Sharing a bed with baby can be risky

By MARTIN JOHNSTON

More than half of Pacific Island babies sleep on a mattress with an adult, a practice seen as contributing to cot deaths.

This rate, reported in the latest New Zealand Medical Journal, is significantly higher than that found in previous research.

There is uncertainty about the risk posed by bed-sharing, because it is also practised in countries where cot death or sudden infant death syndrome is rarely identified.

The authors of the latest study say bed-sharing is a greater risk if the mother is a smoker, and for infants under four months old.

The main official safety messages about reducing the risks of cot deaths are putting babies to sleep on their backs, having a smokefree pregnancy and home, and breastfeeding, if possible.

The Ministry of Health also advises that if a mother smokes, or smoked during pregnancy, then putting a baby to sleep in his or her own bed reduces the risk of cost death.

New Zealand's cot death rate dropped from 4.3 deaths for every 1000 live births in 1987 to 1.2, which was 67 deaths, in 1998.

The Pacific rate in 1998 was 0.7, the same as for Pakeha and "other" ethnic groups. For Maori the rate was 2.4.

The ministry attributes part of the overall reduction to reclassification of some deaths as accidental suffocation, another factor in bed-sharing.

The study, by the Auckland University of Technology and Auckland University, had researchers interview 1376 mothers of 1398 infants (some were twins) born at Middlemore Hospital in 2000.

The interviews, taken six weeks after the birth, are part of a two-year study of Pacific Island families, the largest yet of its type.

Nearly 55 per cent of the mothers said their infants shared a mattress with other people. Of these infants, 80 per cent shared with one person, and 20 per cent with two or more people.

A 1998 study of bed-sharing by babies aged three months found a rate of 40.4 per cent for Pacific infants, compared with 20.2 per cent for Maori and 5.7 per cent for all other groups.

Associate Professor Janis Paterson, one of the authors of the latest study, said doctors and nurses working with Pacific families should be aware of the study's findings.

"Then they can highlight to expectant mothers and mothers of young babies that this may be a risk factor."

Dr Shirley Tonkin, a paediatrician and founder of the Cot Death Association, said that mattresses on the floor were often less dangerous for babies than those on beds, because elevated beds often had a greater "roll-together factor".

She said sharing was a bigger risk if it was with a smoker.

"The big debate is whether it's the smoking or the proximity.

"I'm interested in the anatomy of babies and they're very vulnerable in the first six months.

"It's very easy to displace their jaw back and block the airway.

"I have the strong impression it's the baby who does the moving, not the mother."

nzherald.co.nz/health