Hospitals push safe sleep practices for infants

For the last year, parents have been banned from sleeping with their sick babies at St. Christopher's Hospital for Children.

The hospital instituted the policy after three infants over three months were pronounced dead in the emergency room after bed sharing-related accidents at home.

Babies who sleep with a parent can become overheated, be rolled onto, or be smothered by soft sheets or pillows. They can also lose circulation if wedged between the mattress and furniture.

The hospital's ER typically gets one such death every couple of months. But the "little cluster" of tragedies early last year inspired St. Christopher's nurses to propose that the hospital lead by example.

"Today, people often don't have primary pediatricians," said emergency nursing director Kirsten Johnson-Moore. "So emergency departments, I feel, have a responsibility to educate and prevent."

She said the policy is an extension of the "Back to Sleep" campaign against SIDS - sudden infant death syndrome - by the American Academy of Pediatrics.

The new policy requires that all families of infant patients get talks and brochures on safe sleep practices.

This was what 17-year-old Quinyohna Canty encountered when she applied in May for a free crib from the nonprofit Maternity Care Coalition and its Cribs for Kids program.

Canty, then in her eighth month of pregnancy, said she filled out a "quiz" about safe sleep practices at the coalition:

Should you ever put your baby on her stomach? "I said 'No,' and the lady said 'Correct.' "

What's supposed to be in the crib?, the quiz asked, with choices between images of blankets and toys. "I was real nervous, so I put like, 'One blanket'," said Canty. "And she said not to overcrowd the crib. And if it's warm, I only need one blanket, tucked around her stomach and around the mattress."

In 2008, the Philadelphia Medical Examiner's Office identified 26 infant deaths related to bed sharing, also known as co-sleeping, including four babies asphyxiated when an adult rolled on top of them. Among 49 babies who died from January 2006 to June 2007, 33 were sharing a bed or crib at the time, concluded the Pennsylvania Department of Health.

The U.S. Centers for Disease Control and Prevention reported that across the nation, suffocation - of which bedsharing is one of many causes - was the leading cause of preventable infant deaths from 2000 to 2005.

Concern about bed sharing is not new. In 2005, several city agencies waged a media campaign to educate the public about the dangers.

And just last month, the Pennsylvania House unanimously approved a bill that would establish a safe-sleep public education and prevention program. The bill is awaiting action in the Senate.

But not everyone agrees that banning co-sleeping is the answer.

"Most parents are sleeping with their babies and need safety information," said anthropologist James J. McKenna,  director of the University of Notre Dame's Mother-Baby Sleep Laboratory. "It is normal, healthy, and appropriate" for baby and mother.

La Leche League International, a breast-feeding advocacy group, says bed sharing can facilitate feeding and create a stronger bond that makes parenting easier.

But at area institutions, prevention still means warning against bed-sharing to avoid confusion. At the Children's Hospital of Philadelphia's sleep center, the staff recommends room sharing, but not bed sharing, with the baby in an uncluttered crib or bassinet.

Similar advice is given at Abington Memorial Hospital, the Hospital of the University of Pennsylvania, and Thomas Jefferson University Hospital.

"The list of things to avoid is quite long. From a public-health point of view, we can't have exceptions" to the education campaign, said Esther Chung, an associate pediatrics professor at Jefferson Medical College.

Ultimately, everyone wants babies like Canty's daughter, Abigail, to be safe. Of the hospital and community care she received before giving birth last month, Canty said, "the whole experience was perfect."