I'd like to chime in on this issue as well.  Statistics on SIDS are very
detailed, and SIDS is a diagnosis of exclusion:  i.e. it is diagnosed
after medical problems,  suffocation, overlaying or other such factors
have been ruled out.  Even this distinction is now much muddier because of
the finding that babies diagnosed with SIDS were more likely to be on soft
bedding of some sort, which could actually cause suffocation.

Still, the incidence of SIDS in the US is currently somewhere between 0.5
and 1 per 1000 babies.  If anyone out there has the number of live births
in the US per year, we could calculate the actual numbers, but I would
expect that it amounts to numbers in the thousands.  The number of deaths
reported strictly as suffocation or overlaying deaths appears to be a
handful over several years.  Since the vast majority of baby deaths are
thoroughly investigated and deemed to be either SIDS or suffocation (or
some medical problem), I would imagine that if overlaying or suffocation
from improper bedding were really so common, there would be a lot more
cases reported (especially since so many mothers actually do sleep with
their babies but don't admit it, as Gail pointed out). Now that soft
bedding and sheepskins and excessive bundling of babies have been
documented as risk factors for SIDS, I don't know whether those SIDS
deaths which occurred under such circumstances will still be reported as
SIDS or be changed to suffocation deaths.  If they changed the definition
of SIDS deaths this way, we could conceivably see a lot more reported
suffocation deaths, but I would hope that these would be distinguished
from the overlaying and entrapment between mattress and headboard type of
incidents.

My reading of the 1997 AAP statement was that they could not recommend
co-sleeping as a way of preventing SIDS but were not really recommending
against co-sleeping.  They recommended some good safety measures to take
if co-sleeping, which I hope we all recommend to our moms.  Of course, I
would have been happier if they had pointed out that babies who sleep
separately from their parents are at least as much at risk, and that the
same precautions apply to babies in cribs.  As for the more recent press
release, it does concern me that they come out against co-sleeping in
this way.  I wonder how many moms will abandon breastfeeding due to the
hassle of frequent wakings because of the AAP recommendation against
co-sleeping, thereby increasing their babies' risk for so many other much
more common conditions, possibly including SIDS.

Personally, I will continue to recommend co-sleeping, providing parents
with the data that are available and suggesting safety precautions to
maximize their baby's safety regardless of how they choose to make their
sleeping arrangements.  Regards, Alicia Dermer, MD, IBCLC.

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