When Connie Kerrigan’s oldest children were infants, she used to fall asleep with them on her chest. If she went to visit her mother, she put them on a bed with pillows.

“I thought I was being very loving,” she said.

She never imagined that she was putting her children at risk.

Kerrigan, the manager of community nursing for Parkview Hospital, now helps teach new parents about the dangers of sleeping with their children and other unsafe sleeping environments.

Asphyxia from unsafe sleeping conditions is the leading cause of preventable death among children in Allen County, taking more young lives than drownings, car crashes or suicide, Prosecutor Karen Richards said.

In 2008, unsafe sleeping conditions were responsible for the deaths of seven infants in Allen County. So far this year, four babies – ranging in age from 2 months to 16 months – have been accidentally asphyxiated, Deputy Coroner Patt Kite said.

Two of those deaths occurred this month in Fort Wayne.

On June 19, a 3-month-old girl suffocated when a sleeping sibling rolled over on her. Ten days earlier, a 10-year-old girl did the same to her 6-month-old brother when the two were sleeping together on a recliner, according to coroner’s reports.

What makes accidental suffocation deaths like these all the more tragic, local health care professionals said, is that with a few simple steps, nearly all can easily be prevented.

Babies should always sleep by themselves in a crib. They should be zipped in a sleep sack or a sleeper and placed on their backs, experts say.

Sleep sacks are self-contained wearable “blankets” that reduce the amount of loose cloth that could block a baby’s nose and airways.

“There should be nothing in the bed except the baby and their sleep sack,” Kerrigan said.

That means no bumper pads and no stuffed animals. A lightweight blanket tucked into the mattress and pulled no higher than the baby’s armpits is OK, but anything else is a hazard that could block an infant’s airways.

And babies should never sleep in an adult bed or with an adult or sibling, said Judy Knowles, a nurse and director of clinical education at the neonatal intensive care unit of Lutheran Children’s Hospital.

It’s too easy for even small children to roll over in their sleep onto an infant without waking up until it’s too late, she said.

The danger

It’s not difficult for infants to suffocate. They have small airways – little lungs and little noses, Kerrigan said.

If those airways become blocked, whether by a blanket or a soft bed, infants can quickly breathe in their own carbon dioxide and suffocate.

Sometimes, unattended babies can become wedged between couch cushions, in a reclining chair, between a bed and a foot board or wall, or even against the skin of a sleeping adult, Knowles said.

“If your baby gets up against your skin, they’re going to rebreathe their CO2,” she said. This could lead to asphyxia.

And situations that prove deadly are often the result of nothing more than loving, if misguided, behavior by caretakers, Knowles added.

New parents are often so exhausted that a 10-minute nap can turn into a deep slumber. A parent can then roll over on a baby without knowing it.

“I think that’s the hardest thing about this,” Kerrigan said. “They’re just trying to do what is best for their baby.”

The first four months of a baby’s life are the most dangerous in terms of accidental asphyxiation. Parents should be especially careful until their infant can roll over by itself, Knowles said.

Both nurses said that in the past, such deaths have been labeled sudden infant death syndrome – SIDS – though they cautioned this is a misnomer. SIDS is unexpected, unexplained infant death that cannot be prevented.

As medical understanding of infant sleeping has evolved, deaths from rollovers or unsafe sleeping conditions have become largely preventable, they said.

Further complicating this problem is that the advice from the medical community has changed in a generation.

Before the 1990s, hospitals recommended that babies sleep on their stomachs to prevent them from choking if they spit up. But in 1993, the American Academy of Pediatrics began recommending that babies be put to sleep on their backs, Knowles said.

Some doctors had also recommended that parents put babies to sleep on their sides. This, too, passed out of medical favor because it wasn’t a very stable position, she said.

Resources

The issue has become so important that both Lutheran and Parkview hospitals have been involved in programs that educate new parents about safe sleeping for their infants and give cribs to parents who can’t afford them.

In January, Parkview Hospital stopped swaddling newborns in blankets and began using sleep sacks. Lutheran Hospital, similarly, has been sending new mothers home with sleep sacks since November.

Parkview is also part of the Cribs for Kids program, which provides free, safe cribs to low-income parents. Recipients are required to take a course on safe sleeping habits for their babies.

Lutheran, under Knowles’ leadership, is part of a new plan that will distribute free pack-and-play cribs to families across northeast Indiana.

The initiative, funded by a multimillion-dollar grant from the Bill and Melinda Gates Foundation, will send more than 1,000 cribs to the region in the first shipment alone, Knowles said.

Additionally, A Baby’s Closet at 4800 S. Calhoun St. provides free cribs, Knowles said.

Enough agencies give out free cribs that nearly any parent who needs one can get one, Richards of the prosecutor’s office said.

“Not having a bed is no excuse,” she said. “And having financial constraints is no excuse for not having a suitable bed for your child.”

mzennie@jg.net