Babies, soft, delicate things that they are, typically spend their waking hours surrounded by items of equal softness: plush toys, cushy diapers, fleecy onesies.
When it comes to sleeping, though, the instinct to envelop a baby in all that softness can be a dangerous one. Putting infants to bed with blankets and pillows has been linked to sudden infant death syndrome, or SIDS, one of the leading causes of infant mortality in the U.S. Even so, more than half of American babies still sleep with unsafe bedding, according to a report published today in the journal Pediatrics.
Researchers from the Centers for Disease Control and Prevention examined the survey responses of around 19,000 parents in the National Infant Sleep Position study, compiled between 1993 and 2010. The practice has declined from 85 percent in 1993, they found, but around 55 percent of infants are still covered by or laid on top of bedding while they sleep, a deceptively dangerous state. The use of bedding went down by around 20 percent each year until 2010, when it began to drop much more slowly.
“Parents have good intentions but may not understand that blankets, quilts, and pillows increase a baby's risk of SIDS and accidental suffocation,” Carrie Shapiro-Mendoza, the study’s lead author and a senior scientist at the CDC, said in a statement. While overall rates of SIDS—a phenomenon with no one clear cause—have decreased in recent years, from 66.3 deaths per 100,000 infants in 2000 to 52.7 in 2010, deaths from sleep suffocation have more than doubled over the same time period.
The American Academy of Pediatrics first recommended that infants sleep on their backs in 1992, the year before the survey began; since then, pediatricians have added several additional layers to the definition of a “safe sleep environment.” In 1996, the AAP declared that sleeping areas should be “free of soft surfaces and gas-trapping objects.” Three years later, the Consumer Product Safety Commission, in conjunction with the AAP and the National Institutes of Child Health and Human Development, issued a safety alert that babies “be placed to sleep on their backs on a firm, tight-fitting mattress in a crib that meets current safety standards and that pillows, quilts, comforters, sheepskins, and other pillow-like soft products be removed from the crib.” The AAP issued another, more forceful warning against the use of any kind of bedding in 2000, and again in 2011.
According to the most current guidelines from the National Institutes of Health, the safest way for a baby to sleep is alone in a crib, on its back, on a firm mattress covered only by a fitted sheet.
Often, though, the safest method isn’t the one that parents see.
“Parents get a lot of mixed messages” about how to put their infants to sleep, Shapiro-Medoza told The New York Times. “A relative will give them a quilt or a fluffy blanket that they may feel obligated to use, or they look at magazines and see a baby sleeping with a pillow.”
“Media messages targeted toward pregnant women and mothers of infants may also be related to the high prevalence of using certain types of bedding,” the researchers wrote, citing a 2009 study finding that more than two-thirds of relevant photos in women’s magazines showed babies in unsafe sleeping environments. “Seeing images such as these may reinforce beliefs and perceptions that having these items in the infant sleep area is not only a favorable practice, but also the norm.”