The ads the city of Milwaukee and its Health Department planned to run in November 2011 have received much criticism from people nationwide. In the advertisement, a slumbering infant is shown in an adult bed next to a knife which looks like a meat cleaver. The banner headline implies that bed-sharing is as dangerous as allowing your infant to sleep with a sharp knife.
Although the Milwaukee ads do not specifically mention SIDS (Sudden Infant Death Syndrome), sites like iVillage.com do when discussing the issue. The Milwaukee government website on its “Safe Sleep for Your Baby” page mentions both SIDS and SUDI (Sudden Unexplained Death in Infancy) when discussing the city’s high infant mortality rate. Information about the city’s ad campaign is on the same page.
Speaking as a mother who co-slept with her oldest daughter when she was an infant and has experienced the pain and sorrow of having a baby die from SIDS in 1992, Milwaukee’s ad campaign disturbs me.
SIDS Defined
Some of the news sources with commentaries on the Milwaukee co-sleeping ads seem not to know what SIDS actually is. The National SIDS/Infant Death Resource Center information web sheet tells the reader what SIDS is and what it is not.
The autopsy finding of SIDS is a catch-all term for any infant death which seems to have happened without any reason to a baby who until death appears to be healthy. If evidence of suffocation by the infant’s own vomit, bedding or other items in the sleep area, parental abuse or allergic reaction to a vaccination is found, the cause of death is not SIDS.
SIDS is a medical disorder and can not be prevented. Since 1998, medical examiners have been less likely to list SIDS as a cause of death and more likely to use the terms “unknown causes” or “accidental suffocation” in their reports. Cases of accidental suffocation are labeled SUDI, which seems to be a contradictory title if suffocation is known to be the cause of death.
How SIDS is Determined
The county health nurse investigated the environment in which our baby Samara died and found no possible cause. We were asked several questions about her and our own medical histories including whether she had recently come down with a cold, if anyone in the household smoked and the dates of her last checkup and immunizations.
I was given a copy of our daughter’s autopsy findings within a few weeks of her death. To rule out any parental involvement, the coroner had to examine the brain and other internal organs. He screened the blood and ran other tests and could find no abnormalities or reasons for her to have died. It was as if she had fallen asleep and “forgot” to breathe. That was what I was told.
The trauma of finding my baby dead was magnified by the formal investigation. Even though the investigators attempted to be as considerate as possible, they had to also be thorough.
I did not know what had to be done to my daughter’s body during the autopsy until the funeral home told me to be sure to bring some kind of baby bonnet with her burial clothes.
For a mother who is trying to cope with the loss of her infant to SIDS or SUDI, an ad like the one the Milwaukee Health Department is running will increase her trauma. She did not purposely set out to endanger her infant. The mother of a SIDS infant can not even identify a reason for her baby to have died so suddenly and unexpectedly.
Not Always by Bed-Sharing
Our first daughter slept in our bed with us until she no longer required a nighttime feeding. Our second daughter slept in a crib when she was an infant because she seemed to prefer sleeping alone. From the time she was born, we put our third daughter down for naps and bedtime in a bassinet in a separate bedroom. The bassinet had a firm mattress. We did not put soft bedding in the sleep area. According to the current guidelines, our baby’s sleeping arrangement was safe.
The day before our baby died, the county health nurse checked her at our local WIC (Women, Infant, Children health program) clinic and complimented me on how fast she was growing and developing. The next day, my husband put Samara down in her bassinet for a late afternoon nap. She was a little fussy. Later that evening when it was time to nurse her I found her dead. She was two and a half months old.
Theories
Although the Milwaukee ad campaign targets co-sleeping, several other theories about the cause of SIDS have been proposed. In 1998, an article in Archives of Disease in Childhood stated if a pregnant woman consumed more than four cups of coffee per day she would be more likely to have a baby which died of SIDS.
Prenatal and post-birth smoking by the mother has also been linked to SIDS. The theory is that the baby of a mother who smokes may have a low birth weight and periods when he struggles for breath because of obstructive sleep apnea.
Another theory which has received attention suggests that the crucial areas of a baby’s brain which control the automatic functions like breathing and sleep arousal may not develop properly in some infants.
The Mayo Clinic website indicates maternal drug or alcohol use, inadequate care during pregnancy and teen pregnancy are risk factors. Hopefully, the city of Milwaukee is attempting to address these possible risk factors as well.
Years of If-Onlys
The Milwaukee co-sleeping ads are bound to reawaken feelings of unjustified self-condemnation and guilt within the hearts of those parents who lost an infant to SIDS. This would be especially true if the infant died while sleeping in his parents’ bed and even if an autopsy ruled out suffocation. The ad implies the parent is guilty of, at the very least, child neglect or, at the worst, manslaughter. The parent of a SIDS infant already has a list of “if-onlys” which will haunt him for years.
To this day when the anniversary of our baby’s death draws near I sometimes wonder if she would be alive “if only” I had checked on her an hour sooner.
Researchers are still trying to figure out the physiological reasons for SIDS. If the mechanism of suffocation (baby’s own vomit, narrow crib slats, small parts from a toy, soft bedding, etc.) is known, infant death by suffocation is not SIDS. The Milwaukee campaign ads may make an intolerable heartrending loss even harder to bear for parents who have had an infant die of SIDS.
Milwaukee’s Ad Campaign article
http://www.jsonline.com/news/milwaukee/milwaukee-cosleeping-ad-stirs-nationwide-debate-4m33572-133987863.html
National SIDS/Infant Death Resource Center bulletin “What Is SIDS?”
http://www.childrensmn.org/Web/sids/125891.pdf
SIDS Network: “Facts About Sudden Infant Death Syndrome”
http://sids-network.org/facts.htm
City of Milwaukee site “Safe Sleep for Your Baby”
http://city.milwaukee.gov/SafeSleep
Caffeine and SIDS
http://ndsn.org/FEB98/trends3.html
Smoking and SIDS
http://sids-network.org/experts/smok.htm
Mayo Clinic: Sudden Infant Death Syndrome
http://www.mayoclinic.com/health/sudden-infant-death-syndrome/DS00145