Commentary

Blog - Bed Buggers


 

The American Academy of Pediatrics (AAP) issued new guidelines today on safe infant sleep environments. Spoiler alert: No matter how sweet your Swedish memory foam mattress is (and I know how nice they are; I’ve been kicked out of the mattress store more than once), it’s not where your infant should be sleeping.

Dr. David L. Hill

The new guidelines create a distinction between SIDS (Sudden Infant Death Syndrome) and the much-harder-to-pronounce SUID (Sudden Unintended Infant Deaths). Living in North Carolina, I have to be careful not to say “SUID” too loud, or hogs come running. Why give pediatricians yet another acronym to remember? It turns out not all SIDS deaths are unexplained. SIDS implies an unknown cause of death, but in about half of the cases the cause is actually known.

These deaths are unintentional, but they’re not unexplained, so from now on, we’ll call all the deaths SUID, and the ones that remain mysterious after a full investigation will be SIDS. Are you confused enough yet? Wait for it ... you can also call SUID “SUDI” for Sudden Unexplained Death In Infancy. Phil Collins definitely could not have seen this coming when he recorded “Sussudio.”

So if half these SUID/SUDI deaths are explained, what are their causes? According to a study from New Mexico, prone sleep position remains a big contributor (52% of deaths), but even bigger was sleeping on an unsafe surface (71% of deaths). Now some unsafe infant sleep surfaces are kind of obvious, but it turns out bed-sharing with the parent has emerged as a significant risk factor. A parent doesn’t have to roll over on an infant to cause a death, although that does happen. Simply having a soft bed is enough to put infants at risk of suffocation or respiratory arrest.

This news is guaranteed to bum out some parents. I’m already anticipating the pushback I’m going to hear from parents who understandably take great pleasure in sleeping with their babies. But we’re talking about life and death here, not to mention acronyms no one wants to learn. So it’s clearer than ever what we need to tell parents: Babies must sleep looking at the ceiling, in their own cribs, not over-bundled, without soft bedding/stuffed animals/crib bumpers, in a house where no one smokes, after nursing, and sucking on a pacifier. As for me, I’m planning on hiding in the mattress store until they lock the doors.

--Dr. David L. Hill

Dr. Hill is vice president of Cape Fear Pediatrics in Wilmington, N.C., and is an adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He is Program Director for the AAP Council on Communications and Media and an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television and Internet outlets. Dr. Hill's first book, Dad to Dad: Parenting Like A Pro will be available starting in April 2012 from AAP Publishing.

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