What the Experts Say
Experts aren't certain whether strangulation and suffocation are actually more common now; it's possible that local examiners investigating the deaths are simply more willing to use those labels than SIDS. "Years ago, there was a movement away from putting 'strangulation' and 'suffocation' on a death certificate, because it could be seen as blaming the parent, but that stigma seems to be fading because people are starting to realize that there are other potential causes," says John Kattwinkel, M.D., professor of neonatology at the University of Virginia, in Charlottesville, and chair of the AAP Task Force on SIDS.
Still, some SIDS researchers are convinced that the recent rise is real, and they attribute it to the fact that more parents are now sleeping with their baby. The CDC report found that more than half of the deaths for which sleeping location was noted involved a form of cosleeping, says Carrie Shapiro-Mendoza, Ph.D., lead epidemiologist in the CDC's division of reproductive health. Bedsharing increases the chance that a parent could accidentally smother a child, and an adult bed is also filled with pillows, sheets, and blankets that pose a danger.
Frank didn't intend to sleep with his baby, but for many parents, bedsharing has become a way of life. In 1993, 6 percent of U.S. infants under 8 months usually shared an adult bed. That rate more than doubled by 2000, according to a report from the National Institutes of Health. And a recent study in Pediatrics found that a third of families share their bed with their baby -- at least sometimes -- for the first three months, and 27 percent continue for a year. "Bedsharing is more popular because breastfeeding rates are up, and many breastfeeding mothers advocate it. Formula-feeding parents also like the convenience," says study author Fern Hauck, M.D., associate professor of family medicine and public health sciences at the University of Virginia School of Medicine and an AAP SIDS Task Force member.
Studies have proven that babies are safest in their own sleeping space -- be it a crib, a bassinet, or a cosleeper attached to the side of the parents' bed. That's why the AAP Task Force on SIDS recently reaffirmed its 2005 policy statement, which advises against bedsharing and offers other safety precautions. "At this point, most parents know they need to put their baby on his back. Now we need to focus their attention on other risk factors too," Dr. Kattwinkel says. If all parents stuck to these recommendations during their baby's first year, and especially the first six months, the peak time for SIDS, strangulation, and suffocation, many more babies could be saved. This isn't just wishful thinking. Dr. Hauck's recent study comparing death rates in developed countries found that in ones like the Netherlands, where parents closely obey SIDS guidelines, sudden infant deaths have practically disappeared. In contrast, the rate in the U.S. remains one of the highest in the world. That's why it's crucial to follow safe-sleeping rules from the moment your baby is born.