NEW YORK -- Parents should never sleep in the same bed with infants or toddlers under the age of 2, the federal Consumer Product Safety Commission warned yesterday, because sleeping together poses a significant risk of accidental smothering or strangling.
"Don't sleep with your baby or put the baby down to sleep in an adult bed," Ann Brown, the commission's chairwoman, counseled parents. The agency noted a new study indicating that over an eight-year period, 515 children under 2 -- an average of 64 a year -- died as a result of sleeping in adult beds.
The recommendation evoked outrage from some pediatricians and many mothers and fathers, who argue that sharing a bed is part of child-rearing in many cultures and that it is beneficial, promoting breast-feeding and strengthening bonds between parent and child.
"There is no way on this earth that a U.S. government official should make pronouncements about child-care practices based on a single study," said Dr. Abraham B. Bergman, a professor of pediatrics at the University of Washington.
Bergman and other critics said that while parents need to know about safety hazards associated with adult beds, an across-the-board warning against bed sharing is unwarranted. The commission's recommendations, they said, smack of cultural bias and will frighten parents unnecessarily.
The new study, presented yesterday in New York at a news conference sponsored by the American Medical Association, is based on data from death certificates, coroner's reports and media accounts for the years 1990 to 1997.
In 121 of the 515 deaths, the study found, a parent, sibling, or other adult sleeping in the bed had inadvertently smothered the child. More than three-quarters of the children who died from "overlying" were younger than 3 months.
In the other 394 deaths, children suffocated or were strangled after becoming trapped in the bed structure, ending up, for example, wedged between mattress and wall or between mattress and headboard. Older-style water beds presented a particular hazard to children, who could suffocate while lying face down on the bed, reported the researchers, led by Dr. Suad Nakamura.
Nakamura said the 64 deaths per year associated with adult beds contrasted with an average of 50 deaths each year linked to cribs, most of which did not meet federal standards.
"Placing children younger than 2 years to sleep in adult beds exposes them to potentially fatal hazards that are generally not recognized by the parent or care giver," Nakamura and her colleagues concluded.
A safer option for parents who want to keep their infants close to them at night, she said, is a "co-sleeper" bassinet, several models of which are on the market. The bassinets attach to the bed, but allow the child to sleep in a separate, protected space.
Critics of the commission's report, which will be published in the October issue of the Archives of Pediatrics and Adolescent Medicine, say the study's methodology is flawed.
For example, Bergman said, because no one knows exactly how many babies sleep with their parents in adult beds, the study gives no indication of relative risk, a weakness noted by the study's authors in their report. Death certificates, he said, also may be misleading. In some regions, coroners may be more likely to attribute the death of an infant from a poor family to "overlying," while attributing infant deaths in higher-income families to sudden infant death syndrome.
Bed sharing is the norm in many countries, including Japan, anthropologists say, and is common among Hispanic, Asian and black Americans. Co-sleeping, as the practice is often called, is also gaining popularity among young working couples, who, absent during the day, are loath to be separated from their children at night.
There are no reliable statistics on how many American parents sleep with their children, but some estimates put the figure as high as 60 percent.
Traditionally, American pediatricians have discouraged the practice in the belief that it fostered bad sleep habits, made children dependent and raised the risk of suffocation.
But in recent years, some specialists have revised their views. Noted pediatrician Dr. T. Berry Brazelton, for example, used to advise parents not to sleep with their children. But in an interview, he said a strong recommendation against it "would make people feel guilty but wouldn't change the patterns very much."
Dr. William Sears, who with his wife, Martha, has written 25 books on parenthood, endorses the practice, saying it is "the nighttime parenting style of the millennium."
Pub Date: 9/30/99