I’ve started looking into cosleeping in the wake of the Milwaukee anti-cosleeping billboards. I said to a friend recently that there’s something fucked up in Milwaukee to have caused all of their recent deaths, so that’s where I started in my research: what the fuck is happening in Milwaukee?
I started with the 2010 City of Milawukee Fetal Infant Mortality Review (FIMR) Report.
It’s immediately apparent that Milwaukee has an abysmal infant death rate, which is sharply divided by race and location. That report breaks out two zipcodes, their racial makeup, and their death rate for 2008. One zip code is 97.6% white with an infant death rate of zero. The other zipcode is 94.9% black with an infant death rate of 17.6, which is a shockingly high number. 73% of Milwaukee infant deaths are caused by complications of prematurity and congenital abnormalities. 18% are attributed to “SIDS, overlay, accidental suffocation”. SIDS is a really tricky diagnosis to research, because it has different definitions and is inconsistently applied, but I’m setting that aside for now.
For the deaths in the “SIDS, overlay, accidental suffocation category”, there are several “risk factors” that have been identified as being present in these kinds of deaths. (It’s important to note that “risk factor” doesn’t mean that factor caused the death, just that those factors were present.) The risk factors present in the Milwaukee deaths were 1) pillows, blankets, soft things present with the baby 2) bedsharing 3) secondhand smoke 4) baby placed prone or on side 5) baby was born prematurely 6) alcohol or drug abuse by caregiver 7) baby sleeping on a couch, chair, carseat, or swing. The average number of these risk factors present in each death was four. I can’t tell from the report quite how these risk factors tended to occur together.
There are several scenarios I’m worried about with an alarmist campaign like this:
I’ve never understood the general panic over cosleeping. I mean, “crib sleeping” isn’t safe, either. For safe crib sleeping (or, I like to say “isolation sleeping”) you have to follow a long list of safety guidelines:
Huh. It’s almost like cribs aren’t really a safe place for babies to sleep. How come I haven’t seen any alarmist billboards about the dangers of crib sleeping? Safely bedsharing actually involves many of the same warnings: keep pillows and soft bedding away from baby, have a firm mattress, don’t have gaps between the mattress and the wall/headboard, etc. Why can’t we just let parents know the basic guidelines of safe bedsharing? A huge campaign was launched in 1994 to educate parents to put babies to sleep on their backs, and the campaign is credited with reducing the SIDS rate by 50%. Maybe it’s time for a safe cosleeping campaign.
The reality of bedsharing is that as almost 70% of American parents cosleep with their baby at some point. Why? Because there are strong benefits of cosleeping, both for the children and for the parents.
Instead of listening to alarmist news reports, I recommend that you listen to the research of Dr James McKenna from the Mother-Baby Behavioral Sleep Lab at the University of Notre Dame. The Sleep Lab is a research and teaching laboratory that researches the safety, physiological, and psychological consequences of parent-child sleep choices. Digging into their published articles is a goldmine, but you can learn a lot just by checking out their website:
The facts about formula-feeding really interested me. McKenna’s research on that was verified for a Fox6 news report. All the cosleeping deaths in Milwaukee in 2009 and 2010 up until the report were of formula-feeding babies. In the FIMR from Milwaukee, why isn’t formula-feeding listed as a “risk factor”? The Fox6 report talks about a woman who accidentally killed her 6 day old infant while sleeping with her while drunk. Why is that a “cosleeping death”?!
What’s clear to me is that Milwaukee has a serious infant death problem that highlights their larger problems of racial and income-based disparities. Why are 73% of babies dying from issues with prematurity or birth defects? And why are those deaths clustered in certain zipcodes? Putting scary images on billboards that point the finger of blame at individual parents is a lot easier than addressing economic inequalities or a failing health care system. In the Fox6 news report, Anna Benton of the Milwaukee Health Department says,
“I really don’t think that this is a problem of any specific cultural group. And I guess I don’t feel it’s the place of the health department to distinguish between different types of people.”
But shouldn’t it be the job of the health department to determine the real reasons for these deaths and to address the most important factors? In Milwaukee (and elsewhere), cosleeping deaths occur mostly in poor, black families living in what Pat McManus of the Black Health Coalition of Wisconsin calls “chaotic homes.” Addressing poverty in black communities and the substance abuse, poor health care, and difficult child-rearing choices that accompanies poverty are much harder to do than just creating mean billboards.
Members of The Milwaukee Health Department are not doing their jobs. They are cowards who are ignoring the real needs of their communities.
In conclusion, this quote from the Sleep Lab site stood out to me as the bottom line on the anti-cosleeping mania in which Milwaukee is currently leading the pack:
“Unfortunately, the rhetoric against bedsharing parents has turned very ugly, very vitriolic, negatively judgmental and condemnatory, and indeed, nothing less than threatening, of any and all bedsharing parents even when risks are minimized; and the zeal and imprecise language which is being used by many technicians involved in what is considered “safe infant sleep” campaigns is over simplified to the point that it is inaccurate, misleading, and inappropriate, and is itself dangerous on many different levels, both politically and scientifically.”