It has come to my attention that New Zealand is the latest in a growing trend of places launching anti-bedsharing campaigns. This, on top of the Milwaukee campaign and a smaller, but still significant campaign in Cincinnati that occurred months ago. I feel like it’s time to not just point out what many of us having pointed out over and over – namely that education is key – but to truly examine why these places are feeling the need to take this route and what’s wrong with their approach (beyond the obvious).
Why are these campaigns taking place? The primary reason is that these places all have a disproportionately large number of infant deaths occurring in adult beds. The secondary reason, as I see it, is that it is far easier to try and vilify one action than to make the changes necessary at a societal level that would make these issues moot. In the United States, if one were to take a look at all the areas in which infant deaths in adult beds are happening at a high rate, there is a very large common denominator that no one seems to want to talk about – poverty. There isn’t a rash of infant deaths in upper-class, white suburbia (though they do occur), even though there is a rise in bedsharing in these areas. Coupled with poverty comes higher rates of smoking, alcohol and drug abuse, aspects that have been implicated in unsafe bedsharing, and lower levels of education and access to educational resources, meaning the individuals lack the means (and sometimes desire) to learn how to safely bedshare. In New Zealand, there have been several follow-up studies to the New Zealand Cot Death Study research that examined SIDS rates and found a link to bedsharing which has since altered the conclusions. Namely, it isn’t bedsharing per se but the interaction between bedsharing and smoking that increases the likelihood of infant death. If a mother isn’t smoking, there’s no added risk for SIDS, overlaying or hyperthermia. And according to research, maternal smoking is actually a problem in New Zealand, especially amongst lower-income Maori women who are also at the highest risk of having an infant die of SIDS. So we’re back to looking at the poverty issue again, but again, no one wants to talk about that, so they turn to bedsharing.
The problem with this approach is that it simply doesn’t work. And it’s not just because government health officials haven’t gotten to the root of the problem, but because the demographic they’re targeting usually don’t pay much attention to these types of campaigns. For example, anti-smoking campaigns have been around for ages, with little to no effect on lower SES neighbourhoods and individuals (perhaps one of the reasons NZ still sees very high smoking rates amongst those in low-SES areas). The reasons why are most likely varied, but the fact is that scare tactics don’t seem to work. They do, however, seem to work with middle to upper-class individuals, precisely the people who are not at risk in these situations. And what happens then? Well, if some data out of England says anything, it actually puts babies who weren’t at risk, at risk. How? Because the fear surrounding bedsharing means that women who are breastfeeding end up doing so on sofas or in chairs while exhausted and then fall asleep, putting their infant at a much larger risk of dying. In one study out of the UK, there was a three-fold increase in sofa deaths in a particular region following an anti-bedsharing campaign. Though only based on interviews, the reasons women reported turning to the sofa was out of fear of the bed because they’d seen the campaign and believed the bed was the least safe place for a baby.
Why do politicians focus on fruitless, though very public, campaigns when they don’t seem to help the target demographic and don’t deal with the underlying issues surrounding the problem? While I obviously can’t read their minds, I do have a few ideas, all of which pertain to politics over actual data. First, and not one to be ignored, I think that many times they want the easy fix. In their minds, it’s easier just to tell people not to bedshare than to actually provide education on the issues. Second, there is always going to be a lot of political correctness. No one in government wants to go out and claim that something like bedsharing is primarily in predominantly black or Maori communities, despite the data suggesting this is the case. While we can sit on the sidelines and say that it should be simple to point out that it’s not about being black or Maori, but about poverty, politicians don’t seem to think that way. They worry about re-elections and how things might be perceived. Finally, I think one of the biggest problems is that a splashy campaign makes it look like they’re actually doing something. Quietly going into these communities to provide education or to work on programs that would enable the communities to help themselves (instead of simply being told what to do by the government) doesn’t work politically. The death rates would drop, but if it’s done by a community coming together to help each other out, where is the room for more government programs and oversight in that? Education is tricky politically because to offer real, lasting education is to make yourself obsolete – and that’s the last thing any politician wants. I suppose you could call me cynical when it comes to government, but I don’t think they’ve learned how to either a) teach people how to help themselves, or b) learned to use the funds they collect appropriately and without all the strings attached.
And so we find ourselves here, with campaigns mounting against bedsharing, a practice research and history have told us is safe and compatible with infants’ well-being when done properly. We rally against these campaigns, as we should because we know it’s wrong, but we have to do more as they won’t stop no matter how often those in charge are told of the futility or even negative repercussions that may come from them. One will end and another will begin and our outcry will start anew. But what can we do? We can’t cure poverty, but we can take an active role in providing education and finding ways to get that education to the areas that need it most. Sending pamphlets or information to free clinics in the areas affected can help if they’re willing to share them with their clientele, especially if the people of interest trust the source of the information. We can also push our governments to use the funds they get from us towards programs that would work – like offering real and useful parenting education for all income levels without the high cost that many of these classes incur. In short, if you want to be active there are myriad ways to help these families get the information they need in order to make informed choices about their parenting behaviour. Complaining about the campaigns tells the government we’re unhappy, but it doesn’t do much for those who are losing their babies, and it seems like it’s going to be up to us to help change things.
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