Rebecca Benson, a public health nurse in King County, holds up a box now being given to parents for their babies to sleep in. Benson, who shared a bed with her own babies, now believes that giving babies their own space to sleep is preferable. 
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Rebecca Benson, a public health nurse in King County, holds up a box now being given to parents for their babies to sleep in. Benson, who shared a bed with her own babies, now believes that giving babies their own space to sleep is preferable.
Credit: KUOW Photo/Bond Huberman

This cardboard box could save a baby's life

When infants die in King County, the medical examiner investigates.

One hundred babies were found to have died of SUID – sudden unexpected infant death – between 2009 and 2015, according to data obtained by KUOW.

Of those infants, 38 shared beds with their parents.

“Bed sharing with mother,” says a report for an infant from Kirkland. “Unable to exclude if external factors contributed to death.”

“Sleeping in crook of mother's arm/bed-sharing with two adults in adult-sized bed with soft bedding,” another report says.

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And another: “Sleeping in an adult bed with one other infant, two adults and soft bedding.”

Rebecca Benson is a public health nurse who co-slept with her children. That’s how she was raised – to breastfeed and co-sleep until the child is 1. But she changed her thinking when she started working for King County Public Health.

“As the years have gone by, as a public health nurse, I realized that babies are safest if they have their own safe space to sleep,” said Benson, who leads the Nurse-Family Partnership for King County. She spoke with KUOW’s Jeannie Yandel.

“I was really fortunate that I didn’t have a tragedy that some families have had.”

King County is giving baby bed boxes to families who need them in an effort to help babies have their own space. These are small cardboard boxes with a firm mattress at the bottom.

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Sudden unexpected infant death includes SIDS, sudden infant death syndrome, although it’s hard to tell the two apart. SIDS, although rare, is the leading cause of death in infants between 1 month and 1 year, according to the Safe to Sleep campaign. Most SIDS deaths happen between 1 month and 4 months.

The Safe to Sleep campaign recommends letting babies sleep in their own space, with a firm mattress, tight bedding and no extra blankets or stuffed animals around them.

The babies who died in King County came from rich homes, poor homes and middle class homes, judging by their addresses and other factors listed in the report. Their names were Quinnly, Stella, Kaiden, August and Caleb, among others.

These brief reports do not say if their parents smoked or drank. But they do note if the babies were placed on soft bedding. Of these 38 cases involving co-sleeping, the examiner noted that the babies and their parents slept on a cushy bed. (Five babies sleeping solo were on soft bedding.)

And six of those babies also shared a bed with another infant or child.

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Sleep safety experts also recommend that babies sleep on their backs – a campaign that started in 1992. The annual incidence of SIDS has declined dramatically since then.

In King County, 13 of the 100 babies were listed as sleeping in the prone position – or on their stomachs.

Benson said that bed-sharing can be risky because a baby could roll over into a crack between the bed and a wall and a sheet could be pulled up accidentally over a baby’s face.

"Or being too warm in a bed with other adults or other children," she said. "That's one of the risk factors for SIDS and SUIDs – overheating."

The King County Medical Examiner also noted when a baby had been swaddled. A recent report by the American Academy of Pediatrics found that swaddled babies are more likely likely to die of SIDS, “as swaddled infants have fewer spontaneous arousals from sleep and increased sleep time.”

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Couches are also dangerous. Of the 100 babies that died in King County, six were sleeping alone or with a parent on a couch.

Benson understands the impulse to co-sleep.

“Most parents want to be really close to their infants,” she said. “When you’re first bringing your baby home, you fall in love with that baby, and you want to be close to them.”

She doesn’t want parents to feel badly if they fall asleep with their babies on accident. But her biggest message to parents is “when you’re putting your baby down to sleep, put them into a safe sleep situation.”

The American Academy of Pediatrics recommends, however, that parents sleep in the same room as their infants.

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“Room-sharing without bed-sharing is recommended – there is evidence that this arrangement decreases the risk of SIDS by as much as 50 percent.”