NATIONWIDE — More than a quarter of new mothers have fallen asleep recently while feeding their babies, putting the infants at increased risk of sudden infant death syndrome (SIDS), according to research from the University of Virginia School of Medicine.

More than 80 percent had not intended to fall asleep, and many had chosen to feed in chairs or on sofas rather than in a bed. Unfortunately, the cushions and confines of those locations can be very unsafe for babies, raising the risk of death by 49 to 67 times.

The researchers, with UVA Health and UVA Health Children’s, are urging care providers to provide additional guidance for new parents on safe feeding practices, such as informing new moms that a hormone naturally released during breastfeeding will make them feel sleepy.

“This highlights the need for parents to be educated about the potential risk of falling asleep while feeding and to plan for that possibility by making the space around the baby as safe as possible,” said researcher Fern Hauck, M.D. “That would include removing pillows and blankets to ensure an open airway for the baby.”

Hauck is a safe-sleep expert at UVA Health and the UVA School of Medicine. 

Hauck and her collaborators, including UVA’s Ann Kellams, M.D. and Rachel Moon, M.D. analyzed survey results collected from more than 1,250 new mothers as part of the Social Media and Risk-reduction Training (SMART) study conducted at 16 U.S. hospitals in 2015 and 2016. Most respondents completed the survey when their infant was between two and three months of age.

Among the respondents, more than 28 percent said they had “usually” or “sometimes” fallen asleep during feeding in the prior two weeks. Of those, 83.4 percent said falling asleep was unplanned.

Women who fed in bed were more likely to fall asleep (33.6 percent) than those who fed on a chair or couch (16.8 percent). 

Many of the women who fell asleep on chairs or sofas said they chose those locations specifically to avoid falling asleep, to avoid locations (such as a bed) they had been told were unsafe or to avoid disturbing someone else. (The American Academy of Pediatrics warns moms against sharing a bed or other sleep space with an infant because of the risk the parent might accidentally roll over and smother the child, or that the child could become tangled in bedding. But the group also says that beds are safer than chairs and sofas if falling asleep while feeding is a possibility.)

The researchers note that providing parents with information about safe sleep and feeding has been shown to reduce risk of unexpected death significantly. But this educational outreach needs to be expanded, they say. Care providers should acknowledge that moms face a very real risk of falling asleep while feeding, even if they are trying not to, and provide practical advice on how to reduce that risk. Further, the researchers are urging additional studies to find ways to assist parents in both safe-sleep practices and breastfeeding.

“We hope that parents of young infants will think proactively about what might happen in the middle of the night,” said Moon, a pediatrician and safe-sleep expert at UVA Health Children’s. “Feeding your baby in your bed is safer than feeding on a couch or armchair if you might fall asleep.”

The researchers have published their findings in the scientific journal Pediatrics. The research team consisted of Hauck, Moon, Stephen M. Kerr, Michael J. Corwin, Timothy Heeren, Eve Colson, Margaret G. Parker and Kellams. The researchers have no financial interest in the work

The research was supported by the National Institutes of Health’s Eunice Kennedy Shriver National Institute of Child Health and Human Development, grant number R01HD072815.

Contributed by the University of Virginia Health System.