Despite several years of declines and a public health campaign, the number of babies in Baltimore who die while sleeping in a bed with a parent or caregiver remains a persistent concern, the city's health commissioner said.

Dr. Oxiris Barbot said she is concerned about the number of "co-sleeping" deaths this year: There have been 11 confirmed cases of sleep-related infant deaths, a category that includes babies who were smothered by someone accidentally rolling over on them as well as incidents of sudden infant death syndrome or other unexplained causes of death.

The number of sleep-related deaths had been going down slightly in recent years, from 16 in 2010 to 15 and 14 in the next two years, according to the city Health Department. But when it comes to deaths in which another person accidentally smothers a baby, Barbot said, the number should be zero.

"It's absolutely preventable," she said. "There should be no situation where a parent or caretaker rolls over on a baby."

For several years, the Health Department has waged a "Sleep Safe" campaign in which the message has been reduced to the simplicity of A-B-C: Babies should be put to sleep alone, on their backs, in a crib.

All new birth mothers in Baltimore are shown a video before they leave the hospital in which parents who have lost children to co-sleeping or crib accidents speak tearfully about the need to practice sleep safety. Such measures have helped reduce infant mortality in Baltimore to 9.7 per 1,000 live births — an all-time low — and officials say they want to guard against losing those hard-won gains.

"The issue now is making sure we don't lose the progress that we've made," Mayor Stephanie Rawlings-Blake said. "Far too often, exhausted parents make fatal mistakes when it comes to co-sleeping.

"You think, 'It's just this one time,' and then you wake up on top of your baby. We want to make sure that people understand. I've been there. I've been that tired that you can barely lift your head up," she said. "You have to make sure the baby is alone and in the crib. It's an important campaign we have to continue so we don't lose the ground we've made."

Dearea Matthews continues to work on the campaign four years after her son died of SIDS — first appearing in the video and then taking a job with the Health Department as a peer mentor for other mothers. The video is so widely circulated that she is sometimes recognized by people who tell her, "You're Charlie's mother."

"Everyone knows his name, so he lives on," Matthews, 28, said. "That is special for me."

And yet, as she relates on the video, Matthews would do anything to go back before that day four years ago when she and her husband woke up to find the 1-month-old dead in their bed.

Matthews said her two older children had slept in bed with her to no ill effect. While she had cribs for all of them, sometimes she or the baby she was nursing would doze off and mother and child would remain in bed together until morning. Now, though, she tells parents to always make sure to put their babies back in their cribs.

"You don't ever want to risk a child's life," she said.

Barbot said health officials regularly review child fatalities in the city, evaluating the cause and looking for ways to prevent them. It was during such a review that officials noted "an increase in the number of events around the deaths where co-sleeping has been cited as a factor."

The roll-over deaths tend to garner the most attention, here and elsewhere. Last month, a "highly intoxicated" Hagerstown woman was charged with manslaughter and other crimes after passing out while breast-feeding her 2-month-old daughter and smothering her, according to the Washington County sheriff's office.

And recently, Muriel Morrison, 41, of Baltimore pleaded not guilty to manslaughter, reckless endangerment and other charges stemming from the asphyxiation death of 5-month-old Ilzaryah Morrison. She is scheduled to go on trial in January.

Police found the girl unresponsive when they were called to a home in the 1600 block of North Broadway on Sept. 2, and her death was ruled a homicide 21/2 weeks later. According to news reports, neighbors and friends said the girl was accidentally killed when her mother rolled over her in bed.

The city Health Department and the nonprofit Family League of Baltimore jointly work to reduce infant mortality through the B'more for Healthy Babies campaign. It was started in 2009 with a $3 million grant from CareFirst BlueCross BlueShield, which provided another $1 million to the initiative last year. The city used the CareFirst funding to raise more than $3 million in additional grants for program, which promotes child and maternal health through a variety of campaigns.

The most prominent of the efforts has been the safe-sleep message promoted through pediatricians, community groups and a series of videos in which parents speak about personal tragedies involving their infants' sleep-related deaths.

Dr. Gena O'Keefe, a director of the Family League, compared the efforts to get parents to practice safe-sleep habits every day to the campaign that ultimately succeeded in making many drivers buckle their seat belts every time they get in the car.

"It is a behavior change," O'Keefe said. "It's a risk-reduction strategy. Every time you put your baby to sleep, put them to sleep safely."

Still, she said, there are times when otherwise vigilant parents will slip up. "It ultimately just boils down to people making a choice in the moment," O'Keefe said. "Maybe they're exhausted; maybe they've been breast-feeding."

Barbot said that while cases of parents who are drunk and roll over on their babies tend to get the headlines, those incidents are not the norm. "The sad reality is this can happen to anyone," she said.

Barbot said health officials are continuing to spread the message of safe sleep to more audiences. The B'more for Healthy Babies videos, previously directed at new mothers, have expanded their scope. One features fathers, for example, and another is in Spanish.

"We are focused on increasing the venues where the videos are shown," she said.

Already, they can be seen on healthybabiesbaltimore.com and are sometimes shown to jurors at the courthouse. At some point, you might see them on a screen while riding in the back seat of a cab, Barbot said, in place of "something silly like 'Jeopardy' or 'Wheel of Fortune.'"

"The reality is moms are not always the sole caregivers," she said, meaning the potential audience is vast: "Dads, grandparents, baby sitters, day care centers — anyone anywhere who ever comes in contact with an infant."

jean.marbella@baltsun.com

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