A Bed of Tragedies
Jill Porter - 09/10/04

In 17 months, 43 babies have needlessly died sleeping with another person
ONOAME WALKER awoke on the morning of Aug. 26, looked at the infant son she was sleeping with on the sofa and began screaming.
His lips were blue. His body was limp.
The infant, who'd cooed happily when awakened for his feeding five hours earlier, was dead.
The cause of death of the 5-month-old boy remains a mystery to his family.
But the tragedy shouldn't be a surprise to some city officials.
Because 43 babies have died in our city in the last 17 months while sleeping with other people.
And, unfathomable as it sounds, at least two city agencies knew about the disturbing trend and failed to bring it to public attention.
Naim Carr was the 23rd baby in the city so far this year to have died of sudden-infant-death syndrome while sleeping with another person - a grisly average of nearly three infants a month.
A few were smothered when someone inadvertently rolled over on them. The majority died of asphyxiation for reasons that aren't entirely clear.
What is abundantly clear is that more babies in the city succumb to SIDS when they sleep with other people than when they sleep alone in their cribs.
Since last April, when the medical examiner began expanding SIDS death- scene reports to include information about where the victim was sleeping, only 19 of the 62 victims have been determined to have been alone in their cribs.
You'd think city officials would feel compelled to alert the public to this trend, to try to prevent more deaths.
They didn't.
The Health Department not only refused to join the Department of Human Services last year in an aggressive public education campaign, but continues to insist that bed-sharing isn't a problem.
"We don't think co-sleeping is the factor that killed the babies," said Dr. Joanne Godley, medical director of the Health Department.
"And we don't want to discourage co-sleeping when it's done in a safe manner."
But just how safely is it being done if 43 babies died in the past 17 months?
And how can city health officials justify not alerting the public when that many infants die in any setting, whether it's a family bed, a bathtub or a back yard?
I'll tell you why. The department is paralyzed by the controversy that attends co-sleeping and doesn't want to say the wrong thing.
So they said nothing.
And that's so unconscionable it makes my blood boil.
The phenomenon called the "Family Bed" is just what it implies: parents who regularly sleep with their newborns, and sometimes other young children, in the same bed.
Some people do it for reasons of convenience, or closeness, or economics - because they can't afford a crib.
It's a tradition in some Asian and Latino cultures and, according to the American Academy of Pediatrics, it's commonly practiced by mothers to facilitate breast-feeding.
But even a casual inquiry into the issue unearths a debate as polarized and passionate as that surrounding abortion or the death penalty. Yes, I'm serious.
Many studies have shown co-sleeping to be hazardous for infants, who can be crushed by another person, suffocate in the folds of blankets or soft mattresses, get entrapped between the mattress and the wall or headboard, get fatally overheated, or succumb for other reasons.
But the studies are aggressively attacked by some militant supporters of family bed-sharing, who blame Western bias for skewing the results.
Advocates of an ideology called "attachment parenting" claim co-sleeping enhances everything from family bonding to a child's sense of security and self-esteem and say it's safe when precautions are taken to minimize the risks.
The American Academy of Pediatrics says bed-sharing "may be hazardous under certain conditions," but says there are "insufficient data to conclude that bed sharing under carefully controlled conditions is clearly hazardous or clearly safe."
That was the backdrop two years ago, when DHS began to notice an "alarming" number of children who died while sleeping with others, according to agency spokesman Ted Qualli.
When the eighth baby in less than two years was found dead while co-sleeping, the agency's death-review team urged that something be done, according to a report obtained by the Daily News.
In that case, a 2 1/2-month-old infant died while sharing a bed with his mother and four siblings, according to the report.
The report expressed "some very serious safety concerns related to infants sleeping in the same bed with other family members," and strongly advocated a "public health education program."
Then-DHS Commissioner Alba Martinez, spurred on by Qualli's intense concern, pushed the Health Department for public disclosure of the troubling trend.
"It wasn't an abuse and neglect issue per se but a public- health issue," Martinez said.
Since 70 percent of the co-sleeping deaths occurred in families receiving DHS services, the agency clearly should have gone public alone. But sources said Martinez believed it would be untenable without the Health Department - whose mission is protecting the public health, after all - especially if health officials disputed the warning that bed-sharing was dangerous.
DHS recommended a high-profile public-awareness campaign with a press conference kick-off and extensive educational outreach, sources said.
But Martinez got nowhere.
The Health Department, led by Commissioner John Domzal-ski, cited the cultural sensitivity of the issue and rebuffed DHS' appeal, sources said.
"We were not able to get the Health Department to take a public stand with us," said Martinez, who now heads the United Way of Southeastern Pennsylvania.
"I agree more should have been done."
Domzalski is out of the country and unavailable for comment.
DHS settled for distributing a brochure in January to all of its social workers and provider agencies. The Health Department sent out a flier around the same time to community-based maternal and child-health agencies, among others.
But the brochures soft-pedal the risks of co-sleeping.
The cover of both pamphlets features a mother and baby in the same bed, and both describe the cautions necessary to bed-share safely.
"It looks like they're promoting it," said one worried child- health advocate.
The most outrageous aspect of the brochures is what they don't say: that many infants in this city have died while co-sleeping - a terrifying fact that certainly would grab a parent's attention far more than a list of do's and don'ts.
Meanwhile, fatalities continued to mount.
The resistance Martinez encountered at the Health Department still remains.
To this day, the department refuses to identify co-sleeping as a danger, for fear of alienating the many families who officials claim do it safely.
"Co-sleeping is not a mechanism of death," Dr. Godley said.
"Something else causes a loss of oxygen to the brain," the medical director said, speculating that the infants had been placed in an unsafe sleeping position - on their stomachs - and could have died anywhere.
Only the four of this year's victims who died of "overlaying" - literally, when someone rolled over on them - can be directly attributable to co-sleeping, said medical examiner Dr. Haresh Mirchandani.
The death rate may only be a reflection of "the fact that co-sleeping is a more common phenomenon than sleeping in a crib," Godley said.
And why alarm people unnecessarily, right?
"If two-thirds of the public is co-sleeping and you just tell them to stop," Godley said, "no one is going to hear the message."
Ah, the message.
Kate Maus, director of the maternal, child and family health unit, said if the department was "too hasty" in attributing the deaths to co-sleeping when other factors actually caused the deaths, then "we haven't helped."
Maus said the department was at work on a new brochure and was meeting with DHS and other maternal- and child-health advocates to coordinate their approach and was "absolutely not sitting on this."
"We want to make sure we're providing an accurate, appropriate and usable message," she said.
But while health officials search for a meticulously scrupulous "message" about co-sleeping, countless babies are potentially at risk.
Meanwhile, DHS is belatedly ready to sound the alarm about family bed-sharing. The agency recently mailed its brochure directly to all parents in the system and other outreach is planned, including a possible press conference.
"The incidence of infant deaths associated with the family bed is disturbingly on the rise and the Department of Human Services is looking to increase the publics' awareness of this sometimes fatal practice when not done properly," new DHS Commissioner Cheryl Ransom-Garner said in a statement last week.
But if that warning had been issued two years ago, when DHS first became alarmed at the co-sleeping deaths, could it have saved any of dozens of infants who've died since then?
"If it prevented one," said one critic, "I think it would have been worth it."
Mary Allen awoke for her job as a UPS dispatcher on the morning of Aug. 26, and called down to her daughter to wake up. Then the screaming started.
Allen's 25-year-old daughter had slept on the living room sofa with her infant son because she didn't feel like going upstairs to bed.
"I heard her screaming, 'The baby! The baby!'" Allen said.
"She ran him upstairs to me. His lips were blue.
"I put him on the bed and started doing CPR, but all I could get was a dry rattle."
Walker called 911 and police came immediately. The infant was pronounced dead at Children's Hospital.
An autopsy showed no sign of child abuse or trauma, but did show evidence of asphyxiation, according to the medical examiner. The cause of death is still undetermined, he said, pending the outcome of toxicology tests.
Allen, 58, is skeptical that co-sleeping played a role in her grandson's death.
"I've done them all like that," she said of sleeping with her infant children and grandchildren to keep closer watch on them in the night, "and we've never lost a baby."
But would she have avoided doing so, if she knew the practice were potentially dangerous?
She hesitated.
And nodded her head tentatively.
One thing is for sure. The baby's loss is devastating.
Naim was a curious and active baby who was learning to crawl and already had a strong personality, his grandmother said.
"We were already seeing a lot of willpower and mind development. He didn't like you to cut his hair."
Allen sorted through a few photographs on the dining room table, found one that captured her grandson's sparkle, and took a long look at it.
"He was the king of the roost," she said with a sigh, her eyes on the photo.
"This has sent me over the edge."