Medical examiner: Baby appears to have died sharing bed with mother

The Milwaukee County medical examiner's office on Wednesday said it was investigating the apparent unsafe sleep-related death of a two-month-old baby girl.

Few details were available in this death, but the child appears to have been sharing an adult bed with her mother.

While the death of a baby in an unsafe sleep environment is both heartbreaking and preventable, city health officials worry that the intense media attention paid to sleep deaths warps public perception of what really drives Milwaukee's stubbornly high infant mortality rate and of what must be done to bring it down. 

"Prematurity is the number one driver of infant mortality," said Geoff Swain, a professor at the University of Wisconsin School of Medicine and Public Health and the Milwaukee Health Department's chief medical officer.

"For every one sleep-related death, there are four babies that die, typically in the hospital, due to complications of prematurity.

"The police are never called. The report doesn't go on the scanner. There's no medical examiner's report. And so reporters never find out about them. So the general public never finds out," Swain said.

So far this year, five babies have died in unsafe sleep environments, according to medical examiner's reports. There were 15 unsafe sleep deaths in all of 2016.

In a typical year, about 100 babies die in Milwaukee before their first birthday, according to Health Department data.

Unsafe sleep, on average, is the primary cause in 15 of those deaths. Typically, complications from prematurity are the primary cause in 58 of those deaths while other causes account for the rest.

Sleep deaths not only receive more publicity, Swain said. They are also easier to grasp.

One of the big risks for prematurity, Swain said, is chronic stress. And the presence of chronic stress goes a long way to explaining why black infants in Milwaukee die at about three times the rate of white babies.

"There is a difference in lived experience between black women in Milwaukee and white women," Swain said.

"Lots of people have stress. But the level of chronic stress is higher" for black women.

He ticked off a list: poverty, unemployment, crime, food and housing insecurity, racism. These are difficult problems to solve.

The causes of sleep-related deaths are a complicated mixture, but the risks themselves seem more concrete: bed-sharing, unsafe sleep surfaces, body placement, alcohol and drug use, smoking.

RELATED: Unsafe sleep conditions tied to most sudden infant deaths

SPECIAL REPORT: Empty Cradles

It is often said that the rules for safe sleep are as easy as the ABCs:

Babies should sleep Alone, on their Backs, in a Crib uncluttered by blankets, pillows or toys, without exposure to cigarette Smoke.

Swain said health officials should, of course, continue to promote safe sleep.

But, he said, for the sake of our children, "we must understand and address the full range of forces that drive infant mortality."