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"Largely preventable" were the words used by the Consumer Product Safety Commission (CPSC) (1999) to describe 515 deaths of children under two years of age that occurred between January 1990 and December 1997. "Don't sleep with your baby or put the baby down to sleep in an adult bed," said CPSC Chairman Ann Brown. "The only safe place for babies is in a crib that meets current safety standards and has a firm, tight-fitting mattress. Place babies to sleep on their backs and remove all soft bedding and pillow-like items from the crib" (Consumer Product Safety Commission 1999). A CPSC study (Nakamura, Wind, and Danello 1999) published in the October issue of the Archives of Pediatrics and Adolescent Medicine found that placing babies in adult beds puts them at risk for strangulation and suffocation. The CPSC's study was described as the "first to quantify the number of fatalities resulting from the practice of cosleeping with babies" (Nakamura, Wind, and Danello 1999).
CRITICS CITE DEFICIENCIES IN STUDY
The CPSC recommendations generated tremendous controversy and professionals were quick to identify the many deficiencies in the study:
* The data was not controlled for demographic variables and therefore cannot be extrapolated to the general population.
* The researchers were unable to identify the number of children sleeping alone, with another child, or with an adult when death occurred.
* No comparison was made between the number of deaths that occurred in adult beds and the number of deaths that occurred in cribs or cots during the study period.
* No information was provided on how many children under two years of age bed-share and for what period of time, therefore relative risk could not be calculated.
* No distinction was made between deaths due to Sudden Infant Death Syndrome (SIDS) and deaths due to overlying.
* No distinction was made for deaths that occurred because of known risk factors including co-sleeping with older siblings, sleeping in waterbeds, or sleeping prone (facedown).
* Death certificates provided little or no information on the use of alcohol, nicotine, or other drugs known to impair adult arousal.
Based on available data, the relative risk of infant death due to overlying is 1 in 300,000 births; the relative risk of infant death due...