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The Making of Medicine

Falling Asleep While Feeding Puts Babies at Risk

More than 25% of new mothers have fallen asleep while feeding their babies, raising the children's risk of sudden infant death, a new survey analysis reveals.

Further, more than 80% of survey respondents hadn't intended to fall asleep. The results, from three UVA Health docs and their collaborators, suggest that hospitals and other care providers should work with new parents to develop feeding plans that are as safe as possible.

The researchers -- including UVA's Ann Kellams, MD; Fern Hauck, MD, MS; and Rachel Moon, MD -- looked at survey results collected from more than 1,250 mothers in 2015 and 2016 as part of the Social Media and Risk-reduction Training (SMART) study.

More than 28% of respondents said they “usually” or “sometimes” fell asleep while feeding in the previous two weeks. Of those, 83.4% said they hadn't intended to fall asleep.

Women who fed in bed were significantly more likely to fall asleep (33.6%) than those who fed on a chair or couch (16.8%). But chairs and couches can pose their own dangers -- the cushions and confines raise the risk of infant death by up to 67 times.

This where the medical advice gets a little nuanced. The American Academy of Pediatrics cautions moms against sharing a bed or other sleep space with a baby because of the risk of accidentally rolling over and smothering the child, or that the child could become tangled up in bedding. But the group also says that beds are safer than chairs and sofas if falling asleep while feeding is a possibility.

One key takeaway from the survey findings, the researchers say, is that care providers need to warn parents -- both moms and dads -- the falling asleep while feeding is a very real possibility, even when trying not to. Parenting a newborn is exhausting work, and breastfeeding releases hormones that make moms naturally sleepy.

“We need to meet families where they are and come up with a nighttime plan for sleeping and feeding their baby that works for them and is as safe as possible,” said Dr. Kellams, a pediatrician and breastfeeding and lactation medicine specialist at UVA Health Children’s. “Our data suggest that too many of these falling asleep incidents are not planned, so discussions about how to plan for feeding your baby when you are very tired are important.”

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