Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Letter to the Editor
  • Published:

Response by Bradley Thach

Journal of Perinatology volume 34, page 958 (2014)Cite this article

Subjects

Dr. Paviotti and his associates are to be commended for developing a program that intends to improve newborn infant safety while promoting mother–infant contact and breast feeding.1 I agree on the need to prove the effectiveness of this protocol as in my report a few infants, who died, had awake mothers and room visitors at the time. The scheduled observations may prove valuable, but an infant can become dangerously hypoxic when its airway is obstructed for only a few minutes. I agree that bed sharing should be discouraged.

I certainly appreciated Dr. Somers’ comments2 regarding passive protection that may be provided by assuring firm adult and crib mattresses as well as absent pillows. Even without pillows and blankets, soft adult mattresses could contribute to risk of death during bed sharing, as it is conceivable that the groove next to the mother's body might cause the infant to roll against her causing airway obstruction. However, this may not prevent the breast-feeding scenarios that we described. While breast feeding in sitting position the mother holds the infant in her arms, so mattresses and pillows are unlikely to contribute additional risk. Regarding monitoring techniques yet to be developed, arterial oxygen saturation and heart rate monitoring have been in use for some time to monitor infants and would be readily available in maternity hospitals. However, in its current configuration (sensors, wires and blinking machines), active monitoring of normal infants is likely unacceptable to parents and caretakers wanting a family-like experience.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Paviotti G, Demarini S, Verardi G, De Cunto A, Davanzo R . Making the first days of life safer: time for a new protocol? J Perinatol 2014; 34: (this issue).

  2. Sommers RL . Deaths and near deaths of healthy newborn infants while bed sharing on maternity wards. J Perinatol 2014; 34: (this issue).

  3. Bed-sharing and infant sleep. http://www.unicef.org.uk/BabyFriendly/News-and-Research/Research/Bed-sharing-and-infant-sleep/. Accessed 2 July 2014.

  4. Task Force on Sudden Infant Death Syndrome. SIDS and Other Sleep-Related Infant Deaths: Expansion of Recommendations for a Safe Infant Sleeping Environment. Pediatrics 2011; 128: e1341–e1367.

    Article  Google Scholar 

  5. Trachtenberg FL, Haas EA, Kinney HC, Stanley C, Krous HF . Risk factor changes for sudden infant death syndrome after initiation of back-to-sleep program. Pediatrics 2012; 129: 630–638.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA

    B T Thach

Authors
  1. B T Thach
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to B T Thach.

Ethics declarations

Competing interests

The author declares no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Thach, B. Response by Bradley Thach. J Perinatol 34, 958 (2014). https://doi.org/10.1038/jp.2014.191

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jp.2014.191

Search

Advanced search

Quick links