The U.S. Consumer Product Safety Commission (CPSC) is warning parents and caregivers about the dangers of placing babies to sleep in adult beds. A CPSC study published in the October issue of the Archives of Pediatrics and Adolescent Medicine found that placing babies to sleep in adult beds puts them at risk of suffocation or strangulation. This is a danger of which many parents and caregivers are unaware. The study revealed an average 64 deaths per year to babies under the age of 2 years placed to sleep in adult beds, including waterbeds and daybeds.
A review of incident data from January 1990 to December 1997 linked adult beds to at least 515 baby deaths. Analysis of the deaths revealed four major hazard patterns:
- Suffocation associated with the co-sleeping of adult and baby.
- Suffocation where an infant becomes entrapped or wedged between the mattress and another object.
- Suffocation due to airway obstruction when the baby is face down on a waterbed mattress.
- Strangulation in rails or openings on beds that allow a baby's body to pass through while entrapping the head.
CPSC's study is the first to quantify the number of fatalities resulting from the practice of co-sleeping with babies. Of the 515 deaths, 121 were reported to be due to a parent, caregiver or sibling rolling on top of or against the baby while sleeping. More than three-quarters of these deaths occurred to infants younger than 3 months. The other 394 deaths resulted from suffocation or from strangulation caused by entrapment of the child's head in various structures of the bed. Entrapments occurred between the mattress and the wall, bed frame, headboard, footboard, bed railings or adjacent furniture.
One of the most tragic aspects of these deaths is that they are largely preventable. In many cases, the adult placing the baby in the adult bed was unaware of or underestimated the danger posed. The practice of co-sleeping can result in the adult rolling on top of or next to the baby smothering him or her. Mothers who breastfeed should be alerted to this hazard and should be encouraged to return the baby to the crib after breast-feeding.
"Don't sleep with your baby or put the baby down to sleep in an adult bed," said CPSC Chairman Ann Brown. "The only safe place for babies is in a crib that meets current safety standards and has a firm, tight-fitting mattress. Place babies to sleep on their backs and remove all soft bedding and pillow-like items from the crib."
Of the 394 entrapment deaths, 296 were on adult beds, 79 were on waterbeds and 10 were on daybeds. Bed rails, which are portable railings that can be installed on toddler and adult beds to keep toddlers from falling out of beds, accounted for nine baby deaths. CPSC is working with the bed rail industry on the design of these products to reduce the hazard. The following chart provides more details on the fatality scenarios from entrapment and co-sleeping.
Wedging between mattress and wall
Wedging between mattress and bed frame, headboard or footboard
Entrapment between mattress and adjacent furniture
Strangulation between bed railings
Entrapment between portable bed rail and mattress
Suffocation on a waterbed mattress
Co-sleeping death (rolling on top of or against baby while sleeping)
Total (entrapment + co-sleeping)
For 1998 and 1999, the Commission is aware of at least 76 additional deaths, 35 due to suffocation associated with co-sleeping and 41 due to entrapments. The Archives of Pediatrics and Adolescent Medicine, a member of the Journal of the American Medical Association family of journals, study "Adult Beds Are Unsafe Places for Children to Sleep," primarily written by CPSC's Suad Nakamura, Ph.D., was co-authored by Marilyn Wind, Ph.D., (CPSC) and Mary Ann Danello, Ph.D., (CPSC). Nakamura gave details about the findings at an AMA briefing in New York today.
CPSC has also issued a Safety Alert warning against placing babies in adult beds.