Is breast feeding in bed always a safe practice?
OBJECTIVE
To examine whether infants who are being breast fed in their mother's bed are at increased risk of accidental suffocation.


METHODS
Review of all cases of unexpected infant death occurring in South Australia, Australia during 1996 was undertaken to ascertain whether any cases of sudden infant death had occurred in association with breast feeding in the parental bed. All infants had death scene examinations, history reviews and full autopsies performed.


RESULTS
Three of a total of 28 cases of unexpected infant death were identified where accidental asphyxia associated with breast feeding-related cosleeping was considered a likely cause of death. Maternal fatigue was a factor in each of the three cases. There were nine SIDS cases and 16 other cases which included non-accidental injury, accidental asphyxia, congenital cardiovascular disease and sepsis.


CONCLUSIONS
Accidental asphyxia is a rare but possible outcome if mothers fall asleep in bed with their infants while breast feeding. Nursing mothers should be made aware of the potential dangers of fatigue and sedation in such circumstances. Breast feeding out of bed, or in the company of a second person who can ensure the safety of the infant if breast feeding is occurring in bed may prevent these unfortunate fatalities.
Department of Paediatrics, Women's and Children's Hospital and University of Adelaide, Adelaide, South Australia, Australia. rbyard@mad.adelaide.edu.au
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D000061:Accidents, Home / Q000517:prevention & control / Q000706:statistics & numerical data; D001238:Asphyxia Neonatorum / Q000209:etiology*; D001513:Beds; D001942:Breast Feeding / Q000523:psychology / Q000706:statistics & numerical data; D002423:Cause of Death; D005221:Fatigue / Q000523:psychology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009035:Mothers / Q000193:education / Q000523:psychology; D011159:Population Surveillance; D012307:Risk Factors; D012890:Sleep; D013021:South Australia; D013398:Sudden Infant Death / Q000209:etiology*