Shared Beds Increase Potential for Rebreathing Exhaled Air in Sleep Microenvironments Used by Infants at High Risk for SIDS ♦ 1956

Using firm bedding is recommended, along with supine sleep, to reduce SIDS risk. Among African-American high-risk infants, the risk for SIDS likely increases with bedsharing, and half of SIDS among African-Americans occurs during bedsharing. We compared shared and unshared beds by measuring their softness and potential to cause rebreathing, to determine if these physical properties are increased in shared beds as they were increased in bedding associated with prone SIDS (Peds Res 36:7). Twenty-five infants were selected randomly from among 240 high-risk African- American infants that had been prospectively enrolled in a prenatal safe-sleep intervention study. At 2 mos of age, during a home visit, we used an infant mannequin to measure the softness and rebreathing potential of bedding used the night before.(Am Rev Respir Dis 149:693A) 12/25 had bedshared in adult beds. The shared beds were softer (P = 0.03, area in contact, 52.9 ± 9.1 vs 36.8± 13.5 cm²) and had more potential to cause rebreathing (P = 0.01, 0.66 ±.18 vs 0.31 ± 0.01%CO₂ retained) than beds in which infants slept alone. Conclusions: 1) Shared beds may pose a particular threat among African-American infants, even after education to avoid soft infant bedding, because shared beds are softer and limit CO₂ dispersal more; 2) mechanisms for death during bedsharing are not known, but shared beds create microenvironments with more rebreathing potential than unshared infant beds; 3) efforts to encourage safe sleep environments for African- American infants should address bedsharing.