A top Ontario health official is calling on parents to drop an increasingly popular childrearing practice: co-sleeping.
The recommendation, which is riling proponents of sharing the parental bed with infants and children, comes from Jim Cairns, Ontario's deputy chief coroner.
He authored a report released Monday that included a look at the rise in Sudden Unexpected Death (SUD) of infants under one year of age (which unlike Sudden Infant Death Syndrome, SIDS, can be explained by an accident or illness).
Dr. Cairns found that co-sleeping with an adult or sibling contributed to the deaths of 11 infants out of 21 SUD cases in 2005 in Ontario. The average age of the infants was three months.
The other 10 deaths involved babies placed in unsafe sleeping environments - chairs, couches and cluttered cribs.
In 2004, 16 cases were attributed to SUD.
"We are opposed to co-sleeping, period," Dr. Cairns says. "The only safe sleeping environment is in a properly manufactured crib with a proper mattress and nothing in it."
In his opposition to co-sleeping, Dr. Cairns is taking a stand even stronger than that of the Canadian Paediatric Society. The organization says the safest place for a baby to sleep is in a crib close to the parents' bed, but also offers guidelines for parents on safe co-sleeping, such as avoiding alcohol.
Dr. Cairns's criticism comes at a time when co-sleeping is gaining ground as a mainstream practice. Parents who co-sleep say sharing a bed benefits the whole family because it brings them closer together and makes kids feel safe.
"I get to parent at night and I get to be with them during those waking moments, which are so precious," says Toronto mother Kelly Dobbin, who runs a parenting centre and has co-slept with her husband and two children, aged 6 and 3, since they were born. "They won't be there forever."
Ms. Dobbin says co-sleeping has become more popular among the parents who visit the centre.
Dana Driesman co-slept with her daughter, now 2, until she was 18 months old, and says she'd do it again in spite of the warning. "It just made sense," she says. "My baby nursed a lot - it was instinctual."
Ms. Driesman worries that the report may dissuade other parents from trying co-sleeping. "People are going to get scared," says the Mississauga, Ont., resident.
"They're going to trust that it's coming from a reliable source and they're not going to be fully informed as to what the benefits are."
Melissa Crawford, a Hamilton, Ont., mother of two small children called the report ridiculous. "Co-sleeping has been the norm for most of history, and still is in most of the world," she wrote in an e-mail interview.
While SIDS rates are in decline in North America thanks to public health initiatives - the Ontario report found there were six cases of SIDS in 2005, down from 140 in 1991 - Dr. Cairns says the incidence of Sudden Unexpected Death is on the rise.
"What's been replacing SIDS, unfortunately, is co-sleeping or unsafe sleeping environments," Dr. Cairns says.
A number of the cases he's seen involved unsafe co-sleeping practices of the type that are discouraged by the Canadian Paediatric Society, such as being a smoker, consuming alcohol or being extremely tired. Sleeping with a baby in a chair or on a couch is also deemed high-risk.
But even careful parents following guidelines for safe co-sleeping put infants at risk, Dr. Cairns says. "Unfortunately, it still happens when people are taking proper precautions."
People who support co-sleeping say parents should feel comfortable making their own choices. If "you have made yourself aware of whatever risks there are of sleeping with or not sleeping with your children, then you make the choice that feels safest for you and your family," Ms. Dobbin says.
On that point, Dr. Cairns agrees with co-sleeping advocates. "You're entitled to your opinion and these are our hard facts. I'm not debating. I'll give you the figures. You make the decision."
Surfaces not designed or approved for infants' sleep
Adult beds
Infant swings
Playpens
Bassinettes
Cradles
Waterbeds
Couches
The floor
Mattresses (on floor)
Car seats
