Sleep positioners associated with infant death

Fifteen years ago my nephew died of Sudden Infant Death Syndrome (SIDS), found dead lying on his belly while his identical twin slept peacefully nearby.  And so when my first child was born I used a sleep positioner to keep him on his back, one of those foam wedges that prevents your baby from rolling over onto his belly.   But I threw that sleep positioner out before I had my second child—something told me it wasn’t safe.  This week the CDC finally published the data that supports my hunch: sleep positioners have been associated with 13 infant deaths. The consumer product safety commission has also received dozens of reports of infants found in dangerous sleeping positions after being put to sleep in a sleep positioner.

The irony is terrible: parents buy sleep positioner devices in an attempt to keep their kids safe.  But they really cause suffocation and death.

Most of the infants who died were placed on their sides to sleep, and later found lying on their stomach, dead.  Many had their faces close to the foam positioner.  It is unclear if these infants died of suffocation or of the other proposed mechanisms of SIDS.

All but one of the infants who died were age three months or less.  Most infants who die of SIDS are right around the age when they learn to roll.  That learn-to-roll timeframe is the most dangerous for SIDS.

Sadly, many sleep positioners are advertised to “help prevent SIDS.”  But the FDA has never approved any infant sleep positioner to reduce the risk of SIDS.

The only way for a baby to sleep safely is on his or her back in a crib.  The only things in the crib should be the baby and a tightly fitting crib sheet.  No sleep positioners, bumpers, blankets, stuffed animals, etc.  What about swaddling blankets, babies that roll over, “breathable bumpers” and breastfeeding babies that like to co-sleep with mommy?  I’m a breastfeeding mother of four, and I’ve lived these realities.  Please see my related post that answers these questions .  My colleague and pediatric sleep medicine researcher Dr. James Kemp also wrote an excellent post about co-sleeping.

Researcher Brenda Lawrence, MD, of the FDA, wrote in the CDC report, “At least nine of the infants were placed on their sides (and one prone), raising the concern that the ‘back-to-sleep’ message to position infants on their backs is either not being heard or not being followed.”

Other research has shown that concern for spit-up/GERD is a primary reason that parents don’t put babies to sleep on their backs.  The good news is that babies cannot die by choking on their own spit-up.  Healthy babies have a gag reflex, and just like adults they will cough if spit-up gets in their wind pipe (aka trachea).  Spit-up may make them cough and be uncomfortable, but they can’t die from it.

The FDA has actually approved a special sleep positioner for babies with GERD.  This product can only be obtained with a prescription.  But I’m even dubious of this product.  GERD does not cause death.  SIDS does.  Perhaps I’ll have to wait another fifteen years for this research.

My nephew’s identical twin, David, is now a happy, healthy 15 year-old who runs his own web-development business and avoids homework.  And I know that he has a twin in heaven watching out for him each day.

Kathleen Berchelmann, M.D. About Kathleen Berchelmann, M.D.

Kathleen M. Berchelmann, M.D., is a pediatrician at St. Louis Children's Hospital and Washington University School of Medicine, director of the St. Louis Children's Hospital Social Media Team, and co-founder of the ChildrensMD hospital physician blog. Her work has been featured in print and online publications including the St. Louis Post-Dispatch, the Chicago Tribune, and TIME magazine. She is a frequent contributor to Fox2 News STL Moms. Kathleen and her husband are raising five children.

Follow Dr. Kathleen Berchelmann on Facebook: ChildrensMomDocs Twitter: @MomDocKathleen and connect with her on .

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