Beware the Bassinet
In the hope of reducing deaths of babies from sudden infant death syndrome, or SIDS, the American Academy of Pediatrics recommends babies sleep in their own space, such as in a crib or bassinet. But bassinets, it turns out, may not always be so safe, new research shows.
Jodi Pike and Rachel Moon at the Children's National Medical Center in Washington reviewed all 54 deaths of infants involving bassinets reported to the Consumer Product Safety Commission between 1990 and 2004. Eighty-five percent of the babies suffocated. More than 30 percent had been placed on their stomachs to go to sleep. About 50 percent were found face down. In 74 percent of the cases, other items, such as soft bedding, were in the bassinets.
Based on the findings, published in The Journal of Pediatrics, the researchers urge parents to always put their babies to sleep on their backs and never put loose items such as blankets or pillows in the bassinet with the baby. Babies placed on their sides tend to roll onto their stomachs.
In 17 percent of the cases, a mechanical problem was found with the bassinet: for example, the bassinet collapsed, or had a broken wooden slat or leg or malfunctioning stabilizing clips, which caused the mattress to shift. So parents should also make sure their bassinet is in good shape and conforms to government safety guidelines. In four cases, the bassinet had a mechanical swing or pendulum. The researchers speculated such devices could cause the baby to move to a corner, where suffocation is more likely.
Because six of the babies were found with their faces wedged against the side of the bassinet, the researchers suggest that bassinets with sides made of permeable material such as mesh may be safer.
In a related article , the researchers reviewed the sleep locations of 708 mothers and their infants using data collected from several Women, Infant and Children (WIC) centers in 2005. They found that about a third of the mothers and infants slept together, a practice that is discouraged because of the danger of SIDS.
Where does your baby sleep?
By Rob Stein |
July 17, 2008; 7:00 AM ET |
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Posted by: Anonymous | July 17, 2008 7:41 AM
My daughter slept in a bassinet for about a week, then we slept in a twin bed in the nursery together for about 5 months because it was the only either of us would get any sleep! at about 6 months, i put her in a crib when her sleep patterns evened out and she wasn't nursing so often at night.
Posted by: kristen | July 17, 2008 8:02 AM
my baby slept in the Arms Reach co-sleeper for the first 6 months and has been in his crib for the past 4 months now. but there have been plenty of times where he has slept with me, on my chest (in my arms while i sort of sat propped up). suffocation during sleep (SIDS) is indeed a parent's worst nightmare. We are so careful, but still have to do what's comforting to our baby. The article should note that once babies are able to roll over (around 6 months), you can let them sleep on their tummies. that really helps them sleep better, i think.
Posted by: wats | July 17, 2008 8:21 AM
The only way our baby would sleep as a newborn was on us, so he ended up sleeping on my husband's chest for his first 12 weeks. For about two weeks after that the baby slept swaddled in his bouncy seat (vibrating ALL night). Baby went to his crib after that -- still swaddled. And at around 4 1/2 months he gave up the swaddle. Now he's almost 7 months and he is a full on tummy sleeper. I know that having him in our bed as a wee baby wasn't the safest, but it was the only way anyone got any sleep, and at the time that was the most critical issue. And it was really the sweetest thing to look at him all snuggled up like that.
Posted by: By any means possible | July 17, 2008 8:35 AM
Our baby would actually push himself up against the edge of the bassinet. He clearly has the urge to be next to someone, and this was the only way he would sleep.
I've read several sets of literature. Right now (4 months) he is in bed with us. He has stayed on his back so far and seems very happy and we all sleep better. What are the stats on cosleeping versus babies in the crib?
Posted by: Jon | July 17, 2008 8:41 AM
I'm amazed at the fact that most of these comments seem to ignore totally all of the guidelines to follow in order to prevent SIDS. And yet, they are posted all over the internet a million times. It seems to me that hospitals should give parents a guideline sheet when they leave with a newborn.
One thing I have read over and over and over is that the absolute worst thing you can do is to fall asleep with the baby in your arms. There are a million methods to use before giving up and opting for this very dangerous solution. My sister's baby just wouldn't sleep, but after a few weeks of these methods combined, it all worked out. Never did she fall asleep with him nor allow anyone else to.
Another thing that surprises me is how some bassinets seem to clearly be unsteady, and yet they remain on the market. And all of that fabric!! It makes me feel suffocated just looking at it.
Posted by: laneyjane | July 17, 2008 10:10 AM
I'm a big believer in the benefits of co-sleeping--establishing healthy sleep patterns for the infant, encouraging breast feeding, establishing parental attachment, allowing parents better rest. I personally found it easier to monitor my baby, whether during illness or just to help her get back to sleep when she started to wake up. But there are some precautions we can all do to prevent against SIDS, even when co-sleeping, so it's rather misguiding to say you can't co-sleep at all and still be safe. Rather than discouraging co-sleeping, we should be encouraging using safety precautions instead. For example, products are on the market such as the co-sleeper mentioned above or in-bed dividers that allow the baby to stay free of bedding. Additionally, staying free of influence of alcohol or other drugs helps keep parents aware of their location and the baby. Common sense. Obviously co-sleeping doesn't work for everyone, but when done with precautions in place it can help baby and mom. Accidents can clearly happen anywhere, whether in the crib, bassinett, or bed.
Posted by: Kristin | July 17, 2008 11:42 AM
Actually for years it was acceptable to sleep with one's infant because it was thought that it entrained the child's breathing to yours and helped them breathe better. It was observed that mothers who slept with their infant were aware of the position of the infant even in their sleep. It was said that it was only dangerous if the parent was very overweight, or under the influence of medication or drugs that made sleep deeper. Then, a review of the data a couple years ago showed that sleeping with the child was associated with a slightly higher risk of SIDS than allowing the child to sleep alone.
So given that the recommendation is recent and the association between cosleeping and SIDS so tenuous that it was missed for years, I think it is incredibly silly to castigate parents for not "following the rules".
Obviously, every parent wants to do what is best for their child. Some parents may feel that sleeping next to their child will allow them to get enough sleep that they will be alert during the day, and therefore a safer parent. It's probably difficult to understand how unsafe sleep deprivation makes you unless you have been there.
Posted by: middle70 | July 17, 2008 11:54 AM
Both of my kids slept in a bassinet beside my bed for two weeks before moving to their own room and sleeping in the crib and they are both excellent sleepers. For our family, we have found that we all sleep better in our own beds!!
Posted by: Mom of 2 | July 17, 2008 12:13 PM
"It's probably difficult to understand how unsafe sleep deprivation makes you unless you have been there."
Amen. When you can't get more than 90 minutes of sleep at a time, you don't think straight. There's a reason they use sleep deprivation at Guantanamo. My sister-in-law got so sleep-deprived with her first that she found herself driving straight through a red light. I think the baby would have been a lot safer sleeping on Mama's chest at night than he was in the back seat of that car. You can't parent by statistics alone. You have to use your judgment.
Posted by: Katherine | July 17, 2008 1:44 PM
Amen, Kristen, Katherine, and middle70! Laneyjane, maybe that guideline sheet from the hospital could be tucked in with all the formula coupons they hand out. Mindfully deciding to have the baby sleep in the bed is not the same as "falling asleep with a baby in your arms".
I did not intend to have our baby sleep with us, but when I'd get up to nurse her in the night, I'd be a complete hazard the next day. When I brought her into bed to nurse, we both did better, and then one night I fell asleep while she nursed. And you know what? I did not squish her. After that, we followed the safety guidelines for co-sleeping and quit worrying about what worked for anyone else. She is happily sleeping on her own now, but I wouldn't trade the time we spent snuggling in the night.
Posted by: Heather | July 17, 2008 2:08 PM
Frankly, I wish we could get away from all the hysteria. I brought my eldest son (now 26) in bed with us from about 9 months to about 18 months. I did that after a month of listening to him "cry it out", which meant he screamed until he vomited on himself, and was so worked up he couldn't sleep more than 3 hours at a time (so I couldn't either). Considering that most of the world brings their babies into bed with them, where are the statistics that show this is dangerous? How many dead babies are there each year in America, killed by sleeping with their parents? Were these parents drunk or on drugs? This is all just such BS, and I'm really tired of all the judgemental nanny-ism out there. Sleep with your babies if you want to. Don't do it if you don't.
BTW - my second son couldn't stand to sleep in bed with us, not even as an infant. He much preferred being alone in his crib. So that's where he slept. Not a problem.
Posted by: greensleeves | July 17, 2008 2:16 PM
I am amazed that any baby can grow up now a days with all the warnings and do's and don'ts compared to when I was a kid. Actually I am surprised I didn't die as an infant...
Posted by: Krazijoe | July 17, 2008 2:37 PM
I absolutley cannot believe the comments in blind support of co-sleeping. I work in a children's hospital and spent my day yesterday with a family whose newborn died while they were cosleeping. Do what you want with your own kids, but please be aware of the facts. You are putting your infant in danger just by having them in bed with you. Which do you prefer -- a few nights/weeks where you and possibly your baby lose sleep while you work on having them sleep on their own or a dead baby? Just because your infant might have made it through cosleeping without suffocating does not mean that your child wasn't at increased risk during the process.
Posted by: Good Luck | July 17, 2008 2:42 PM
Previous commenter:
You are putting your infant in danger just by having them in bed with you. Which do you prefer -- a few nights/weeks where you and possibly your baby lose sleep while you work on having them sleep on their own or a dead baby?
***
Comments like these are so frustrating because they do nothing to help. The first step in helping would be to recognize the realities of life (and sleep) with a baby. It takes most children months to sleep through the night, if not more than a year. Many pregnant women have interrupted sleep for months before delivery because aches/pains/urination needs/baby movement/etc. So we're now talking about years of sleep deprivation.
Sleep deprivation is a dangerous situation that causes serious medical problems, both short and long-term. Local governments have been debating laws about creating punishments for "sleep-impaired" drivers who cause accidents, much like drunk/drugged drivers.
It's so unfortunate (and to my mind, outrageous) that some people who put themselves out there as advocates for SIDS prevention are actually advocating behaviors that increase the dangers for children. No, they may not die in their parents' bed, but they are more likely to die in a car accident if they follow some of this advice.
Just remember, there are safe ways to do most things as well as dangerous ways. Bleach can kill and yet most people have it in their homes. Let's all try to remember to use common sense, reasonableness, and most of all, empathy, when discussing these important parenting topics.
Posted by: Frustrated | July 17, 2008 3:07 PM
I think if you read though the reports on many of the co-sleeping deaths, (I was a former reporter and wrote a few myself) the parents make many of the same mistakes: drinking or using drugs, having lots of sheets, blankets and fluffy quilts in the bed, and not understanding their own sleep habits. I never co-slept with my son because I'm a really deep sleeper. I've rolled over on my cats, who always fought back, and I could easily see it happening with a baby.
I've seen parents who make a serious commitment to co-sleeping by doing things like moving the mattress onto the floor and using mesh rails along side the bed to protect against falls and entrapment, and sleeping without any blankets or pillows until the child is out of the bed. BOTH parents also abstain from alcohol and even OTC medication like decongestants. I think their kids are probably more safe than the ones in the cribs I've seen stacked high with pillows, quilts and stuff animals.
I think the bigger risk comes from the "in the moment" parent who isn't used to co-sleeping and does it out of fatigue without taking the above precautions. They're exhausted and not thinking in terms of safety. If you're not willing to make your bed meet the same requirements as a safe crib every night, then your child is safer in a crib.
Another note on media coverage--these "layover" deaths attract a lot of attention, but I've never read or written a newspaper story about a baby that died in a crib. I think the public health system always wants to get the word out about how dangerous co-sleeping is, but they forget parents need just as many reminders about all the fluffy stuff they put in cribs. No matter where your baby sleeps, just have a sheet and a warm sleeper--that's all they need.
Posted by: seen it before | July 17, 2008 3:45 PM
Even though I put my first-born son in a bassinet, I was leery. There was no air ventilating freely as would have been with mesh surroundings or a crib. So that lasted only about a week.
Also, I know what the research says, but I allowed my two children to sleep on their stomachs. My logic was that if they threw up, it would go out of their mouths and onto the crib (of course, they could've rolled over and suffocated in the vomit, I know), as opposed to throwing up and it laying in a pool in their throat and causing them to choke. Also, sleeping on my back gives me a feeling of suffocating and I've awaken startled in the middle of the night feeling that way.
Even in the NICU where my preemie remained for three months after his birth, they laid the babies on their tummies.
The blessing is that neither of my children died in their sleep, and I pray the same for all babies.
BTW: Dad said we were not going to spoil our first-born by allowing him to sleep with us, but mysteriously this infant would grow tinker-bell wings and end up in our bed every night after I fell asleep! And guess who was holding him??!!
Posted by: luv2laff11 | July 17, 2008 5:52 PM
This topic always seems to draw such polarity. I think it is important to remember that no one understands WHY SIDS happens. If a child dies alone in a crib, the death is attributed to SIDS. If that same child were to die in bed with his parents, it suddenly becomes reason to rant against cosleeping. Suffocation (whether in a crib or in bed) is not SIDS. SIDS is the UNEXPLAINED death of an infant. Whether sleeping in a crib or in a bed, parents MUST take measures to make sure that the sleeping environment is as safe as it can be. I think most of the judgment that is thrown around regarding infant sleeping habits is a result of our fear and frustration that these deaths keep happening and we don't understand why. The assumption is that if I follow a set of rules to the letter my child won't be at risk...
Posted by: a few points | July 23, 2008 9:25 AM
Is it really that difficult to just say "hey there is a RISK of my child dying in my bed but there is ALSO a risk of my child dying in the bassinet?" It's the truth people, there are mothers who delivered perfectly healthy intelligent babies who drank wine or did crack the entire pregnancy and I'm sure no one here could convince any of them that those practices were harmful to the fetus. Same thing here, it's been proven harmful so now you gotta be careful. Plain and simple.
And really is it THAT hard to have the baby sleep in a crib near thebed? Is that so far away that it would hinder sleep? I mean unless you're sleeping with your nipple in your child's mouth all night then at some point you WILL lose sleep to nurse and hopefully burp your baby. It's part of parenthood, get over it.
Posted by: Mrs | July 24, 2008 3:06 PM
This article is slightly absurd... 54 infants died in bassinets over 14 years. That's less than 4 per year in the US.... I highly doubt there is any serious issue here.
Posted by: Joe | July 25, 2008 3:20 PM
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Both slept in a crib, which also turned out to be more cost effective because the crib had removable sides so that it became a bed. My oldest used her "crib" until she was five. I also felt more comfortable because the crib was much sturdier.