Disciplining Parenthood: Child Protective Services and Infant Sleep Arrangements in Illinois

Background: Although the risks and benefits of infant bedsharing have not been resolved in the scientific literature, the Illinois Department of Children and Family Services (DCFS) in 2010 began implementing a new policy whereby infant deaths that occurred while bedsharing can be classified (“indicated”) as child neglect if it is documented that the parent(s)  received education about  “safe sleep.”

Methods: We reviewed publicly available data on Illinois child death investigations from FY 2012 and 2013 to explore the extent to which a range of risk and protective factors are taken into account when classifying bedsharing deaths. 

Results:  Of 96 infant deaths investigated 60 occurred during sleep and 45 occurred while sharing a sleep surface with at least one other person, usually an adult caregiver.  In 22 (48.8%) of these cases, at least one parent/caretaker was indicated for “death by neglect” or for “substantial risk of physical injury.”  In more than half (12) of the indicated cases, bedsharing alone (as opposed to substance use or other risk factor) was cited as contributing to the death.  Known protective factors such as breastfeeding, absence of soft bedding, and habitual bedsharing were rarely mentioned in the reports.

Conclusions: Hard-line child protection policies like those being implemented in Illinois are inconsistently applied and disproportionately stigmatize and traumatize families under DCFS supervision.  They are arguably less likely to be effective in reducing deaths from SIDS and SUID than a more nuanced approach that acknowledges parental reasons for bedsharing and articulates conditions under which risks are minimized.