons why SIDS diagnosis and recording has been flawed, non-uniform, and subject to human opinion and prejudice; so that there is no specific evidence that bed-sharing is a risk factor for sudden infant death.

“The National Center for Health Statistics receives its in- formation about causes of death from a potpourri of US coroners and medical examiners in 2185 different death investigation jurisdictions. This lack of uniformity means that the personal beliefs of coroners and medical examiners determine the diagnoses written on death certificates.”

Referencing another article in the very same issue, Bergman states:

“Colson and colleagues report that from 1993 through 2010, the overall trend for US caregivers to share a bed (also known as cosleeping) with their infants has significantly increased, especially among black families. Because of their belief that bed sharing increases infant mortality, the authors call for increased efforts by pediatricians to discourage the practice. I find the report disquieting because evidence linking bed sharing per se to the increased risk for infant death is lacking.”

Bergman has worked with families for over 50 years in Seattle as a pediatrician at the University of Washington Medical Center, and Harborview Medical Center. He has worked with families for over 50 years in Seattle as a pediatrician at the Seattle Children’s Hospital and Harborview Medical Center. My favorite thing about Bergman? He spearheaded a national movement to support families who had lost a child to SIDS- rather than sending them to jail. Bergman has also made huge changes in the areas of food stamps and school lunches, bike helmet laws, safe and educational playgrounds, and Indian health improvement. He has always fought for lower income families and families of color and that’s why his work with SIDS is even more important. He believes that something prejudiced may be afoot here with SIDS diagnoses. Milwaukee’s famous scare-tactic using anti co-sleeping campaigns aimed at families of color has been a total flop. Those scare tactics didn’t saving babies. I could have told you that. Families co-sleep because they are exhausted in the middle of the night and because babies love and need closeness. Those two things have greater importance to families in the moment than how one’s city advises them to parent. Bergman notes:

“…I detect a note of irony in the AAP’s position. Are we advising our patients against a practice that many of us follow? Colson et al1 show that bed sharing is reported among 12.2% of caretakers with some college education and 9.2% of caretakers who have graduated from collage and/or had post- baccalaureate education. Many pediatricians’ families seem to be among those who ignore the AAP recommendation, with or without guilt.”

The American Academy of Pediatrics has a policy against bedsharing but researchers, medical professionals, and worldwide organizations question the AAP’s position. The truth remains that there are no studies that show bed-sharing as a risk factor with a  control for major concurrent risk factors like formula feeding, excessive bedding, and nicotine use in the home.  Personal and cultural biases play a role in death reports which have no standardization methods. A major concern is that countless officials use their own judgment to decide cause of death rather than using a standardized reporting system that looks at all SIDS risk factors. If an infant dies in an adult bed it would be common for the bed-sharing itself  to be cited as the cause of death when there may be other important factors to consider.  What many people don’t know is that SIDS has remained very mysterious for so long because determining exactly what caused breathing to cease in an infant is extremely difficult. We have begun moving toward calling it Sudden Unexplained Infant Death (SUID) for this reason- it doesn’t have the characteristics of a syndrome at all.

When possible suffocation deaths began being called SIDS, SIDS stopped meaning anything. The death of a baby while sleeping with an adult on a couch or lounge chair (both dangerous sleep situations with a high risk of entrapment and suffocation) is classified as a death due to bedsharing as well even though suffocation itself is not SIDS. With co-sleeping, we are really talking about suffocation deaths and not SIDS. Automatically labeling a family with a suffocation death simply because they had been co-sleeping (which may not be the actual cause of death) is problematic and has been biased against lower income and African American families.

Bergman quotes the Centers for Disease Control:

“Since 1998, it appears that medical examiners and coroners are moving away from classifying deaths as SIDS and calling more deaths accidental suffocation or unknown cause, suggesting that diagnostic and reporting practices have changed. Inconsistent practices in investigation and cause-of-death determination hamper the ability to monitor national trends, as certain risk factors, and design and evaluate programs to prevent these deaths.”

Another sleeping and SIDS researcher, Dr. James McKenna has published his belief that co-sleeping is safer than crib sleeping namely because of his research showing steadier breathing and heart rate while bed-sharing and that co-sleeping babies are likely to sleep on their backs. McKenna’s Research is compiled here. An international survey by the SIDS Global Task Force showed that countries practicing the most c0-sleeping and bed-sharing had the lowest rates of SIDS. They also happen to be countries with high breastfeeding rates. And what’s more? JAMA published a review of data from the National Infant Sleep Position Survey that recorded numbers actually rising of self-reported bed-sharing during the same time period that SIDS deaths lessened. That’s what we call very interesting indeed. 

Here we have a trusted pediatrician in Dr. Abraham Bergman who worked for many years to save babies from unexplained death- and he’s saying that the science just isn’t there to  name bed-sharing itself as a risk factor for sudden infant death. So this is my continuing call for more research about infant sleep deaths and the actual risk factors for SIDS, as well as how protective breastfeeding and co-sleeping actually may be. Let’s not throw baby (and baby’s natural needs for closeness) out with the bath water. We aren’t helping anyone with the scare tactics. People are co-sleeping anyway. Let’s figure out how to get info about safe co-sleeping out to parents. *Note that though we don’t yet know the exact risk factors for infant sleep death, what knowledge we do have suggests it is a good practice to not co-sleep if your child is exclusively formula fed, if you have a sleep disorder, if you are morbidly obese or use nicotine or if there is any alcohol abuse in the home- in those cases, baby should sleep solo on their back on a firm mattress in clothing and without pillows or blankets.

-Moorea Malatt-  Supporting breastfeeding, co-sleeping families with my gentle Sleep Savvy Method.  http://www.savvyparentingsupport.com/programs/sleep-savvy/ 

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