A MOTHER who lives in a crime-ridden neighborhood is terrified a random bullet will strike her newborn in his crib, so she brings the baby into bed with her.
An infant who's sick is brought into the family bed because the parents are deep sleepers who fear they won't hear her if she wakes up crying.
Good intentions. Potentially tragic outcomes.
Because bed-sharing is far riskier for infants than the imagined dangers the parents are trying to prevent - and somehow, that urgent message isn't being heard.
Last week's report on the city's Department of Human Services showed a jarring number of infants who died while co-sleeping, despite a city public- awareness campaign and a crib- giveaway program designed to halt these preventable deaths.
The report by the Child Welfare Review Panel revealed that a dozen babies had died while bed-sharing, "a staggering number," said acting DHS Commissioner Arthur Evans.
That's nearly half as many as the 27 who died of abuse or suspected abuse over the same five-year period.
"I actually was kind of appalled. These are so preventable," said pediatrician Dr. Cindy Christian, a panel member who holds the Children's Hospital of Philadelphia chair in the Prevention of Child Abuse and Neglect.
But the statistics are far worse than those reflected in the report, which focused only on DHS-related cases.
The fact is that most of the city's babies who died "sudden, unexplained" deaths in a recent 15-month period were sharing a bed or crib with someone else, according to the Health Department. That's 33 babies - out of 49 overall - who died unnecessarily for want of knowing the dangers of co-sleeping.
They were rolled over on. They smothered in loose blankets. They were asphyxiated when they got wedged between the mattress and a wall.
"It appears to be a major public-health matter," said Carol Tracy, who heads the Women's Law Project and is a member of the child-review panel.
For years, the city ignored mounting evidence that infants who slept with other people were at increased risk of dying.
But in 2004, city officials responded to that alarming fact - cited in a series of my columns - and did an about-face, launching a high-profile media campaign urging parents to put their infants to bed, alone, in a crib.
The city even helped fund a free-crib program through the Maternity Care Coalition, which has given away 1,729 cribs in the past 10 months alone.
But, as the Health Department's Kate Maus acknowledged, there's been no decrease in infant deaths related to co-sleeping.
"This is really hard behavior to change," said Maus, director of the division of Maternal, Child and Family Health.
"You can't do it on the basis of a once-and-done health-education effort."
For one thing, the population that needs educating changes every day.
"It's always a new group of people who have to learn about safe sleep; there are constantly new people having babies," said JoAnne Fischer, of the Maternity Care Coalition.
Not to mention that families co-sleep for reasons ranging from cultural custom to family tradition to lack of a crib to individual circumstance, such as the sick infant or the baby in a violence-infested neighborhood.
"I hope to analyze the data very carefully so we can customize our educational efforts for various populations," Fischer said.
The city is set to launch another high-profile public-awareness campaign - perhaps a smarter one.
For one thing, it will be more targeted to low-income African-American and Latino communities, where most co-sleeping deaths occur, said DHS Commissioner Evans.
And this time, the warning will be far more explicit about the danger of co-sleeping.
"We don't want to scare people out of their wits, but you do need for them to know this is not just a little FYI," said the Health Department's Maus.
"We really are talking about things that can pose a significant risk to your baby's life."
Donations for the crib giveaway program can be made to the Maternity Care Coalition, 2000 Hamilton St., Suite 205, Phila., Pa. 19130 or at www.Momobile. org. |
