The Baby and the Bathwater

This evening on Facebook, I came across a post that caught my attention.  It was a picture of a baby.  I have a thing for cute, sleeping babies, so I looked closer... And, to my horror, I discovered that the image was of a baby sleeping in a bed with - get this - a butcher knife. The title across the top of the image reads, "Your baby sleeping with you can be just as dangerous."  These shocking, ghastly images are put out by the City of Milkwaukee Health Department, part of a campaign from the Mayor's office to reduce the abominably high rates of infant mortality in their city.

It turns out that Milwaukee has had an unusual number of infant deaths that occurred while the child was bed-sharing.  Or so it would seem.  The City Health Department claims that 89 infants died in an "unsafe sleep environment" (which is not exclusive to bed-sharing) from 2006-2009.  (In the US in 2000, only 60 deaths are reported to have occurred in an adult bed, whether or not it was related to being in the bed.)  Even the Milwaukee Health Department acknowledges that there are multiple factors involved in these tragic deaths.  In fact, it doesn't appear that being in bed with a parent or caregiver is actually the most common factor!

Still, they have decided to vociferously work to undermine bed-sharing.  For the first time in my life, I was compelled to write to those in charge of making this abhorrent ad campaign.  Following is the letter I emailed to the Mayor of Milwaukee, Tom Barrett.  I encourage you to also write to the Mayor's office and the Department of Health and encourage them to withdraw these provocative, misleading ads.

Mayor Barrett,

I have recently been made aware of an upcoming publicity campaign directed by your office with the purported goal of reducing infant mortality.  The ghastly image of a child sleeping with a butcher's knife is certain to evoke emotion - but unfounded fear of bed-sharing with an infant will not, in fact, affect your city's infant mortality rates.

While you have had some notable deaths in your area related to bed-sharing, you have neglected to see the underlying and root cause of the problem.  It is not sharing the bed that is harmful; it is doing so when impaired (i.e., drunk) and, moreover, doing so when not breastfeeding.  

Dr. James McKenna of Notre Dame has done extensive research on mother-baby sleep patterns.  His summary of risk factors for infant death in bed-sharing are as follows:

"In sum, overwhelmingly, bedsharing deaths are associated with at least one independent risk factor associated with an infant dying. These include an infant being placed prone (on its stomach) and placed in an adult bed without supervision, or no breastfeeding, or other children in the bed, or infants being placed in an adult bed on top of a pillow, or who bedshare even though their mothers smoked during the pregnancy therein compromising potentially the infants ability to arouse (to terminate too little oxygen, or to terminate an apnea). 

Drug use and alcohol have historically been associated with poor outcomes for bedsharing babies so if drugs and/or alcohol are present, please don’t bedshare."

(Source:  http://cosleeping.nd.edu/frequently-asked-questions)

Bed-sharing with a sober, clean, non-smoking, breastfeeding mother in a suitable environment is not only safe but actually safer for the baby, as the mother is immediately available to any distress, illness, or need.  It is a normal, healthy human behavior that should not be discouraged by any government office.

(Sources:  http://www.askdrsears.com/topics/sleep-problems/sids-latest-research-how-sleeping-your-baby-safe

and http://cosleeping.nd.edu/ - video)

How much better would it be for your office to undertake education and support for your at-risk population to initiate and continue breastfeeding?  The benefits of breastfeeding are multifold and bed-sharing while breastfeeding is rarely harmful; indeed, the opposite.  Your bed-sharing concerns could be reduced or eliminated by educating mothers and supporting them in providing the most perfect, healthful feeding for their babies.  The rates of breastfeeding in African American mothers is significantly lower than other demographics.  The poorer and younger the mother, the less likely she is to breastfeed, as well.  Addressing these issues will have long-term benefits to your city and the generations to come.

(Source:  http://www.breastfeeding.com/all_about/all_about_more.html

and http://www.cdc.gov/nchs/data/databriefs/db05.htm)

Would it not also make sense to address the issues of drug and alcohol abuse, which present significant dangers to mothers, their children, and society?  There are, in fact, numerous factors that have led to the abysmal infant mortality rates in your city.  Addressing these issues is admirable and needed, but the attack on a normal, nutritive, safe practice is abhorrent.

Let's not "throw the baby out with the bathwater," shall we?

Sincerely,

H. B.

I dare say that providing accurate, research-based information on creating a safe sleeping environment would be far better, in the long run, for all of the children of Milwaukee.