Infants are “effectively being killed” by the practice of co-sleeping

There has been a lot of focus in the New Zealand media lately about the practice of co-sleeping, and the occurrence of infant deaths as a result. I know this, despite not owning a TV and avoiding the newspaper in my hormonal state, because people keep telling me, upon learning that we co-sleep, “Oh, but did you hear that they’re finding now it’s actually really dangerous?”

It has been interesting, reading the recent articles, as well as other articles from around the world in recent years.

It is important to note that New Zealand parents, upon the birth of their child, are given information on Sudden Unexpected Death in Infancy (SUDI) or Sudden Infant Death Syndrome (SIDS). Most parents are given a pamphlet distributed by Change For Our Children, which provides a list of the factors which make a baby more vulnerable to sudden death. These are:

  • Exposure to tobacco, both during and after pregnancy
  • Born before 36 weeks gestation
  • Weighing less than 2500 grams at birth
  • Not breastfed

Being unwell is also said to weaken a baby’s drive to breathe. Parents are also advised to sleep their baby face up and face clear, on a firm mattress with no adult bedding, no pillows, and no soft toys. If there is alcohol, drugs or partying around the baby, parents are told to ensure a sober person is with the baby.

The recent focus on bed-sharing in the media has been spurred by the fifty-five to sixty deaths of infants that have occurred during the night as said infant slept in the same bed as another person each year for the past four years (NZ Herald, ‘Co-sleeping baby deaths ‘like an epidemic,’ says coroner‘).

The death of Ivan Karaitiana in September 2011, at four months old, is one recent example that has been used in this campaign against bed-sharing and co-sleeping. Bed-sharing is being named as the culprit in little Ivan’s death, which has been ruled as SUDI. However, in reading the recent details of his death, it is clear that there were more prominent risk factors involved,

“[Ivan] was 6 ½ weeks premature and weighed 4lb 8oz (2.04kg) when he was born at Hutt Hospital…Cherie slept with Ivan in the double bed where they would normally top and tail, and his siblings slept in bunk beds…On the night before he died, Ms Karaitiana fed him formula and put him to bed, covered by a polar fleece baby blanket and a larger mink blanket.”
(NZ Herald, ‘Co-sleeping baby deaths ‘like an epidemic,’ says coroner‘ bold effects added by me)

Not only did Ivan have a very low birth weight, he was premature, so his lung function was potentially not as developed as it would have been, had he been full term. This is a known risk factor for SUDI. Further to that, he was not exclusively breastfed, providing the potential for the suppression of hormones which allow the mother to mimic her baby’s sleeping patterns. He was also covered by adult bedding, which placed the baby at risk for suffocation. The article also mentions that Ivan’s two older siblings also slept in the same room, as they had moved in with their grandfather due to financial difficulties.

Almost as an afterthought, right at the end of  the quoted article, the reporter adds, “[Ivan’s mother] had drunk a bottle of wine and smoked cannabis before going to bed“. Any baby, whether in the adult’s bed or not, is arguably placed in danger when their caregiver has consumed an entire bottle of wine and taken drugs.

Five month old Roretana Holland died of Sudden Infant Death Syndrome (now commonly synonymous with SUDI) in July 2010, while sharing a bed with his four year old sibling. The coroner was reported to have said that Roretana’s death was “another tragedy involving co-sleeping arrangements for infants as well as other matters highlighted by the pathologist” (The Dominion Post, ‘Infant died in bed with sibling‘), though it is important to note that this is not a direct quote of the coroner. However, closer reading of the article which details the coroner’s findings reveal again that bed-sharing, as attachment parents use it, was not the most prominent problem,

“The baby, one of four children aged under-five, co-slept with his four-year-old sister. All four children shared the same bedroom because they relied on a single oil heater for warmth. “Bedding consisted of a duvet cover acting as a mattress protector with a sheet over the top with a queen sized mink blanket (this was an unzipped sleeping bag). The children each had their own pillow.” On the night Roretana died he was given formula and pureed food before being put to bed at 7pm… Dr Kerry Thornbury of the Ora Toa Cannons Creek Medical Centre said the baby had been developing well, though had suffered skin infections, which were treated with Penicillin. There had been some concern about possible family violence but attempts to engage the Tamariki Well child nurse had been unsuccessful. The coroner’s decision stated that the mother had smoked throughout her pregnancy and drank alcohol, though gave up the latter when she found out she was pregnant after two months.”
(The Dominion Post, ‘Infant died in bed with sibling‘, bold effects added by me)

Roretana was not sleeping next to his exclusively breastfeeding, teetotaling, drug-free, healthy weight mother. He was sleeping with a very young sibling, out of necessity due to poverty. He was not sleeping on a firm, safe matress, but on a duvet cover, with adult bedding keeping him warm. The article seems to suggest that he may have been using a pillow, and if he wasn’t, his head was certainly next to a pillow, as his sibling used one. He was not exclusively breastfed, he was at least given formula at night, and was already being fed solids. He was not in perfect health, and was taking antibiotics. There is speculation that there may have been family violence in his household. And, perhaps most significantly, he had been exposed to tobacco from the time his mother had been pregnant with him.

The death of three month old ‘Baby N’ in June 2010 is being used as another example of why parents should not share their bed with their baby, despite it being clear that co-sleeping was one of several significant risk factors involved in his death,

“[Baby N] was born prematurely in Wellington Hospital in March last year, weighing just 785 gramsExposure to tobacco smoke and sleeping in the same bed as his parents against medical advice, on top of a premature birth also likely contributed…After being readmitted to Hawke’s Bay Regional Hospital with vomiting and lethargy he was discharged but died at home later that night. Staff at the hospital were concerned about his parents smoking, and that they shared a bed with the baby. Mr Devonport said asphyxiation caused by Sudden Unexpected Infant Death  was the main cause of death. ”[But Baby N] should have slept in his own cot, appropriately positioned with his face clear, and preferably with an apnoea alarm attached.””
(The Dominion Post, ‘Baby died needlessly, coroner finds‘)

Baby N was born prematurely, and very underweight. Guidelines given to New Zealand parents suggest that babies born under 2500 grams are at a higher risk for SUDI. Baby N was less than half of this weight. He had also been exposed to tobacco, and had been in hospital that day with vomiting and lethargy, where concerns had been raised about the safety of co-sleeping for this particular baby. This was a baby known to have been very at risk of SUDI, and he should not have been in bed with his parents. But this does not automatically prove that co-sleeping for healthy babies of a normal weight is dangerous.

Kompton Renata Joseph’s 2009 death, at the age of one month, is particularly frustrating for the coroner involved, as his parents admitted to co-sleeping with their new baby at the time of Kompton’s inquest. But, as in the cases above, co-sleeping does not appear to be the whole problem.

“Kompton Renata Joseph, aged one month, was found dead in his parents’ bed after they woke in the morning…About 5am parents Lesley and Kirsty Joseph went to bed after drinking bourbon mixers with Mr Joseph’s brother, Lance. Ms Joseph began to feed the baby in bed but then fell asleep. When she woke about 9am she found the baby lying in the bed between her and her husband, with a “purple face”. An autopsy found Kompton died of sudden unexplained death in infants, or Sudi.”
(The Dominion Post, ‘Sleeping with baby earns coroner’s ire‘)

The parents had both been drinking alcohol. Kompton appears to have been breastfed, but if his mother was consuming a fair amount of alcohol on a regular basis, I do wonder whether this may have effected him. Certainly, he was not in a safe environment with both of his caregivers being under the influence of central-nervous-system depressants.

Interestingly, it is the same coroner who looked into Kompton’s death, as Ivan’s. In the article detailing Kompton’s death, the said coroner, Wallace Bain,  is quoted as having blamed co-sleeping for the death of the baby, “The country needs to get serious, but I’m not sure how long it will take to get the message through. It is an absolute no-no.” (The Dominion Post, ‘Sleeping with baby earns coroner’s ire‘) I can understand why Bain may be getting frustrated at the regular occurence of infant deaths. But I would argue that co-sleeping is not the problem.

Deliberate co-sleeping can be just as safe as any other sleeping arrangement. According to The Womanly Art of Breastfeeding, studies have shown that a breastfeeding mother will naturally sleep facing her baby, with her lower elbow forward and her legs curled up underneath the baby. A sober, breastfeeding mother of a healthy weight will not roll over onto her baby. A later blog will discuss how to safely co-sleep, but rest assured it does not involve tobacco, alcohol, pillows and adult bedding, nor does it involve sleeping with a baby who is known to be vulnerable to sudden death.

In all four of the deaths discussed above, the parents were users of tobacco and/or alcohol. In two of the four deaths, the co-sleeping was acknowledged to have occurred because of financial difficulties. At least two of the four babies were formula fed. Where birth weight is provided, it is under 2500 grams, and both of these babies were premature. Co-sleeping itself is not the danger, it is co-sleeping coupled with known risk factors that proves to be a danger to babies.

Why not me?

In light of the earthquake in Christchurch and it’s surrounds on Tuesday, I’ve had a lot of conversations with people asking “Why, God?”

And I’ve noticed that I don’t struggle with “Why?” I understand why. God promised it would happen. It is unspeakably unfair that it’s the second big earthquake for them in such a short time, but God must have a reason. I trust Him to know what He’s doing, so I don’t ask Him why.

What I do struggle with is “Why not me?” Why Christchurch twice, when it hasn’t happened to me once? I don’t struggle to understand the suffering of others, I struggle to understand my own good fortune. Why isn’t pain spread out evenly amongst us all? Why don’t I suffer?

So now I’m just waiting. Because surely it must be coming soon. My life, my good fortune, is so fragile. On Monday, the people of Christchurch and it’s surrounds were still saying “Wow, we are so fortunate that no one died in that 7.1 magnitude earthquake in September, now we can get back on our feet and start to recover.” So many reports have people saying “We thought we were safe.” That’s the thing that freaks me out so much, we just don’t know.

I find myself looking around to figure out what I’m going to do if there’s an earthquake. I’m nervous about going to Melbourne with my friends in March now, because my husband won’t be there and something might happen while we’re apart. I dream more than usual about being bombed, or rebel soldiers marching up my road, or some other aspect of war. I wonder what it will be that happens to me, and I hope it’s not too bad.

I can’t stop thinking about the friends and family of those who are still missing. When something like this happens, all you want is to be able to get hold of your loved ones and know they’re okay. There are people out there who have been waiting two days to hear that their loved ones are okay, and there’s the ever-increasing possibility that they aren’t. Not knowing must be beyond horrible. And then there are the people potentially still trapped under fallen buildings. I don’t really want to think about what they must be going through.

I can’t find a quote that really encapsulates this blog. It seems disrespectful to use a quote about ceasing to love, or the beauty that’s all around us, even though the people who wrote those quotes knew pain like no other. I don’t want to  take away from anyone’s pain. So, for today, no quote.

Whisper words of wisdom

“There’s a road, we must travel. There’s a promise we must make… The riches will be plenty, worth the price we had to pay.”
– I Know Where I’ve Been, Hairspray

I was watching Hairspray last night, and I know it’s not very often that a cute little musical inspires action against injustice, although, admit it, I know you tear up a little when Motormouth Maybelle sings “You can’t stop today, as it comes speeding down the track. Child, yesterday is history and it’s never coming back! Tomorrow is a brand new day, and it don’t know white from black (Yeah!)”

But during the march scene, the emotion that built up inside me was so strong I just had to get up and dance. This isn’t unusal, dancing is often what I do with pent up emotion. It meets with the music and flows out through my body until I have nothing else to feel. 

I felt sorrow. Sorrow for all the people I know are out who there suffering. Sorrow for the hearts of young girls who don’t know that they’re worth dying for. Sorrow for the millions dying each day without having ever lived. Sorrow for the least of these.

I felt anger. Anger because we’re not doing anything about it. When the African Americans were fighting for equality, it was not enough for them to stand up. It took for them to scream. But when they did, they were heard. The young men, women and children trafficked into sexual slavery do not even have legs. They are hidden without a voice and without hope. They can’t fight. But I can stand. I can speak out. I can shout. I can scream. I can fight. And I don’t. I always say that I’d like to think that if I saw some injustice, I’d do something about it. If I saw somone hitting their wife or child, for instance, I’d step in and help that woman or child. But I know I wouldn’t. Because I see injustice every day, and I ignore it. 

I felt despair. Despair because sexual slavery is such a huge problem. Certainly too huge for one person to have an influence. But we’re all one person, and if each of us stood up and screamed for this injustice to stop, the problem wouldn’t seem so big. It is overwhelming, but it is not bigger then my God. And I have a responsibility to do something about it.

What will I actually do about it? That’s up to God, and my prayer is that He would show me. Because I can not ever say I did not know.

Someone like you

A woman born in South Africa is more likely to be raped then to learn how to read. A survey found that 60% of school children think that it is not violence to force someone you know to have sex. Damage from the rape of babies can be so severe that surgery is needed to rebuild even the respiratory system.

During the recent war in the Democratic Republic of the Congo, rape was used as a weapon against hundreds of thousands of people, especially women and children. Many women now live with chunks of flesh torn out by bayonets or sticks, urine and blood continuously streaming from between their legs. Most are too poor and ashamed to seek help, and too afraid of backlash to report the rapes.

The estimated number of people trafficked into slavery of various forms is more than the population of New Zealand, several times over. In many places all over the world, children are sold into sexual slavery by their parents or another relative to pay off debts. It’s not that these children are unloved, it’s that their families often have little other choice.

I am not the norm. My life is not representative of any other life out there. I am unbelievably, unfairly privileged. Yes, I have had moments of intense darkness and pain in my life, but I do not have a vaginal fistula due to gang rape or lack of medical care after childbirth. I don’t have enough money to buy everything I want, but my body is not paralysed by hunger pains. More people are in need then are not. More people are suffering then are not. How did I ever get to be one of those fortunate people born in 1989 in New Zealand? Why is this my reality? Why do I get a house, a bed, food? Why was I allowed to live without terror? When the odds were so slim, why me?

There are generally two statements that will be made when discussing the holocaust. The first is “How could the world have let that happen?” and the second is “That would never happen these days, because information is far more easily gained now. People would know about it and stop it.” We’re lying to ourselves. We let it happen. We sit around and say “Oh, that’s so sad” and don’t do anything about it. It does all seem so huge. What could we possibly do to stop it all? We could never eradicate human trafficking. We could never stop anyone from ever being raped. There is so much we could never accomplish in our lifetimes, but we must try. How could we not even try?

I must admit, I do not want to go to the Democratic Republic of the Congo. It is the place that haunts me most, but I do not want to go there. If there is a way that I can help, while sitting safely in my lounge, I would gladly do it. But God, please, do not send me there. I am too terrified of being raped by 10 soldiers. I am too scared that one will rape me with a rifle, and then shoot me from the inside. I do not want to be one of them. I can barely grasp just how fortunate I am, but I do know that never would I ever want to know the suffering they have experienced. Just knowing that so many of the crown of creation have suffered in this way tears me up. I feel physical pain in my sympathy for them. But I am not as brave as they are. I could never live through that.

The thing that scares me most is the thought that my good fortune will not last. Any second, any day, I could become one of those statistics. A war could break out here, or a natural disaster could occur. My freedom could be lost in seconds, and there’s nothing I can do about it. I guess that’s where it really hits me. These are women just like me. The 9 year old Cambodian girl who was sold into prostitution today, was just like me at 9 yesterday. Apart from the fact that I am unbelievably privileged, and they are not, young women in countries terrorised by sexual violence are just like me. She could be me. I could be her.

Oh, thank You, Lord, for Your unexplainable mercy. Don’t let me forget just how lucky I am. Don’t let me go through my life without doing something with what You have given me. I know that You have made me so incredibly blessed for a reason, and I know that I only have too much to give too much. Don’t let me forget, Lord.

“Unless someone like you cares a whole awful lot, nothing is going to get better. It’s not”
Dr Seuss