Sensationalism and Sleeping Arrangements

Recently the City of Milwaukee Health Department began circulating ads intended to dissuade co-sleeping amongst Milwaukee residents. Mayor Tom Bennett has made it a personal campaign to lower the incidence of SIDS within his city.
"In Milwaukee around 20% of infant mortality is attributable to a combination of Sudden Infant Death Syndrome (SIDS),  and Sudden Unexplained Death in infancy (SUDI). " - City of Milwaukee

"The Journal Sentinel said Milwaukee had an “infant mortality crisis.” Milwaukee’s infant mortality rate in 2009 was 10.4 deaths for every 1,000 live births, according to the city’s health department. As noteworthy as this overall rate is the racial breakdown: For white babies, the rate was 5.4; for blacks, 14.1, the JS said." - ABC News

Although that is commendable, what is not commendable is the way in which they are going about it.


Yes, it CAN be, if done like the pictures show, with a baby in one ad, on it's stomach, and, in another ad, with his head on a pillow and, in both ads, surrounded by down comforters and tucked in sweetly next to a butcher's knife.
"The second-leading cause of infant mortality in Milwaukee is SIDS, or sudden infant death syndrome, which often results from  ”unsafe sleep,” according to the health department’s website. A form of “unsafe sleep” is bed-sharing with parents." - ABC News 
The problem with this statement is two-fold. First, SIDS is defined as the cause of death of a seemingly healthy infant for no apparent reason. So, if the baby dies from SIDS, it is unexplainable. If the baby dies from asphyxiation due to unsafe sleep environment, whether or not it is co-sleeping, then one automatically has a reason for the death. 
The other side of the problem is that there are ways to SAFELY co-sleep, as well as ways to UNSAFELY co-sleep. Just as unsafe crib sleeping can result in a baby's death, so can unsafe co-sleeping.
"“Is it shocking? Is it provocative?” asked Bevan Baker, the city’s commissioner of health,  according to the Journal Sentinel. ”Yes. But what is even more shocking and provocative is that 30 developed and underdeveloped countries have better [infant death] rates than Milwaukee."
Of these deaths the majority die in an unsafe sleep environment. The City of Milwaukee Health Department strongly advises parents NOT to share a bed with their infant. This is based on an American Academy of Pediatrics 2011 Policy Statement which states that the risk of SIDS has been shown to be reduced when the infant sleeps in the same room as the mother, but the AAP recommends that infants not share a bed with parents or anyone else, due to increased risk." - ABC News  
 I would reply to this with, "is it shocking? Is it MISLEADING?". The answer to both of those is a resounding YES. The ads, like the information above, are erroneous.
"“If the ads make some people uncomfortable, I guarantee it’s a lot less uncomfortable than having another baby die from co-sleeping,” a cause of death that is “so preventable,” [Bennett] added." - ABC News 
Do you know what I would rather see parents given? Better information on how to keep their baby SAFE. Babies who are at an increased risk for SIDS:
  • African American babies are twice as likely to die from SIDS than Caucasian babies
  • Boys are at a greater risk as well
  • babies from parents who smoke, drink, or use drugs during pregnancy
  • babies from mother's who received no or poor prenatal care
  • babies who are premature or low birth-weight
  • babies born to mothers younger than 20
  • babies who live with family members who smoke or are routinely exposed to tobacco smoke following birth
  • overheating from excessive sleepwear and bedding
  • stomach sleeping

Now, Milwaukee is a cold area... this is coming from a person who has lived in Chicago and Michigan in the past. So, already, there will be a greater risk from babies being covered or dressed to warmly to snug against the cold weather. Additionally, Milwaukee has a high poverty rate, a high population of young mothers, and a high population of African Americans.  (all information taken from citystats and US Census).

Further, Milwaukee suffers from some of the strongest social and racial inequalities, is one of the fastest climbing populations of poor, and has some of the largest and fastest growing crime rates in the nation.Wisconsin is also reported to have a high population of smokers, and an obese population of over 63%. Although Wisconsin can tout low rates of teen pregnancies and births, Milwaukee cannot.
"The teen birth rate in Milwaukee is one of the highest city rates among all the industrial nations in the world. Teen pregnancy has a negative impact on educational attainment, physical and mental health, and financial well-being of the teen parent. The infants of teen mothers are more apt to die during their first year and/or be born prematurely." - City of Milwaukee Health Dept.
Milwaukee is noted for having an issue with women not getting good prenatal care, and many women don't even seek out prenatal care until the 2nd or 3rd trimesters. Part of that is due to limited access to care, as Wisconsin has cut funding for state medical assistance by over 16%, and part of that is the population to healthcare provider ratio being grossly unbalanced. There are also some very low breastfeeding rates reported, especially in one local hospital (under 50%)

In other words, I believe, as many do, that Bennett's ad campaign is short sighted, completely off-based, and being used as a panacea... when, in fact, UNSAFE co-sleeping is only part of the problem, as shown above.

Proper co-sleeping, in fact, has been shown to be safe. In fact, it can help reduce the risk of SIDS. How? A few of the ways include the fact that co-sleeping promotes more rest in baby and mom remains more alert, although rested. Add to that the fact that co-sleeping increases breastfeeding success, and breastfeeding reduces the risk of SIDs.

Instead of telling families not to co-sleep because it is as dangerous as letting your baby sleep with a knife, why not tell them that improper co-sleeping is dangerous. 

Safe Co-Sleeping follows these rules:
  • Babies will be of healthy gestation, and not low-birth weight
  • Family members within the home will not be smokers (baby will not be exposed to second hand smoke)
  • Specifically and especially, those in the bed with baby will not be smokers
  • Mom will be breastfeeding her baby
  • Babies will be on their backs, on firm, clean mattresses or bed mats (no couches, intersecting furniture, water beds, or rocking chairs)
  • Only light blanketing will be used, and never over the babies head (no use of heavy quilts or satin sheets)
  • The baby will not have stuffed animals or pillows either under their heads or near their bodies
  • Those sleeping with the baby should not be on any over-the-counter, recreational, or prescription medication, or be drinking any alcohol
  • Long hair should be tied back and grossly obese individuals should consider carefully whether they should co-sleep
When these rules are followed, co-sleeping is a safe and healthy option for a family and their baby. Dr. Sears even writes that co-sleeping results are as follows:
  • Research shows that co-sleeping infants virtually never startle during sleep and rarely cry during the night, compared to solo sleepers who startle repeatedly throughout the night and spend 4 times the number of minutes crying. Startling and crying releases adrenaline, which increases heart rate and blood pressure, interferes with restful sleep and leads to long term sleep anxiety.
  • Studies show that infants who sleep near to parents have more stable temperatures, regular heart rhythms, and fewer long pauses in breathing compared to babies who sleep alone. This means baby sleeps physiologically safer.
  • Worldwide research shows that the SIDS rate is lowest (and even unheard of) in countries where co-sleeping is the norm, rather than the exception. Babies who sleep either in or next to their parents’ bed have a fourfold decrease in the chance of SIDS. Co-sleeping babies actually spend more time sleeping on their back or side 1 which decreases the risk of SIDS. Further research shows that the carbon dioxide exhaled by a parent actually works to stimulate baby’s breathing.
  • The Consumer Product Safety Commission published data that described infant fatalities in adult beds. These same data, however, showed more than 3 times as many crib related infant fatalities compared to adult bed accidents. Another recent large study concluded that bed sharing did NOT increase the risk of SIDS, unless the mom was a smoker or abused alcohol. (all information taken directly from The Scientific Benefits of Co-Sleeping).

Milwaukee would do better to invest more in their African American and teen pregnancy programs, promote breastfeeding through in-home lactation education, and provide centering groups and insurance-covered midwifery care both in the hospital and outside of it. Likewise, they should make more of an effort to lower their alcohol, teen pregnancy, low-birth weight, and smoking rates. 

All there is left to say at this point is: City of Milwaukee and Mayor Bennett, shame on you. I'm sorry to say it, because I understand that they aren't meaning to give bad information or mislead parents into a false sense of security... but, since they have the very public ability to influence a large amount of the population, they are held to a higher standard - to make sure that science and research back up their claims, and that they give the public full and informed disclosure.

To petition the removal of these ads, please sign here

Additional Reading and Research:
State Health Facts
LeapFrog group
University of Notre Dame Mother-Baby Behavioral Sleep Laboratory
Mother-Infant Cosleeping, Breastfeeding and SIDS
SIDS, Co-Sleeping, and Breastfeeding
Never Sleep With Baby?
PowerPoint on Media/Gov vs Fact
Dr. Sears on Co-Sleeping
California SIDS council on Safe Co-Sleeping
UNICEFs Safe Co-Sleeping Printable
Here's Your Knife, Milwaukee
Parenting Co-Sleeping Response
The Dangers of Demonising Bed Sharing 
Don't Allow Your Babies To Sleep With Knives


Archaeology cat said...

Love it! Linking on my blog.

Corey said...

This is a petition I created asking the city of Milwaukee to remove its fear mongering ads. It is 2 days old and has been signed almost 500 times. Please considering signing or sharing.

Lessons in Life and Light said...

I wrote about this too yesterday. I was INFURIATED! Such a stupid, misleading ad. Ugh!

LovingEarthMama said...

This is great. I have actually been avoiding mentioning it on facebook and my blog as I didn't want to give this stupid image any more coverage but... I love your rebuttal and in this frame I am happy to share it.


Sara said...

I thought also that formula feeding is a big risk factor in SIDS? I bet we won't see any public service ads with a bottle in them..

Claire said...

I don't even believe in co-sleeping in the first place, but this is really a ridiculous ad. Even I knew there was more than meets the eye.

It's really just not the right thing (to me, that is) to do no matter what age you are. Kids belong in their own bed, because if you don't put them in their own bed come time their at least two, they'll never sleep in it. So many people complain about it and it just drives me nuts. Why do you do it in the first place??

Mimì said...

I do not think that co-sleeping is so dangerous ,there are a lot of articles saying co-sleep is good for the baby! I always followed all the instructions anti-SIDS but I also always believed that if it has to happen ..it happens ,for this the scientists are always say it happen for no reason,they do not know it at all..so how do they know that all this precautions work?

Mimi from Italy

Dr. Laura Markham said...

Claire- Co-sleeping is a very individual decision and I think families should sleep in whatever way gets everybody the most sleep. But I must respectfully point out that your experience is not everyone's. My daughter slept with us until she was four, at which point she moved to her own bed. Our son slept with us until he was three. They are teenagers now, and very independent, and they sleep (LOL)very well. All kids do learn to sleep in their own beds, use the toilet, and eat solid food, sooner or later, even though none of them begin that way! It isn't necessary to worry about letting them into the bed when they're babies. That's like saying it's a cold cruel world so we should make them sleep without blankets. Instead, let's fill their love cups with as much warmth as possible so they can move fully fueled into independence on their own schedules!

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