July 2016
Here in the United States, the push to completely ban bed-sharing or co-sleeping, co-bedding, and the like is going full force. This provides a great deal of controversy on many levels, and concerns are being voiced about the increase in very unsafe sleeping arrangements. Sofa, recliner chairs, cribs filled with pillows, blankets, toys and bumper pads are posing new risks to the babies who are no longer in close proximity of their breastfeeding mother.
Judy Beal, DNSc, RN, FNAP, FAAN addresses one aspect of this situation in her article, "Infant Deaths From Use of Crib Bumpers Are Increasing." (p 253). Although the data seems a bit old, it is very frightening to see a threefold increase in crib bumper related deaths between 2005 to 2012 than those in the years 1985 to 2005. Beal reports, "Crib bumpers caused 48 suffocations, 67% of which were caused by the bumper alone and 33% by the infant being wedged between a bumper and another object in the crib. Beal shares information contained in the U.S. Consumer Product Safety Commission (CPSC) report. "The mean age of the infants involved in these crib deaths was 4.6 months, with 50% less than 3 months and 90% less than 7 months."
Crib bumper pads were developed to protect infants and young children from becoming entrapped between the crib slats in the years prior to the manufacturer guidelines being changed to spacing less than 2 3/8" or narrower between slats. At this point, there have been no US Federal regulations put in place to safeguard against bumper use. Therefore, companies can continue to produce and sell what is now considered to be an unsafe product for use with infants and young children.
As an aside from this article, the Step 2 Education team attended the 2016 annual conference for the International Lactation Consultant Association, in Chicago, Illinois, USA. At several sessions, the issue of where infants can and should sleep safely were discussed, reinforcing the well-researched issue of co-sleeping, including information from the World Health Organization. One session even documented the much higher number of infants who die in the crib environment vs. the co-sleeping environment, which includes bed-sharing, close proximity (separate but shared space), and separate sleep areas within the same room. The scare tactics used by some US organizations in a one-size-fits-all promotional campaign does not take into account this research. Nor does it consider the research showing the maternal nearness actually teaching infants to come into a natural deep/light sleep pattern, as is done in all mammals worldwide.
For those of us who work in a facility that has "outlawed" discussion of any type of co-sleeping, how do you handle the discharge teaching on safe infant sleep? Do you teach that sleeping on the couch or recliner is more unsafe? Let's get a discussion started on this topic.
Kathy Parkes, MSN-Ed, BSPsy, RN, IBCLC, RLC, FILCA
Professional Development Educator, Step 2 Education International
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