Co-Sleeping and Dead Babies - Milwaukee County

A first-of-its kind study is adding to the case against co-sleeping.

From the Milwaukee Journal Sentinel:

Three out of every four Milwaukee County babies who suffocated in their sleep or died of SIDS in 2007 and 2008 were sleeping with an adult or with another child, according to a first-of-its kind analysis of infant fatalities.

Co-sleeping was a factor in 10 of the 11 suffocations that occurred in the county during that time period.

It was a factor in 28 out of 40 deaths attributed to sudden infant death syndrome.

The analysis, conducted by the Milwaukee County medical examiner's office and by the Children's Health Alliance of Wisconsin, comes amid a widening debate among those who extol co-sleeping as beneficial to mother and child and community health officials who say co-sleeping is unsafe.

"If you sleep with your child," said Milwaukee County Medical Examiner Christopher Happy, "you are playing a kind of Russian roulette."

...An analysis of co-sleeping and infant death in Milwaukee County has never been done before, Happy said.

His office and the Health Alliance were compiling a larger report on infant death in Milwaukee County. Researchers were so startled by the unsafe sleeping statistics that they decided to release them before the rest of the report was completed.

"Our focus is prevention," Happy said. "We thought it was important for the community to get the numbers out there right away."

Researchers examined the deaths of all 203 Milwaukee County infants 12 months or younger who died in 2007 and 2008 and whose deaths were reported to the medical examiner's office.

Researchers, combing through reports, isolated the deaths that occurred while infants were sleeping or while they were in sleep environments. Researchers classified them as "unintended sleep related deaths."

Nonpreventable deaths caused by disease, such as congenital birth defects, were not included.

The deaths of 51 infants - 25% of all deaths - were unintended sleep related deaths.

Researchers broke this number into two groups: Infants who suffocated and infants who died of SIDS.

Eleven of the 51 infants suffocated. Ten of those suffocated while co-sleeping, usually with an adult.

The other 40 infants died from SIDS.

Some 70% of the infants who died of SIDS - 28 out of 40 - were co-sleeping with an adult or with an adult and another child.

Sleep environment was so clearly a factor in SIDS deaths that Happy has changed the way such deaths are recorded on Milwaukee County death certificates.

SIDS, he said, is a relatively new diagnosis, about 30 years old. It is a catch-all category, defined as the death of an infant less than a year old whose fatal episode began while the infant was asleep and whose death can not be explained after a thorough investigation.

"SIDS is basically a name we have applied to cases with an undetermined cause of death," Happy said.

If an infant dies of SIDS but investigators determine the child was co-sleeping, an unsafe sleep environment cannot be ruled out as contributing to the child's death. SIDS deaths involving co-sleeping are now recorded on Milwaukee County death certificates as SIDS Category II.

"We are trying to separate out real SIDS that occurs in a crib that is properly used," he said. "It's a more honest way to say we don't know."

That's quite a distinction to make on death certificates, differentiating from "real SIDS" and SIDS involving co-sleeping.

Co-sleeping proponents aren't happy with the City of Milwaukee Health Department's campaign against the practice of co-sleeping.

...The debate over co-sleeping is sometimes characterized as a cultural one, one that ignores the realities and traditions of American minority groups.

The Black Health Coalition of Wisconsin, for example, offers tips on its Web site (www.bhcw.org) on how to safely co-sleep with infants, noting that "telling caregivers to not co-sleep is not enough when many will do it anyhow."

That's the "free condoms for school kids" argument.

They're going to do it anyway so the emphasis should be on safety rather than curbing the behavior.

Regarding co-sleeping, isn't it enough to educate caregivers that they are putting the baby's life at risk? Isn't that a huge deterrent to not "do it anyhow"?

Many co-sleeping advocates insist that it can be done safely, instead blaming drug and alcohol use as critical factors in the babies' deaths.

Though many recent co-sleeping death cases have involved an irresponsible adult under the influence, that's not always the case.

Many mothers, regardless of race or ethnicity, embrace co-sleeping as a healthy practice, one that deepens the bonds between mother and child.

Julie Ticcioni is a 33-year-old mother who lives in Brookfield and has chosen to sleep with each of her six children. She is troubled by Milwaukee's safe-sleep campaign.

"I get disgusted," Ticcioni said. "I get angry."

No one would accuse Ticcioni of being a thoughtless or unloving mother. She home-schools her children. She works as a doula and a natural child birth educator. She and her husband believe the child-rearing decisions they make are in the best interest of their children.

She says Milwaukee's campaign against co-sleeping is unhelpful and offensively morbid.

"People are going to do it," she said.

"Instead of depicting that horrible, horrible outcome, they should be focusing on safe co-sleeping."

City officials disagree.

"There is no such thing as safe bed-sharing," said the Health Department's Anna Benton, director of family and community health services.

She said that while she recognizes that bed-sharing is part of many cultures and traditions, "bed-sharing is a behavior."

"It's an individual decision we are trying to discourage by providing facts."

But traditions are hard to change.

Perhaps no one knows that as well as Sarah, a 35-year-old mother of four whose 8-month-old daughter, Elena, died in September when, left alone in an adult bed, slipped to the floor and died with a blanket wrapped around her throat.

"You die along with them," said Sarah, who for her family's security asked that her last name not appear in the newspaper.

"That is the hardest part, trying to find your way back. You are never, never, never the same."

Sarah shared her bed with all her children. It was, she says, the right thing to do.

And, she says, she would do it again.

Sarah's 8-month old daughter died because she was sleeping in an adult bed, yet Sarah, mother of four, says she would do it again.

WHAT?

Sarah says:

"You die along with them."

"That is the hardest part, trying to find your way back. You are never, never, never the same."

No.

She is the same. She says she'd do it again. Although she suffered the loss of her daughter, she didn't learn from her baby girl's death.

That is stunning.

Sarah says she died along with her daughter, but she'd do it again.

She must have a death wish.