Sleeping on sofas increases the risk of sudden infant death syndrome and other sleep-related deaths. We sought to describe factors associated with infant deaths on sofas.
We analyzed data for infant deaths on sofas from 24 states in 2004 to 2012 in the National Center for the Review and Prevention of Child Deaths Case Reporting System database. Demographic and environmental data for deaths on sofas were compared with data for sleep-related infant deaths in other locations, using bivariate and multivariable, multinomial logistic regression analyses.
A total of 1024 deaths on sofas made up 12.9% of sleep-related infant deaths. They were more likely than deaths in other locations to be classified as accidental suffocation or strangulation (adjusted odds ratio [aOR] 1.9; 95% confidence interval [CI], 1.6–2.3) or ill-defined cause of death (aOR 1.2; 95% CI, 1.0–1.5). Infants who died on sofas were less likely to be Hispanic (aOR 0.7; 95% CI, 0.6–0.9) compared with non-Hispanic white infants or to have objects in the environment (aOR 0.6; 95% CI, 0.5–0.7) and more likely to be sharing the surface with another person (aOR 2.4; 95% CI, 1.9–3.0), to be found on the side (aOR 1.9; 95% CI, 1.4–2.4), to be found in a new sleep location (aOR 6.5; 95% CI, 5.2–8.2), and to have had prenatal smoke exposure (aOR 1.4; 95% CI, 1.2–1.6). Data on recent parental alcohol and drug consumption were not available.
The sofa is an extremely hazardous sleep surface for infants. Deaths on sofas are associated with surface sharing, being found on the side, changing sleep location, and experiencing prenatal tobacco exposure, which are all risk factors for sudden infant death syndrome and sleep-related deaths.
Comments
A Safe Place
Rechtman et al report in October Pediatrics the increased risk of sudden infant death syndrome in babies who were put to sleep on sofas. They analyzed 1024 deaths that occurred in 24 states from 2004-2012. These deaths comprised 12.9 % of sleep-associated deaths during this time interval.
Parents often place their infant on a sofa as a temporary sleeping space but the surface is hazardous for many reasons. They are more likely to be placed in prone position, roll onto their side during sleep, and share the surface with an adult who may be watching TV, smoking, or who has dozed off to sleep.
Interestingly, in Finland a country with one of the lowest infant mortality rates, expectant mothers receive from the state a cardboard box fitted with a firm mattress. The box serves as a safe place for a newborn to sleep. In addition, the box is filled with the essentials to care for a newborn baby. It is said that the baby box has helped Finland achieve one of the world's lowest infant mortality rates( Helena Lee, BBC news: Why do Finnish Babies Sleep in Cardboard Boxes?) The baby box tradition dates back to the 1930s when the government of Finland wanted to send a message that all children born in that country should have an equal start in life, regardless of socioeconomic status. As the program evolved, mothers were encouraged make their first prenatal visit before the fourth month of pregnancy.
Finland learned a long time ago that parents need a safe place for a baby to sleep at home or when visiting friends and family. . The Baby Box provides that place where babies can go "back to sleep" anywhere and still be close by while parents take a few minutes off. Finland also sends an important message to parents that the country values every infant born in Finland. Perhaps we should be asking the question "Why Don't' American babies Sleep in Cardboard Boxes"?
Conflict of Interest:
None declared