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Infant bed-sharing rates increasing especially among minorities

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Despite all the reported dangers, more parents are sharing a bed with their infants, according to a new study.

Researchers have discovered that the number of infants sharing a bed with adults has more than doubled between 1993 and 2010, especially among black and Hispanic families.

That's worrisome, say researchers, because bed-sharing has been linked to a higher rate of sudden infant death syndrome (SIDS), which is the unexpected, sudden death of a child under the age of 1 where an autopsy cannot determine a cause of death. No one knows what causes SIDS, but doctors believe it has to do with problems with the baby's ability to wake up (known as sleep arousal) and a problem the baby's body might have with detecting a buildup of carbon dioxide in the blood.

The Centers for Disease Control and Prevention says about 4,000 infants die of no immediate, obvious cause. They estimate that about half of these deaths are due to SIDS, making it the leading cause of death for infants between one and 12 months.

A previous study in BMJ Open in May linked bed-sharing with a five-fold increase in SIDS risk.

In addition to sharing a bed with an adult, putting a child to sleep on their stomach, being a multiple birth child, being born prematurely and having a brother or sister who died from SIDS has also been known to increase the chance of SIDS. Exposing the fetus or infant to cigarette smoke, soft bedding in the crib, having a mother who used illegal drugs, being born to a teen mother, having a short period between pregnancies, late or no prenatal care and living in poverty has also been known to up SIDS risk.

Researchers interviewed almost 19,000 caregivers in 48 states who were part of the National Infant Sleep Position Study. Eighty-five percent of those surveyed were the mothers of the children. About half were 30 or older, had at least a college education and made at least $50,000 a year. Around 80 percent of the participants were white.

The caregivers were questioned about their infant's sleeping habits. They were also asked if their physician had ever talked about where the child should sleep and whether that medical professional was positive, neutral or negative about bed-sharing.

Researchers found that bed-sharing rates went up from 6.5 percent in 1993 to 13.5 percent in 2010.

White caregivers were less likely to share a bed with their children compared to black and Hispanic caregivers. During the time period, the bed-sharing rate increased from 5 to 9 percent for white infants. However, it went up from 21 to 39 percent among black children, and 13 to 21 percent among Hispanic babies.

More than half of those surveyed said they did not receive advice from a medical professional about bed-sharing. Those who were warned about the risks were more likely to heed that advice. Those whose doctors remained neutral were more likely to share their beds.

"This shows that a healthcare provider's advice matters, and they can play a key role in educating caregivers about the possible dangers of bed-sharing," study co-author Dr. Eve Colson, professor of pediatrics at Yale School of Medicine, said in a press release. "We find this concerning because black infants are at a higher risk of dying of SIDS than white and Hispanic infants."

The study was published in JAMA Pediatrics on Sept. 30.

Dr. Fern Hauck, a professor at the University of Virginia School of Medicine in Charlottesville and the director of the International Family Medicine Clinic at the school, said to Reuters that women from different cultural backgrounds may have different reasons for wanting to bed-share, including because their parents did it, because they feel it keeps the child safer and because it helsp the moms breast-feed.

"The recommendation to not bed-share was made very, very carefully, because we know how big it is. It's an emotional thing for people," Hauck, who wasn't involved in the new study, said.

Dr. Abraham Bergman, a pediatrician Harborview Medical Center in Seattle who wrote an accompanying editorial in the same journal issue, pointed out that it isn't exactly clear if bed-sharing does increase the rate of SIDS. He said doctors should counsel their patients both about the risks and benefits of bed-sharing, which could include more sleep for the parent and easier breast-feeding since the child is nearby.

"I find the report disquieting because evidence linking bed-sharing per se to the increased risk for infant death is lacking," he wrote.

But Hauck claims that even among women who have low-risk factors for having a child with SIDS, there is evidence that shows that bed-sharing can increase the rate of SIDS.

The authors called for more doctors to talk to families about bed-sharing and for more research into why there is such a racial disparity in the rates.