Breastfeeding Not to Blame for Recent Infant Death, Urge Experts

Infant reportedly died while being breastfed, sparking debate.

December 1, 2009, 5:09 PM

Dec. 2, 2009— -- A mother may have accidentally smothered her child when she fell asleep while nursing on board a transatlantic flight last Tuesday, according to reports in the British media.

United Airlines declined to confirm to that an infant had died aboard one of their flights, but did say that flight 982 from Washington, D.C., to Kuwait last Tuesday, Nov. 24, was diverted to London Heathrow Airport due to an "ill passenger."

But according to U.K. press reports, the unscheduled landing occurred after an Egyptian woman dozed off while nursing her 4-week-old infant and woke to find her child was pale and not breathing.

While this rare scenario, if true, could alarm many mothers, pediatric experts caution that breastfeeding is safe -- and the episode should not discourage its practice.

"This has nothing to do with breastfeeding," says Heather Kay, a lactation consultant in Princeton, N.J. She says it's not the breastfeeding, but rather, the act of falling asleep while holding an infant that can lead to accendental death.

"If she had been holding the child and she fell asleep, she could have smothered it as well [and] making it sound like [breastfeeding] is the reason the baby a really uncomfortable idea," Kay says.

Though an on-board doctor attempted to resuscitate the child and the plane diverted to London's Heathrow Airport so that the child could be rushed to nearby Hillingdon Hospital, the child was pronounced dead upon arrival according to reports in the British newspaper The Sun.

United Airlines declined to identify the woman due to privacy laws.

Breastfeeding Not to Blame, Experts Say

Though it is very rare, this would not be the first time that sleep-nursing has resulted in accidental death.

In 2006, British mother Lisa Briggs told the U.K. press that she accidentally smothered her child after falling asleep while nursing and said she had previously lost an infant under similar circumstances.

"Breastfeeding doesn't smother babies," says Dr. Ruth Lawrence, past president and founder of the Academy of Breastfeeding Medicine. "I don't know a mother who hasn't fallen asleep while feeding her child, whether nursing or bottle-feeding," Lawrence adds.

Instead, Lawrence feels there must have other extenuating circumstances responsible for the death because "under normal circumstances, babies do not get smothered [while breastfeeding]."

Co-Sleeping May Be Responsible, Experts Say

Lawrence suggests that in an attempt to cover themselves in public while nursing, mothers can accidentally cover the baby's head and suffocate it.

But other experts feel that these accidents are simply a consequence of sharing sleeping space with your infant -- an act known as co-sleeping or co-bedding. It is a practice many pediatric organizations advise against.

"The issue is not breastfeeding, it is co-bedding," says Dr. Ronald Cohen, director of the Intermediate and Special Care Nurseries at Packard's Children's Hospital in Stanford, Calif.

"You can fall asleep in bed with a child after breastfeeding, bottle feeding, or just plain snuggling... [and] accidental smothering during co-bedding is a major concern of the American Academy of Pediatrics and other [organizations] nationally and internationally -- we advise against it strongly," he adds.

But while breastfeeding and pediatric health organizations such as the March of Dimes, La Leche League International, and the World Health Organization have guidelines warning mothers about the dangers of co-sleeping, none of these guidelines specifically address concerns over falling asleep while nursing.

According to Lawrence, there are no guidelines on falling asleep while breastfeeding because it is such a common practice. But a quick survey of online early infancy discussion forums reveals that many mothers worry they may harm their infant when they accidentally fall asleep while nursing.

Part of the issue, says Dr. Miriam Labbock, director of the Carolina Global Breastfeeding Institute, is that "we give only over-simplistic messages" about sleeping with your infant, advising against it altogether despite the fact that in some situations, such as onboard a flight, it can be unavoidable.

"There has been so much media about the risks of co-sleeping...but no one is covering how to sleep safely when you are not in those situations," she says, "[so] moms have to make due when reality and personal decisions are in conflict with the single recommendation...and sometimes, the choices are not well informed."

Breastfeeding May Not Be 'Innocent Until Proven Guilty'

On the United Airlines case, unless autopsy reports can confirm the cause of death, Tuesday's tragedy will be officially considered "unexplained" London police told the U.K. press.

But given that the mother was breastfeeding at the time of death, experts still worry that this tragic, isolated incident will have the added tragedy of discouraging mothers from breastfeeding.

"We don't want to offer mothers disincentive to breastfeed or worries that are unusual [because of] this is one, unusual, tragic, case," says Kay, because "overall the benefits of breastfeeding outweigh any of the disadvantages."

"It's very distressing," Lawrence adds, "because no matter what we say, this [incident] is going to discourage [some] women from breastfeeding."