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Posted on Wed, Oct 19, 2011 : 4:55 p.m.

Experts want stronger message: Babies need to sleep on their backs and alone

By Juliana Keeping

A renewed call to encourage putting babies to sleep on their backs and discourage co-sleeping were among the solutions suggested by a panel of doctor-academics at a statewide summit in Ypsilanti called to curtail infant mortality in Michigan.

The causes of infant mortality are complicated. Participants in this week's summit heard data involving issues like race, access to healthy foods, access to health care, education levels and other factors.

“A lot of those problems are more difficult to tackle. You can’t just change the community overnight,” said University of Michigan Dr. Timothy Johnson, department chair of the department of obstetrics and gynecology at the University of Michigan.

Sometimes, it's simpler than that. Both the American Academy of Pediatrics and the National Institute of Child Health and Human Development link unexplained infant deaths - part of the infant mortality rate - to babies sleeping on their stomachs. Both groups recommend back sleeping, and recommend against practices like co-sleeping.

That's why the panel, which included Johnson, suggested that Michigan pursue a renewed educational campaign to end co-sleeping and encourage back sleeping among infants.

The most recent state data shows 881 infants born in Michigan died before their 1st birthday in 2009, including 21 in Washtenaw County, said Susan Cerniglia, a health educator for the Washtenaw County Public Health Department. About 107 Michigan babies died in 2009 due to Sudden Unexpected Infant Death or other causes; 57 of those babies suffocated while in bed with their parents, according to the Michigan Department of Community Health.

SUID encompasses deaths in babies under 1 year of age that occur for unknown causes, or are due to accidental suffocation or other reasons, according to the Centers for Disease Control and Prevention. Putting babies to sleep on their backs is considered a preventive tool.

The state MDCH in May appointed an 11-member team of doctor-academics to begin to address infant mortality.

The group asked itself, “What can have the greatest impact in the shortest amount of time?” said Dr. Valerie Parisi, the dean of the school of medicine at Wayne State University.

While “Back to Sleep” or “Safe Sleep” campaigns have been underway since the early 1990s, the panel recognizes that not everyone is getting the message.

There are racial disparities involving infant deaths when it comes to back-sleeping and bed-sharing, Parisi said. State data shows white mothers are more likely to put babies on their backs than black mothers, and that white mothers are less likely to co-sleep with their infant.

The disparity relates not just to SUID, but to total infant mortality statewide. According to the MDCH, the 2009 state infant mortality rate of 15.5 for black babies is three times higher than for white babies. The hope is addressing disparities in back sleeping and co-sleeping habits will help to close that gap.

“We have to all get on the same page,” Parisi said.

An intervention, such as an educational campaign, should target populations whose infants are at a higher risk for death due to SUID in bed, Parisi said. Improvements could be made by integrating media and social media efforts and integrating safe sleep education into Michigan medical and nursing schools, she said.

Johnson said Mott Children’s Hospital has comprehensive educational campaigns targeted at safe sleeping and back sleeping for babies.

“It’s surprising how many related deaths still occur across the state from babies not sleeping in the appropriate place,” he said.

Juliana Keeping covers general assignment and health and the environment for Reach her at or 734-623-2528. Follow Juliana Keeping on Twitter



Thu, Oct 20, 2011 : 3:54 p.m.

SIDS is something that has always confused me...because it is not necessarily just suffocation...there are children that die from "SIDS" (sudden infant death syndrome) that do not suffocate and the point is that they really don't know what causes those why not call deaths associated with suffocation: "suffocation" and consider all other deaths where the cause is truly unknown as SIDS? As far as deciding what is safe and what isn't, that decision should mostly be left up to the parents since every baby is different. Our daughter held her head up steadily since the day she was born...the doctors were a little shocked. And I personally saw her wiggle and move away from things that obstructed her breathing, so I felt comfortable having her sleep with a thin blanket and mesh crib bumpers. I realize not all babies are like this and that's the point, all babies are different and have different needs. I think that as long as there is some kind of training given so that parents can know the risks and any signs to look for showing that their baby either can or cannot handle certain things, then it should be up to the parents to make the ultimate decision.


Thu, Oct 20, 2011 : 11:59 p.m.

The CDC distinguishes between SIDS and other causes of sudden unexpected infant deaths (SUID). See <a href="" rel='nofollow'></a> for more information.

the thing is...

Thu, Oct 20, 2011 : 2:44 p.m.

881 Michigan infants died in 2009 -- 107 from SUID including 57 who suffocated while sleeping with a parent. Why did the other 774 die? That seems to be the bigger problem.

G. Orwell

Thu, Oct 20, 2011 : 2:11 a.m.

Based on the latest scientific study by prestigious researchers, in order to reduce infant mortality rate, reduce the number of vaccines given to babies. The study shows a very high correlation between vaccines given to infants to the mortality rate. The countries that vaccinate the least had the lowest infant mortality rate while countries that vaccinate the most (U.S.), had the highest infant mortality rate. In the U.S., babies are given a staggering 26 vaccines before the age of one. Infant mortality rate in the U.S. is 6.22 per thousand. In Sweden and Japan, only 12 vaccines are given before the age of one, and they have the lowest infant mortality rate at 2.75 per thousand. I thought vaccines were suppose to save lives? Just Google, &quot;infant mortality rate and vaccines.&quot;


Fri, Oct 21, 2011 : 7:02 p.m.

Do you have kids? The recommended vaccines in no way add up to 26 before they are a year old. There are other reasons that the U.S. has a high infant mortality rate.


Thu, Oct 20, 2011 : 2:51 p.m.

And yet my 18 month daughter got all her vaccines, but not a flu shot and some how managed to survive.

say it plain

Thu, Oct 20, 2011 : 1:41 a.m.

I agree with @Max Peters, with the exception that there is valid reason to believe that 1) babies should be helped to sleep on their backs, without overly fluffy bedding (because the risk of suffocation obviously increases when there is lots of billowy material or when the baby is face down in their bedding) and 2) very new babies lack the head and neck strength to move out from under something like a parent's pillow, or a parent (or sibling, for that matter). Once a baby is older these issues relating to suffocation risk from co-sleeping are no longer relevant (and indeed, every year we hear about strangulations *caused* by faulty cribs and parents in the next room who don't know what's happening to their babies). The whole phrasing of this article (and especially the title) makes it seem like somehow the physicians are making a case for a certain 'style' of night-parenting, when that is just clearly not so.


Thu, Oct 20, 2011 : 3:12 p.m.

I agree, @say it plain. Headline writing can be challenging. Technically, the headline is accurate but, as you say, misleading.

say it plain

Thu, Oct 20, 2011 : 2:14 a.m.

thank you @DBH for providing that extra info, and further clarification that pediatricians and 'experts' in this domain are *not* talking about sleeping 'alone' in the way some people may believe they are :-) ! Perhaps would consider changing the title of the piece to avoid being misleading? !


Thu, Oct 20, 2011 : 2:06 a.m.

My apologies, as the link provided apparently does not work directly. You will need to go to <a href="" rel='nofollow'></a> and then click on the link that says &quot;new recommendations&quot; to access the recommendations to which I referred in the previous reply.


Thu, Oct 20, 2011 : 2:02 a.m.

&quot;...and parents in the next room who don't know what's happening to their babies&quot; Go to the following link and read all of the recommendations. One of them is to have the baby sleep in the same room as the parents, just not in the same bed. Put them in a crib on their backs in warm and comfortable clothing without blankets. There are several other pieces of advice, one of which I like quite a bit consisting of having them on their abdomens while awake and while being monitored closely so as to allow them to develop neck strength and to avoid developing a flat area on the back of their skull. <a href="" rel='nofollow'>;nftoken=00000000-0000-0000-0000-000000000000&amp;nfstatusdescription=ERROR%3a+No+local+token</a>

Max Peters

Thu, Oct 20, 2011 : 12:58 a.m.

50 of the 107 died in cribs, eh? Maybe that should be the story. How many kids were born in MI last year? How many slept in cribs? How many co-slept? Without these denominators you're just flaming mommy wars.


Fri, Oct 21, 2011 : 7 p.m.

Not necessarily. It just said 57 died in a bed. The other 50 could have been cribs, carseats, swings, couches, bouncy seat, the floor, wherever people happen to lay a baby down when it's 0-4 months old...


Thu, Oct 20, 2011 : 12:11 a.m.

Well I believe that there is a reason why more african american babies are dying, part is from lack of education on their end, but also comes from lack of education on all caregivers in the babies lives(e.g. family,friends,child care provid...). The reason I say this is because being African American myself , and a young mother I know when I first had my son in 2009 @ 21 some of the things I learned through patient education at St. Joes which is to not to co-sleep,and to lay a baby on their back.which i followed one because I agree and it makes sense but also as a nursing student then , I was educated on the matter before hand. However myself and his father still being inexperienced first time parents relied mostly on the self knowledge both our parents and families had to offer and sometimes even though it was GOOD advice some was outdated like my mother believed it was ok to place a baby on it's stomach because thats what she had done to us in the 80's . So I think while educating new parents on the importance of following safety measurements it would also be just as important to educate the community, family, and friends because believe it or not alot of these people play vital and important roles in our, babies/ children lives, they help throughout the growth and development stages.


Wed, Oct 19, 2011 : 10:34 p.m.

Co-sleeping is not unsafe as long as the parents are not on any drugs, alcohol and don't have any medical issues(sleep apnea, obesity).

say it plain

Thu, Oct 20, 2011 : 12:30 a.m.

Oh yeah, lol, @Anonymous?! I have many years experience with children, plus very good knowledge of the research indicating that there is a different between &quot;helicopter parenting&quot; and meeting children's needs (sometimes the lay-person-oriented literature calls this style &quot;attachment parenting&quot;, the idea being that to lay the groundwork for all subsequent development, one needs to help their baby become &quot;securely attached&quot; to caregivers)... so sorry, you still don't trump the research and the experience of people who don't agree with you lol :-)


Wed, Oct 19, 2011 : 11:59 p.m.

Research and reality and experience and two totally different things. I have 25 years experience working with children. Many raised by helicopter parents and co-sleeping. You can say what you want, I know what I know. It's not helpful in any way for the child to sleep with their parent/s each and every night.

say it plain

Wed, Oct 19, 2011 : 11:56 p.m.

Anonymous is *dead wrong* about why babies need to sleep alone...but I do agree that until a baby is physically able to roll out from under a sleeping parent, it is best for them to sleep alone. The stuff about self-soothing has been completely debunked by research and deserves to be tossed out the parenting-advice window already, pulease! Each family can decide what they are happy doing as parents and how they feel about meeting a child's needs, so unless you'd like a lecture about how you're messing with your kid to let them cry or be scared alone (other cultures think Americans especially are cruel to their children for forcing them to sleep alone as little babies and children!), don't pretend that one must refuse to sleep with their kids/babies! It just needs to not happen while the babies are tiny!


Wed, Oct 19, 2011 : 11:34 p.m.

Children belong in their own bed, period! It teaches them self-soothing and the beginning of coping mechanisms. It allows parents independence in a healthy relationship as well. It's ok for children to come to parents bed for an occasional concern, however they should always be returned to their own bed. Parents that allow their children to sleep with them nightly are doing it to comfort themselves, not their children.


Wed, Oct 19, 2011 : 11 p.m.

I do not agree. There are multiple deaths of infants from co-sleeping arrangements that are not directly related to drugs or alcohol or underlying health issues.