ME: Co-sleeping a factor in Iowa infant deaths

Co-sleeping — a controversial practice where parents sleep with infants — was a contributing factor in four infant deaths this year and at least seven deaths over the past two years, according to an Iowa medical examiner.

Des Moines police on Wednesday urged parents to stop sleeping with their children after reporting that three infants had died of apparent suffocation within the past week, after their parents rolled on them in their sleep or left them with a loose blanket.

Polk County Medical Examiner Gregory Schmunk said co-sleeping with an adult was a significant factor in the deaths of the four infants this year.

But he said Thursday that the official causes of death still are medically "undetermined" and the cases are pending.

"In none of these cases do we have good evidence right now that the co-sleeping parent actually rolled over on the child," Schmunk said. "We may develop that later, but we're too early in the investigation."

Co-sleeping was not involved in the possible suffocation death of an infant, age 15 months, who died April 21 after a blanket was left in the bassinet where the child was sleeping. Schmunk said that investigation also is pending and an "unusual sleeping condition" is a factor in the death.

Facts garnered from police on infant fatalities, Schmunk said, don't rise to the level of "reasonable medical certainty" to determine a cause of death.

Des Moines Police Sgt. Jason Halifax clarified Thursday that suffocation or smothering is considered a possibility in the deaths of four children since April 21, including three in the past week.

Still, Schmunk said he can't recall a time when he had investigated three infant deaths within four days under these circumstances.

Callen Boutchee, the grandmother of 2-month-old Kingston Ware, who died Wednesday, said co-sleeping had nothing to do with the baby's death.

The baby's father, Demassion Ware, was sleeping in the bed with Kingston, who had a sinus infection, she said. Ware woke at one point to reposition the baby, Boutchee said.

When the baby's mother returned from work at 7 a.m., she found her son had passed away.

"The daddy was worried so much that he had him in bed with him," Boutchee said. "But he didn't have anything to do with his son passing away. ... That baby was loved."

In all, six Polk County infants have died this year. The first, on Jan. 28, died of a virus and infection, according to Schmunk's findings.

CO-SLEEPING FACTOR IN 2014 DEATHS

Of the 10 Polk County infants who died in 2014, three had definite evidence of co-sleeping, Schmunk found.

Another two had evidence of prone sleeping, where babies were positioned on their stomach — a practice discouraged by child care experts during the baby's first year.

• An Aug. 4 death of a 4-month-old included definite evidence that the child was sleeping on its stomach on an adult's lap, which was a contributing factor, Schmunk reported.

• An Oct. 26 infant death indicated the baby was prone sleeping on comforter on an adult bed, but there was also an on-going medical condition, Schmunk found.

It's hard to prove what actually happened to an infant in these cases, Schmunk said.

Schmunk said none of the deaths could be attributed to sudden infant death syndrome.

SIDS-related deaths have dropped dramatically since the "Back to Sleep" program initiated in 1994 by the National Institute of Child Health and Human Development, he said.

Medical examiners nationally also have redefined SIDS to eliminate cases of infant deaths involving co-sleeping, sleeping on an adult bed or prone sleeping, Schmunk said.

"That is important to us because a medical examiner is really a public health person," he said. "And that tells us that many of these deaths are probably preventable."

MOTHER ADVOCATES SAFE CO-SLEEP

Despite warnings from some experts, co-sleep remains extremely common, with one study finding that an estimated 2 million babies share a bed with a parent.

Many parents and some experts believe co-sleep is beneficial, if practiced correctly.

Alissa Tschetter-Siedschlaw, a Des Moines mother, said she practices "attachment parenting," which includes some modified form of co-sleep or bed sharing with all of her five children.

She said early sleep sharing has helped her now 12-year-old son cope with reactive attachment disorder.

"I credit how far we've come due to being responsive at night, being able to ... snuggle him when he needed that," she said.

Tschetter-Siedschlaw said sleep-sharing is safe if parents follow specific rules: Don't sleep share if you're obese, under the influence of a substance, smoke or are taking prescription medications, she said.

Also, no fluffy blankets and no air mattress or water bed.

"It's not a one-size-fits-all parenting style," Tschetter-Siedschlaw said. "The most important thing in the philosophy of attachment parenting is being responsive at all hours so you're not punching off the clock because it's eight at night."

Tschetter-Siedschlaw put her mattress and box springs on the floor to decrease the chance of a fall at great distances and pushed it into a corner to eliminate places where a baby could get stuck.

"If it came down to saving the life of a baby, do I believe you should sleep-share at all costs? No way. What's more important is meeting the needs of a child," she said.

Mary Goldsberry, a mother of a 15-month-old and a developmental neuroscience researcher at University of Iowa, doesn't practice bed sharing or co-sleeping.

"When I was pregnant with her, I was so paranoid about sudden infant death syndrome, meanwhile I'm hearing 'don't co-sleep,' " Goldsberry said. "But in the first weeks, you're super exhausted. I would be on the couch sleeping and I would doze off."

Concerned about co-sleeping, Goldsberry and her husband would take turns holding the baby while on a couch or chair.

But Goldsberry was conflicted after reading research that said falling asleep sitting up could be just as dangerous.

"I had no idea I was engaging in such risky behavior," Goldsberry said.

While she's not an advocate or strong co-sleeping practitioner, Goldsberry stressed that other behaviors such as smoking or drug use are much more likely to cause an accidental death.

EXPERTS FROM DIFFERENT CAMPS

Janet Geyer, a nurse with the University of Iowa's Safe Sleep work group, teaches safe sleeping practices and performs quality checks on hospitals. Bed sharing is not encouraged.

She said the close proximity of baby to mother during the evening promotes breastfeeding of newborn babies, which is a big plus.

But the message she gives mothers is put the baby back into the crib, Geyer said.

Janna Day, coordinator of Safe Kids Greater Des Moines, stressed again that the American Academy of Pediatrics does not support bed sharing under any circumstances.

"It's not pointing fingers at the co-sleeping community," Day said. "But I have never found something credible to say there is a safe way to bed-share."

Bill Sears, a pediatrician who writes for askdrsears.com, said the safest place for a baby is in a bedside co-sleep bassinet.

"Baby and mother are close enough to each other for easier comforting and feeding yet they both have their separate sleeping surfaces," he said.

He said whatever sleeping arrangement gets the family the best night's sleep is the right arrangement.

"Imagine if you were a baby would you rather sleep alone in a dark room behind bars or close to your favorite person in the whole world, mom. The choice is obvious," Sears said.