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.
Sources
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Ball HL. Bed-sharing and co-sleeping: research overview. NCT New Digest 2009; 48: 22-27.
Barnett R, Moon G, Kearns R. Social inequality and ethnic difference in smoking in New Zealand. Social Science and Medicine 2004; 59: 129-143.
Blair PS, Fleming PJ, Smith IJ, Platt MW, Young J, Nadin P, Berry PJ, Golding J. Babies sleeping with parents: case-control study of factors influencing the risk of the sudden infant death syndrome. British Medical Journal 1999; 319: doi: 10.1136/bmj.319.7223.1457.
Blair PS. Perspectives on bed-sharing. Current Pediatrics Review 2010; 6: 67-70.
Mitchell EA, Scragg R, Stewart AW, Becroft DM, Taylor BJ, Ford RP, Hassall IB, Barry DM, Allen EM, Roberts AP. Results from the first year of the New Zealand cot death study. The New Zealand Medical Journal 1991; 104: 71-76.
Mitchell EA, Taylor BJ, Ford RPK, Stewart AW, Becroft DMO, Thompson JMD, Scragg R, Hassall IB, Barry DMJ, Allen EM, Roberts AP. Four modifiable and other major risk factors for cot death: the New Zealand study. Journal of Pediatrics and Child Health 1992; 28: s3-s8.
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Last year I went to a symposium where I heard James McKenna speak on co-sleeping. Fascinating angle based on–wait for it–science. And a healthy understanding of how the machine works to convince the public that something is dangerous. As he said, a baby dies in a crib, and we have to figure out how to make cribs safer. A baby dies in a bed, and co-sleeping is vilified.
Unfortunately it is also true that the numbers of these studies done by government agencies aren’t telling the truth. I know of one locally that included a baby that died in a carseat in the house (from not being strapped in properly, and left unattended, then suffocated), and this death was added into the numbers for co-sleeping. I also saw a poster in my local Family Services office that said ‘If you knew your baby was 40% more likely to die in your bed, where would you put her to sleep?’ Now the people who funded that, amongst others, First Candle, say that it is a positive step toward ‘room sharing’ because the picture showed the baby in a cradle next to the bed. The family in the photo was clearly Mexican, so one would assume the campaign was aimed at Mexican families. What conclusions can I draw from this campaign? Mexican families should not co-sleep. There is clearly a racial issue going on here that we’re just supposed to be ignoring, I guess.
bed sharing can be a compassionate way to show your love to your kids, but yes, you also need to help them know how to be independent by leaving them when they sleep.
I admit I’m rather confused – by bedsharing, you’re not leaving your child. And how does leaving them alone “teach” them independence in your eyes?
Well you pretty much nailed it there at the end, governments are loath to actually fix a problem, not because they don’t know how, but because if the problem is fixed then their money and jobs dry up. Continued problems, while appearing to do *something* to ‘help’, keeps the money and jobs flowing. Bedsharing is free, easy, and works well with families in poverty (small spaces, less likely to have new beds/cribs/extra rooms, etc) Smoking, meanwhile, is expensive, difficult to maintain in poverty, and does not help quality of life. It’s not hard to imagine a pamphlet to encourage high school students in low income areas from never picking up that first cigarette and a pamphlet to encourage prenatal women to consider safe co-sleeping. But that would employ far less for far shorter than the elaborate and mostly useless campaigns politicians lobby for now.
It really is incredibly frustrating isn’t it? I find myself getting very angry when faced with these realizations. For all the rhetoric of fixing things and helping people, really the only people who are helped are those getting paid, eh?
I think this article is a little off mark. You are quite correct I know from my own research that Co – sleeping when you eliminate the risk factors is very safe. I also know that the five a day campaign (5 portions of fruit & veg per day runs in the uk) isn’t wholly accurate and scientifically it’s believed we should be eating around at least double that. Here’s the issue many many people struggle with five and so the campaign was set at a level believed to be achievable by the masses as it’s better than nothing. It’s the same with not co – sleeping, many many many people will hear it’s safe and not all the clauses that come with it. So, it’s easier and will ultimately save more babies if they just say no. I agree that’s not necessarily the correct answer but it’s not as simplistic as you make out. We all know the dangers of smoking which is a simple straight no yet recently I heard a girl saying it strengthened her unborn babies heart. When you’re up against that kind of ignorance it’s not easy to have a campaign saying do co – sleep but don’t have baby to high on the bed, don’t be overtired don’t. ..etc etc.
Except the research would suggest you are wrong. Parents CONTINUE to co-sleep regardless, only they don’t ensure it’s safe. And families who try to adhere to “no bedsharing” end up falling asleep on sofas or rocking chairs, as evidenced by the increase in deaths from those places in the UK following the “no bedsharing” recommendation.
I admit I don’t see the link to the smoking bit either. Plus, it’s not about saying, “You SHOULD co-sleep”, but rather saying, “IF you’re going to co-sleep, this is how to do it safely.” The best analogy is sex ed: If you ONLY preach abstinence you end up with worse outcomes overall. If however, you say the “safest” is to abstain, but if you’re going to do it anyway, these are the steps you take, you save more lives. It really is that easy 🙂 Of course there will be some people who don’t listen to the nuances, but I would imagine they aren’t listening to “don’t bedshare” either. They are likely doing what they want regardless.