April 24, 2008

Hey LA County, Is It Still Co-Sleeping When You Pass Out?

So LA County's Inter-Agency Council on Child Abuse and Neglect [ICAN] wanted some attention for their 2008 Child Death Review Report, and they got it. The front¢er recommendation--the only recommendation, in fact--is that "co-sleeping" is a "potentially lethal act."

Of 115 undetermined child deaths in LA County in 2006, 44, 38%, "were associated with co-sleeping. ICAN has previously made recommendations regarding the need for public awareness efforts to highlight the dangers of co-sleeping, yet co-sleeping deaths continue in alarming numbers."

Taking a closer look, 40 of the 44 deaths were <6mo [26 0-3mo, and 14 3-6mo]. 34 involved sleeping with one or two adults, and another 5 involved one adult and more than one kid. But beyond that, the data underlying this recommendation raises a great deal of questions, none of which seem to have been asked by the LA Times, which boiled the report down to, "Parents warned about sleeping with infants."

1) Does the term "co-sleeping" mean the same thing to yuppie hippie parents as it does to LA County coroners? Is it relevant or accurate to use the term of a conscious parenting strategy as a generic cause of death?

2) When the report says, "It should be noted that, anecdotally, many co-sleeping related deaths can be tied to parents who are under the influence of drugs or alcohol," and when one of the reports five specific action items is to train responding officers that they "should take steps to determine if a parent [in a 'baby not breathing call'] might have been under the influence of drugs or alcohol," and then no data about drug or alcohol involvement is released, does that mean that there is no systematic effort to determine the involvement of parental substance use/abuse in these cases?

3) Should a case where a high or drunk parent passes out and a kid suffocates be called "co-sleeping"? Or should it be classified alongside the 25 deaths of kids 0-6 months old "due to maternal substance abuse"? [Meth and coke each accounted for 12 deaths. Of those 25 deaths, only 7 kids made it to 6 months; the rest were classified as "fetal deaths."]

4) If there are several callouts for over-represented groups in the report, why does the 3x over-representation of African Americans in the deaths "associated with co-sleeping" [29.5% of deaths vs 9.8% of the child population] not warrant a mention?

5) Hey wait, there were only two suffocation deaths and no SIDS. Are the other 71 undetermined deaths attributed to SIDS, in which case, SIDS is by far the major cause of undetermined infant death [duh], or are all the SIDS deaths classified as "natural causes," and are thus screened out by the ICAN staff before they even begin their tally? Would anyone pay attention to a report that called for renewed vigilance against SIDS?

Expected answers:
1) Not at all.
2) Nope, a huge blind spot.
3) Probably with the coke & meth.
4) No idea, is there a socio-economic or geographic slice of this data that's more relevant?
5) No idea, and probably not.

Parents warned about sleeping with infants [latimes via dt reader dt]
Get the 2008 Child Death Review Report (pdf) at the ICAN National Center For Child Fatality Review site [ican-ncfr.org]

Previously: detailed study in Detroit on the actual causes of SIDS-attributed deaths

4 Comments

I agree that I'm not sure that sleeping with a baby in a recliner or on a couch is quite the same as intentional "co-sleeping." I wonder how many of these deaths were caused by "intentional" cosleepers, many of whom take precautions such as removing additional soft bedding, only having the child sleep next to one parent, don't use drugs or alcohol prior to sleeping, etc... It's always amazing to me to see the advocating of wholesale bans on cosleeping without any statistics about intentional cosleeping.

Austin has the same problem. Asphyxiation is the second leading cause of death in children:

http://www.kvue.com/news/top/stories/042308kvuechilddeaths2-cb.92227afd.html

They don't really jump into the co-sleeping politics pool. But they are pretty explicit about what caused the deaths:

"Three of the seven children became wedged in pillows or against walls. Four became trapped next to an adult or larger child. "

The fact that two yuppie packed cities are suddenly having this problem makes me think it might have to do with the mainstreaming of co-sleeping and family beds.

[is it sudden? And I suspect that if there were socio-economic data available, the LA deaths would contain almost no yuppies. Also, this, " Travis County officials warn parents -- don't use alcohol, drugs or sedating medicines if you chose to sleep with your infant. " -ed.]

Apparently cigarette smoking is a risk factor as well.

I'm with you -- all the stats I've ever heard of show that a sober parent sleeping with a baby is no risk to the baby at all.

Oh, phew, it's just poor, drug-addled and drunk minority parents killing their kids, not yuppies. I guess we can all rest easy now!

Whether you call it co-sleeping or "parents sleeping with their children because they don't have the money or space for a crib", these statistics should lead to widespread public health campaigns like we have for SIDS. We can have a special fine print that says, *"if you are an attachment parent you can ignore this warning; don't worry we are NOT criticizing co-sleeping because God knows we'd get attacked for that!"

[I agree, if it's seen as a NOKD problem, there's the risk of letting the whole thing slide unaddressed. But I don't think it's at all helpful to get yuppie hyperparents worked up and guilty, either. And if the problem is really drugs or drunks or no crib money, the solution should look different. Ultimately, this data is incomplete; it needs the rest of the "baby not breathing" cases, the crib vs. not-crib deaths, and the passed out data to ID any larger issue besides "make sure your kid is secure and clear before you check out." -ed.]

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