We will stop at various opinions that explain the debate for and against colecho (put in relation to sudden infant death syndrome), and I'm going to focus on the positions that defend both the American Academy of Pediatrics and the Spanish Association of Pediatrics. Always keeping in mind that, even within the same associations, there are opposing voices.
And we know that the issue of sleeping with babies in the same bed, the colecho, is controversial and there are positions found about it, especially when putting the practice of the colecho in relation to the risk of sudden infant death syndrome.
The concern of many parents with regard to these issues is founded because, despite the reduction in the incidence of sudden death in recent years, it is still the leading cause of death during childhood after the neonatal period.
The American Academy of Pediatrics (AAP) includes among its latest recommendations to reduce sudden infant death syndrome, after reviewing the latest studies in this regard, the use of the pacifier or not practicing colecho.
These are recommendations of 2005 as a result of the review of new epidemiological studies that seemed to show that colecho can be dangerous. These recommendations have aroused much controversy, especially among those who see how these guidelines do not favor breastfeeding or the mother-child bond.
But what studies pointed to colecho as a risk factor for the SMSL? Some of these studies have found that the correlation between sudden death and colecho reaches statistical significance only among smoking mothers.
But we also took into account the study of the European Coordinated Action against SIDS, a large multicenter study carried out in 20 European regions, which found that colecho was also a significant risk factor in children of non-smoking mothers up to 8 weeks old Most research indicates that the risk of SIDS seems to be particularly high when there are several who share the bed or when those who share it have consumed alcohol or are very tired.
However, within the American Academy of Pediatrics itself there are sections that do not agree with the global recommendation against colecho, such as the breastfeeding section. They see weak data to support that recommendation, and consider that many of the studies cited by the AAP are not methodologically correct.
That is to say, the colecho defenders they believe that while there are no data that support important side effects directly related to sleeping with an adult, there are substantial data that the school confers benefits to infants (improvement of breastfeeding, decreased crying of the child, improvement of sleep of the baby and parents, help to establish the parent-child bond ...), which would be enough not to advise against sleeping with the babies in the same bed.
Currently, the Safe Sleep Guide for Parents found in the AAP says that it is best for the baby to sleep by the parents bed, In the same room. The literal recommendation is that
The safest place for your baby to sleep is the room where you sleep. Put the baby's crib or bassinet near your bed (within easy reach). This facilitates breastfeeding and creating bonds with the baby.
Regarding the state of the matter for the AAP, I recommend reading the article by Ana Gimeno Navarro, deputy physician of Neonatology at the La Fe Children's University Hospital (Valencia), which summarizes the state of this controversial issue in an excellent way. It is titled "Controversies in Sudden Infant Death Syndrome: Colecho. Pacifier. Prematurity. Gastroesophageal Reflux."
For its part, if we are going to the Spanish Association of Pediatrics (AEP), we see that it also tracks the latest studies on the issue. In the section dedicated to whether it is bad to share the bed with a baby, it is commented, regarding the sharing of a bed with the baby, that there is no definitive data on the complex fact that relates to sleeping with the babies and the SIDS, except in the case that the mother is a smoker, when it is advised against:
There is an increased risk if the child shares the bed to sleep with a smoking mother. However, in some countries with low incidence of SIDS, the bed is shared with high frequency. Currently studies are being conducted to determine this complex fact, through an International Study on Baby Care.
Within the same AEP we find that your Breastfeeding Committee does not opt for colecho (without mentioning sudden death). They affirm that the baby sleeps in the bed next to the parents is not a medical question, but personal and cultural, and bets on the "freedom of choice":
Some families put the cot to the side of the mother's bed and others prefer to sleep together in the same bed, but there are also couples who cannot stand it. It is not an obligation, nor is it essential, either for breastfeeding or for personality formation. For people who are doing well, perfect and who are not doing well, do not do it.
In the White Book of Sudden Infant Death (2003) offered by the AEP portal we find several mentions of the relationship between the syndrome and the colecho. As in this article by F. Camarasa Piquer, coordinator of the "Working Group" for the Study and Prevention of Sudden Death of Infants of the Spanish Association of Pediatrics. In the study, entitled "Evolution of sudden infant death syndrome in developed countries. Current situation in Spain", it is claimed that there are numerous investigations that significantly associate the SIDS with the colecho:
There are numerous bibliographic data in which a statistically significant association between prone posture sleeping position of infants and SIDS seems indisputable. The same has happened with excessive enclosure and ambient heat (overheating or thermal stress); also with the mother's smoking habit before and after childbirth and with have the child share the bed with an adult. The change in infants sleeping in a "supine position" and the avoidance of previous factors related to the environment has been inevitably accompanied by a decrease in mortality rates due to SIDS. (page 7-8)
In the article entitled "Epidemiology of sudden infant death syndrome (SMSL) "(Chapter 4 of the White Paper") states, among the risk factors related to the child's gender of life, that sharing the bed with the mother if she smokes increases the risk of sudden death significantly, in the same way as if the father smokes or if the mattress is excessively soft. Though,
If the mother does not smoke does not seem to increase the risk, it may even have a protective effect in the sense of favoring breastfeeding, and for some authors it would favor the awakening of the child. In any case there is no evidence at the present time to encourage the child to sleep in bed with his mother to reduce the risk of SIDS.
However, as noted in the same article, sleeping in the same room as the parents does reduce the risk.
As we can see, the positions are far from clear, and only more accurate and extensive research could clarify the issue in the future. Virtually every week we can talk about new studies on sudden infant death syndrome. Some that we have brought to our pages, talk about how the colecho could be a risk factor. Others point out otherwise.
And soon we will continue to offer our readers new data, conclusions from different authors and different investigations so that a more complete (and surely more complex) idea of the state of the matter can be formed, after reviewing what relationship do different pediatric associations see between colecho and sudden death?.
