Bed sharing with parents raises risk for SIDS

Infants who share a bed with their parents during the first 3 months of life are at a 5-fold greater risk for sudden infant death syndrome (SIDS) than babies who share their parents’ rooms and sleep in their own beds, according to a British study. The findings hold even if a baby is breastfed and the parents do not smoke, drink alcohol, or use illegal drugs.

In the largest-ever analysis of datasets from 5 major case-control SIDS studies, 1,472 SIDS cases and 4,679 control cases were examined for risk predictors associated with bed sharing with parents. Researchers looked at parents’ breastfeeding practices, smoking, alcohol consumption, and illegal drug use and factors such as whether the baby slept in the parents’ room or elsewhere, the position in which the baby was put to sleep, and the baby’s age and birth weight. Datasets also included infants who died from asphyxia because they were found to be bed sharing or sleeping face down.

In the combined datasets, 22.2% of SIDS cases and 9.6% of controls were identified as bed sharing with parents. When the infants were aged younger than 3 months and breastfed, and neither parent smoked or had other risk factors, babies who shared their parents’ beds were 5 times more likely to die from SIDS than infants who slept in separate beds in parents’ rooms or in their own rooms. The risk to infants who slept in their parents’ beds jumped 65-fold when both parents smoked compared with risk for babies who shared rooms with nonsmoking parents. If the mother consumed alcohol, the risk for bed-sharing infants was nearly 90 times higher, and the risk of SIDS was “inestimably large” for bed-sharing infants if the mother used illegal drugs.

Peak incidence of SIDS deaths in the study occurred between 7 and 10 weeks and the risk declined with increasing infant age.

The researchers say their models predict that nearly 90% of SIDS deaths attributed to bed sharing probably would not occur if a baby is placed in its own bed on its back to sleep. Despite recommendations from the American Academy of Pediatrics for safe sleep practices for infants, SIDS remains the major cause of postneonatal death in the first year of life.