Wednesday, October 14, 2009

Cot deaths linked to co-sleeping

According to an article published in the Irish Times today, more than half of cot deaths happen when a baby is sleeping with a parent, a study revealed today.

Researchers said this could be linked to the baby’s parent having been drinking or taking drugs.

Despite a dramatic drop in the rate of cot death in the UK since the early 1990s, experts are advising parents to avoid dangerous co-sleeping arrangements in order to help reduce these deaths even further.

A team of researchers at the Bristol and Warwick universities studied all unexpected infant deaths — aged from birth to two years old — in the south west of England from January 2003 to December 2006.

To investigate a possible link between cot death and socio-economic deprivation, they compared these deaths with a control group at ‘high risk’ — young, socially deprived mothers who smoked — as well as a randomly selected control group.

The parents were interviewed shortly after the death and information was collected on alcohol and drug use.

A detailed investigation of the scene and circumstances of death was also conducted by trained professionals.

Of the 80 cot deaths analysed, more than half (54 per cent) occurred while co-sleeping compared to one-fifth (20 per cent) co-sleeping rate among both control groups.

Much of this risk may be explained by the combination of parental alcohol or drug use prior to co-sleeping (31 per cent compared with 3 per cent random controls), and the high proportion of co-sleeping deaths on a sofa (17 per cent compared with 1 per cent random controls), say the authors.

A fifth of cot death infants were found with a pillow and a quarter were swaddled, suggesting potentially new risk factors emerging.

The researchers said some of the safety messages were getting across to parents and may have contributed to the continued fall in the cot death rate.

However, the majority of the co-sleeping deaths occurred in a hazardous sleeping environment.

The safest place for an infant to sleep is in a cot beside the parental bed in the first six months of life, the study published on bmj.com said.

The term sudden infant death syndrome (SIDS) was introduced in 1969 as a recognised category of natural death that carried no implication of blame for bereaved parents.

Since then, a lot has been learnt about risk factors, and parents are now advised to reduce the risk of death by placing infants on their back to sleep, placing infants in the ‘feet to foot’ position at the bottom of the cot, and

keeping infants in a smoke-free environment.

But it is not clear which risk messages have been taken on board in different social or cultural groups, and little is known about the emergence of new or previously unrecognised risk factors.

Lead author Prof Peter Fleming, Professor of Infant Health and Development Physiology at Bristol University, said: “We have been able to look at the conditions that make sharing a bed or sofa with a parent hazardous.

“People understand the implications of drinking and driving and the vast majority follow that advice.

“So we want parents — if they’ve had a drink or taken drugs — not to co-sleep with their baby.”

Prof Fleming said many parents got up in the middle of the night to feed their baby on a sofa or armchair — believing it was safer than feeding them in bed, however, the opposite was true.

“It is really important that parents should not fall asleep with their baby on a sofa as it is very, very dangerous,” he said.

“It is 25 times more risky than having a baby in bed with you.

“After parents have fed a baby it is really important they put them back in their cot.”

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