Monday
Nov142011
Fun with Analogies: Co-Sleeping and Knives, Car Travel and Guns
Monday, November 14, 2011
The City of Milwaukee Health Department wants to tell you that co-sleeping is like letting your baby sleep with a sharp knife . They are sharing this news via two new posters (one with a black baby one with a white baby) that tell parents that babies can die when sleeping in adult beds and that warn parents to always put their baby to sleep on its back in a crib. They also give a phone number for people to call if they cannot afford a crib.
I've been over this before. Statistically, co-sleeping is as dangerous as traveling by car (really, read the stats). But the health authorities ignore that. When I wrote about this previously, I said:
But since the City of Milwaukee likes its analogies in visual format, I thought I would help them out by creating an equivalent poster with the message that taking your baby in the car is just like giving your baby a loaded gun to play with.
The idea that crib sleeping is always a perfectly acceptable alternative to co-sleeping is laden with as much societal and cultural baggage as the assumption that walking is always a perfectly acceptable alternative to travel by car. Sometimes it might be, but often it simply isn't. Health authorities need to stop scaring and shaming parents and instead teach them about the pros and cons of different sleep options and about the things that they can do to make their chosen sleep environment as safe as possible.
More info: Co-Sleeping Safety
I've been over this before. Statistically, co-sleeping is as dangerous as traveling by car (really, read the stats). But the health authorities ignore that. When I wrote about this previously, I said:
Cars are convenient. People like cars. Peoples lives would be changed significantly and we would have to drastically change our habits to give up cars.
Bed sharing is convenient. Parents and babies like co-sleeping. Parents would be more tired, breastfeeding rates would be reduced, and parents would be less responsive to their infants at night if they had to give up bed sharing.
Bed sharing is a reality. Parents do it. Banning it or discouraging it is as ridiculous as trying to ban or discourage car travel.
If people stopped traveling by car except when it was really necessary, there would probably be more accidents and more deaths because the roads would be full of inexperienced drivers. And when parents are generally discouraged from sleeping with their babies and then bring them into bed when really desperate, there are more accidents, more deaths.
The Ontario coroner should stop telling people not to bed share and instead tell them how to make bed sharing safer. Public health agencies don’t tell people not to travel by car, instead they tell them to use seatbealts, use car seats, drive the speed limit, don’t use cell phones while driving, etc. Address the conditions that make bed sharing unsafe. But don’t tell people not to do it. Because they will. And they will do it unsafely.
But since the City of Milwaukee likes its analogies in visual format, I thought I would help them out by creating an equivalent poster with the message that taking your baby in the car is just like giving your baby a loaded gun to play with.
The idea that crib sleeping is always a perfectly acceptable alternative to co-sleeping is laden with as much societal and cultural baggage as the assumption that walking is always a perfectly acceptable alternative to travel by car. Sometimes it might be, but often it simply isn't. Health authorities need to stop scaring and shaming parents and instead teach them about the pros and cons of different sleep options and about the things that they can do to make their chosen sleep environment as safe as possible.
More info: Co-Sleeping Safety
Reader Comments (135)
No, I hadn't seen those. Ugh.
http://www.askdrsears.com/news/latest-news/dr-sears-addresses-recent-co-sleeping-concerns
Addresses the science behind safe cosleeping.
[...] with Your Baby: A Parent’s Guide to Cosleeping Fun with Analogies: Co-Sleeping and Knives, Car Travel and Guns Common Sense and [...]
I have mixed feelings about this ad. As a co-sleeping mom, I HATE IT when co-sleeping is made out to be the bad guy, when really it's unsafe sleeping conditions in general (soft bedding, intoxicated parents, etc) that is causing the problem.
But from a public health perspective I can see why it's easier to get one definitive message out (DON'T do X) than many nuanced messages (here's how to co-sleep safely, consider not co-sleeping if x, y, z...)
Here's my experience with "early outreach". A day after my 2 1/2 year old daughter Clara was born (at home, normal delivery) she turned blue several times in a row. Though we never did find out exactly why, the assumption is that she had a few minor seizures due to bleeding on the brain, probably caused by a quick delivery.
Anyway, she was hospitalized at our nearest level III NICU, but after a few days seemed totally normal and healthy. Unfortunately she'd had some suspicious blood work so they wanted to keep her in to finish a round of antibiotics (10 days.) I was so freaked out by the whole experience that I just went with it.
For the last 7 days of her stay, I almost completely took over her care. The nurses checked on her every four hours, and I'd usually go off and try to get some real sleep in the middle of the night, but otherwise, it was pretty obvious I knew what I was doing. I talked with the nurses enough that they must have understood that I was an experienced, confident, educated mom.
The last couple of days we were moved into what they called the "Parent Training" room (UGH) where there was a private bathroom and two little sofa beds. I actually did not co-sleep with Clara, though I really wanted to, because the beds were so narrow that I was afraid she'd be buried in my armpit or fall off. (Also, did I mention the whole hospital experience had me freaked out?) But I did bring her into the bed to nurse...lying down, of course.
Early in the morning one of the nurses happened to come in while we were cuddling/nursing on the sofa bed. She didn't say anything at the time, but about an hour later came back and lectured me about the dangers of co-sleeping: "I have seen some really awful stories. I want you to never sleep in bed with your baby." I was completely dumbfounded. This was not "public health", this was a nurse lecturing an experienced, educated, reasonable mom of five in a setting where I could not get away or even defend myself (we were going through her check-out paperwork and the last thing I wanted to do was delay the process in any way, and I was so freaked out by the "authority" figures and all the hospital procedure that I was, frankly, too scared to make a fuss.)
It's easy enough to ignore ads, billboards and commercials that don't seem to be aimed at me, specifically. Not so easy to ignore or disregard a health "authority" lecturing me while I was in a vulnerable position. What killed me about it was that there was absolutely no room allowed for nuance, no recognition of my status as a smart, conscientious mom, the expert on my own baby. Just a lecture, as though I was planning to go home, do some meth, chase it down with a bottle of vodka and then perch my baby atop a nice fluffy pillow on a waterbed. I'm sure she meant well, but I felt worse at that moment than I had the entire rest of the hospital stay. And it didn't help my insecurity about taking my baby home, either.
Fortunately I got over it pretty quickly. Once I was out of the hospital setting it's amazing how fast my baby stopped seeming fragile and helpless and how readily I got my confidence back. But again, she was my fifth baby. Imagine if she'd been my first or even second?
That's what scares me, honestly, more than billboards or public health efforts. It's health officials scaring people in a personal, one-on-one way. And not just the "intended audience" we keep talking about here, either.
I just want to applaud this comment. That's the heart of the issue isn't it? That this may not just scare the parents who would do something to make the sleep environment unsafe, but that it may also scare parents who would be willing to learn the safe guidelines and would happier and more rested if they bed-shared.
It's similar to the issue of formula ads. We, women who tend to read blogs like this, love to say how we are not influenced easily by advertisements, but then we aren't the intended target. There are women (and men) who are easily influenced and we do them a disservice by not trying to provide them with accurate information.
Aurora - Please go have a look at the stats. In the first year of life, sleep related deaths are the number 1 cause of death in babies born healthy.
All the things you mentioned do raise the risk, but so does co-sleeping itself when that environment contains pillows, blankets and adult mattresses - basically any material that can trap exhaled CO2 and inhibit the free movement of oxygen. This is *especially* true for babies under 4 months of age.
Courtney, there are studies that have stratified for this. Here's one - "The risk of suffocation was approximately 40 times higher for infants in adult beds compared with those in cribs. The increase in risk remained high even when overlying deaths were discounted (32 times higher) or the estimate of rates of bedsharing among living infants doubled (20 times higher). " http://pediatrics.aappublications.org/content/112/4/883.long
And terri How many of those were actual cosleeping or really accidents where the parents just passed out and did not happen to have their bed cosleep safe? http://www.askdrsears.com/news/latest-news/dr-sears-addresses-recent-co-sleeping-concerns
http://www.my-natural-motherhood-journey.com/only-on-fox6-is-sharing-a-bed-with-your-infant-right-or-wrong.html
There is a HUGE difference in passing out from Exhaustion while the baby is in your arms and cosleeping.
opps wrong link
http://www.fox6now.com/news/witi-100503-bed-sharing,0,7099533.story
I love your analogy, it's perfect and your poster is priceless! Can you send it to the folks that made the baby in bed with the knife ...ha!
good point.
[...] campanha contra a cama compartilhada baseou-se em estudos que faziam ligação entre esse antigo hábito familiar e casos de morte por [...]
[...] Annie who blogs at PhD in Parenting has provided an intelligent response. You can read it here. As Annie points out, co-sleeping is statistically as dangerous as travelling by cars. So [...]
[...] Annie at PhD in Parenting gave a great response to the shameful advertisement from the city of Milwaukee in Fun With Analogies [...]
This is my favorite post of yours ever.
:)
[...] First is PhDinParenting’s comparison of car travel and cosleeping. [...]
Thanks! :)
I love this post; I've often thought there was a parallel between cosleeping and driving, in that rather than walk, we try our hardest to make driving as safe as possible. I think, though, that this post implies that cosleeping and driving are equally dangerous. It is my understanding that driving is the leading cause of death (approximately 300 deaths per year in Canada). I am not sure how many deaths we have attributed to cosleeping, but I'm pretty sure it would be less than 300 per year. SIDS is approximately 150 per year: I imagine that cosleeping deaths would be fewer simply because of the attention our public health gives to carseat safety and SIDS, but I could be wrong.
At any rate, I saw a few people share this post on Facebook and state that driving and sleeping with your baby were of equal risk, when I think in fact that they are not. One blogger says this about your post: As Annie points out, co-sleeping is statistically as dangerous as travelling by cars." (here is her blog post: http://lilsnowflakes.wordpress.com/2011/11/19/co-sleeping-and-scare-tactics/?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+npnVolunteersViaNpnInGoogleReader+%28NPN+Volunteer+Posts%29 )
I LOVE your ad, with the baby and the gun! That made me laugh pretty hard. It is interesting how we perceive risk, and also how culture gets very entangled with behaviour.
I also get quite irritated with the Milwaukee ads because it echoes for me the ad phenomenon Gabrielle Palmer mentions in The Politics of Breastfeeding, where physicians were running public health campaigns disdaining the "Ignorant Mother" and promoting public education (on the benefits of formula), and blaming ignorant mothers for the infant mortality rate. The Milwaukee ads belittle parents by fear mongering. Rather than scolding parents, disseminating information is a far less arrogant approach. Give facts, give information, and allow parents to decide. That is what informed choice is all about: shocking images simply ignite divisiveness and produce fear and guilt amongst parents. Grr. There is a blog carnival coming up on the benefits of cosleeping! I'm going to participate. Here's a link; http://monkeybuttjunction.com/2011/11/17/safe-cosleeping-blog-carnival-call-for-submissions/
Hopefully my links don't make this wind up in your sp*m box!! I just wanted to add to the conversation!
There are fewer co-sleeping deaths per year than there are driving deaths, but there are also fewer babies (that would be in "danger" from co-sleeping) than there are people (that would be in "danger" from car travel). That is why I calculated the co-sleeping numbers as deaths per live birth, whereas I calculated the driving numbers as deaths per population. It still isn't perfect because not every baby co-sleeps and not every person rides in a car and we don't have exact stats for the percentages for either of those, but it is close enough to draw a parallel.
Has anyone called Milwaukee to tell him how wrong they are? Presented FACTS about cosleeping and let them know That they need to show how to do it safely not demonize it? Anyone have the contact information to the Health department there? I know its a long shot because any government office thinks they know everything and can not be told different but someone needs to DO something. Last news report I saw said they were going to try and make co-sleeping Illegal in all of Wisconsin!!
Now I know they cant police the bedrooms but they are planning on prosecuting any parent that fell asleep with their baby in their arms if that baby tragically dies for Murder!
Someone else pointed out that poorer families are more likely to live in crowded homes and put the baby to sleep where they can--with mom or possibly other relatives or siblings. They're more likely to be unable to afford enough cribs for each baby/tot. At the same time (due to nutrition, smoking and prenatal care issues) more likely to have pre-term or low-weight infants at high risk for SIDS. And far less likely to breast-feed. All of which points to long-term education, support for moms and access to resources (and drug/alcohol/smoking treatment when needed) as ways to save kids. I'd guess these posters aren't really helpful.
These ads make me angry but I think Ontario's approach to assessing SIDS deaths makes me even more angry. How is anyone trying to research the ACTUAL causes of SIDS supposed to make any headway when the statistics they have to work with are completely worthless?
According to the Center for Disease Control The leading causes of death fro children under 1 year in the US are 1) Congenital defects, also known as birth defects, are problems that occur while a fetus is developing in the womb. Some of these can be prevented by prenatal care including nutritional and substance abuse counselling. 2) Preterm birth, also referred to as short gestation period, is a length of pregnancy less than 37 weeks. see above for the relevance or prenatal care. 3) Sudden infant death syndrome - which includes all unexplained deaths- in cribs or anywhere- only a very small fraction of these occur in beds- 4) Maternal complications of pregnancy- see above on prenatal care 5) Complications of the Umbilical Cord, Placenta, and Membranes- nothing to with beds or cars 6) unintentional injuries- majority of which are car accidents. As I wrote before - more babies die in cars (total) than in beds with non-drnking, non smoking parents.
okay, thank you! That makes sense! =)
[...] in which to drive with our children through the proper usage of car seats. (Melissa’s Note: PhD in Parenting also commented on this, click to see her post)A February 1992 Congressional Budget Office Staff [...]
[...] just like choosing to wear a seatbelt or not wear a seatbelt when driving a car (and interestingly, this author compared the statistics and found co-sleeping equally as risky as riding in a car in Canada). I am by no means making light [...]
Wow! I cannot believe that they were all formula fed. It is so interesting that there is no mention of this. Also, sounds like there was a lot of unsafe bedsharing going on. I also think the driving with baby analogy is a good one.
[...] Fun with Analogies: Co-Sleeping and Knives, Car Travel and Guns (phdinparenting.com) [...]
[...] with Your Baby: A Parent’s Guide to Cosleeping Fun with Analogies: Co-Sleeping and Knives, Car Travel and Guns Common Sense and Cosleeping Safe Cosleeping My Baby Sleeps With [...]
[...] sharing were not impressed with the Milwaukee department of health’s campaign. In the words of one blogger, “Statistically, co-sleeping is as dangerous as traveling by care… Health authorities need [...]
I'm not sure if the analogy is quite right. Playing with a loaded gun is equal in risk to riding in a vehicle?
Though I understand your point.
Not quite, Liza.
Saying that co-sleeping is like sleeping with a knife is equivalent to saying that playing with a loaded gun is equal to riding in a vehicle.
In other words, co-sleeping is NOT REALLY like sleeping with a knife.
Exactly!
Structural racism is killing these babies. When I see high rates and extreme racial disparities like this, it tells me that blaming the individual situations at the moment of death will not get us very far. The ad is just a slap in the face to all the parents who've lost their babies. The real problem is the lack of support for parents. Some of our children, we lift up and cherish and others, we crap on. This is obvious in the whole "except in the case of incest or rape" pro life movement. Even before birth there are a whole lot of people picking which babies we care most about. Still, we say to overwhelmed mothers, "well, you chose to have children," and pressure them to get a job, while services that are supposed to serve at risk populations cater to suburban stay-at-home moms. Back babies are more likely to be born too early and have inferior prenatal health care. And black mothers are more stressed. That's where the risk begins. They are also more likely to be poor. Top that off with this unsupportive judgmental campaign and I don't think they will get anywhere, but just continue the blame game.