Bed sharing, smoking, and alcohol in the sudden infant death syndrome. New Zealand Cot Death Study Group.

Abstract

Objectives-To investigate why sharing the bed with an infant is a not consistent risk factor for the sudden infant death syndrome in ethnic subgroups in New Zealand and to see if the risk of sudden infant death associated with this practice is related to other factors, particularly maternal smoking and alcohol consumption.Design-Nationwide case-control study. 0-44 to 2-18). Neither maternal alcohol consumption nor the thermal resistance of the infant's clothing and bedding interacted with bed sharing to increase the risk ofsudden infant death, and alcohol was not a risk factor by itself.Conclusion-Infant bed sharing is associated with a significantly raised risk of the sudden infant death syndrome, particularly among infants of mothers who smoke. The interaction between maternal smoking and bed sharing suggests that a mechanism involving passive smoking, rather than the previously proposed mechanisms of overlaying and hyperthermia, increases the risk of sudden infant death from bed sharing.

Racial Disparity and Modifiable Risk Factors Among Infants Dying Suddenly and Unexpectedly

“…The increased risk for SIDS among bedsharing infants including AA infants is well documented. 8,12,13 Recent findings confirm that bedsharing is a risk factor for SIDS in US urban, predominately AA populations. 5,16 A number of studies have reported a positive interaction between maternal smoking and bedsharing.…”

Infant Arousals During Mother-Infant Bed Sharing: Implications for Infant Sleep and Sudden Infant Death Syndrome Research

“…In fact, in a recent epidemiologic study from New Zealand, bed sharing (defined as bed sharing with anyone) was found to increase significantly the risk for SIDS when practiced in association with maternal smoking. 57 A subsequent epidemiologic study in southern California 58 failed to find increased risk for SIDS associated with similarly defined bed sharing when passive smoking was controlled for in the analysis; and a recent epidemiologic study in the United Kingdom 59 found that bed sharing with a parent(s) was associated with increased risk only in conjunction with parental smoking. It is also noteworthy that the New Zealand study found that room sharing (as opposed to bed sharing) with one or more adults conferred significant protection against SIDS, whereas room sharing with children did not.…”

Infant Sleep Location: Associated Maternal and Infant Characteristics with Sudden Infant Death Syndrome Prevention Recommendations

“…(4,5) As the rate of prone positioning has declined, other previously unrecognized risk factors for sudden unexplained infant death have emerged in recent epidemiologic studies. Despite the fact that bedsharing between an infant and adult facilitates breastfeeding and enhances parent-infant interactions, (6,7) this sleeping arrangement has been identified in epidemiologic studies as being hazardous in certain situations, particularly when one or both parents are smokers, (8)(9)(10)(11)(12) on excessively soft surfaces, such as waterbeds, sofas, and armchairs, (9,10,(13)(14)(15) or when the infant is less than 2-3 months of age. (9,12,(14)(15)(16)(17) In addition, there is an increased risk for sudden unexpected infant death when there are multiple bedsharers (13) and when bedsharing occurs for the entire night.…”

“…(9,12,(14)(15)(16)(17) In addition, there is an increased risk for sudden unexpected infant death when there are multiple bedsharers (13) and when bedsharing occurs for the entire night. (9,11) The risk for infant death may also be increased when the bedsharer has consumed alcohol or is overtired. (11,16) While it may not be bedsharing itself but the accompanying conditions that are hazardous, bedsharing may increase the risk in certain circumstances for overheating, (18) rebreathing, (19) and exposure to tobacco smoke, (20)all of which are known risk factors for SIDS.…”

“…(9,11) The risk for infant death may also be increased when the bedsharer has consumed alcohol or is overtired. (11,16) While it may not be bedsharing itself but the accompanying conditions that are hazardous, bedsharing may increase the risk in certain circumstances for overheating, (18) rebreathing, (19) and exposure to tobacco smoke, (20)all of which are known risk factors for SIDS. Currently, approximately half of all sudden and unexpected infant deaths in the US occur when the infant is sharing a sleep surface with someone else.…”