The Saskatchewan Case Against Co-Sleeping

To attempt to comprehend the pain and suffering endured by young Regina mother Amanda Brass is an exercise in futility.

In March of this year Amanda lost her five-hour-old baby girl, Cambria Tammie-Leigh Shuba. While the coroner’s final report is still not back, it appears the infant went into respiratory distress while sleeping in the hospital bed next to her mother. The cold reality is that Amanda, exhausted after labour, was advised by a nurse to leave Cambria lying beside her after an attempt to breastfeed. Less than an hour later she was brutally awoken to a nurse standing in her room screaming “She’s not breathing!” over her daughter’s tiny lifeless body.

As both a mother and a human being — unimaginable.

Only days later the Saskatchewan NDP put an inconsolable, broken-down Amanda in front of reporters in the provincial Legislature in a politicized attempt by the party to tie little Cambria’s death to healthcare staffing shortages.

At the time, the sobbing mother also questioned the Regina hospital’s “family-centered” policy of placing newborn’s in the room with their mothers, as opposed to in a hospital nursery.

Last week the Regina Qu’Appelle Health Region (RQHR) released six recommendations that surfaced from the critical incident report that followed the baby’s death. Despite the Opposition’s efforts, staffing shortages were not listed as a factor in the tragedy.

Co-sleeping — or the practice of putting a newborn in the same bed as their exhausted, post-delivery mothers — was listed as a contributing factor, and is up for policy review by the RQHR. Following the publicized recommendations, Amanda Brass and her family released a statement stating that the region has guaranteed them a new no-co-sleeping rule.

Reflecting on my own experience giving birth in Saskatoon’s Royal University Hospital seven (really?!) years ago, two things immediately came to mind. First, despite my best efforts to be a screaming, swearing, thrashing, “OH MY GOD THIS HURTS!!” holy terror, the nurses and hospital staff were unbelievably awesome. Second, after my perfectly healthy son was born at 11.30pm (following a relatively brief twelve hour labour), he was whisked to the hospital nursery and I was off to a quiet room for sleep. Despite the fact that I forced my husband to repeatedly check on him in the nursery before retiring home to his own bed, I was cool with it.

The next night, however, my son was placed in my room in a bassinette. And with that, I haven’t had a normal night’s sleep since. (I joke).

Things have apparently changed in Saskatoon since 2004. According to the Saskatoon Health Region (SHR), today’s newborns and their mothers bunk together from day or night one, unless there is a clinical or social reason why they shouldn’t. The SHR lists many benefits to rooming together, including reducing the risk of Sudden Infant Death Syndrome (SIDS), newborn temperature and blood sugar regulation, and the facilitation of successful breastfeeding. RUH does have a newborn nursery, but it’s only used for babies who may require additional monitoring for social or physiological reasons.

As for co-sleeping, Saskatoon is thankfully already a good step ahead of Regina on this one. The SHR’s Joint Maternal Child Policy: Safe Sleeping does not allow co-sleeping.  Instead, babies are placed in a bassinette in the room with mom, with nurses explaining the benefits of room sharing and the dangers of co-sleeping.

After everyone gets home, the sleeping arrangements are obviously a personal decision. For this mom, that meant wrapping up little Zackery “like a taco” and tucking him into his own bed, which he grew to love (and still does, for that matter). Co-sleeping has never appealed to me, and my perfectly healthy, just-plain-perfect seven-year-old son is the only proof that I need that it’s absolutely unnecessary.

Amanda Brass wanted to ensure her precious Cambria’s death wasn’t in vain, indicating that she wanted to make sure no future infant’s life is jeopardized by ill-advised maternal sleeping policies. Thanks to last week’s announcement by a contrite RQHR, hopefully Ms Brass can find some semblance of solace in knowing that she has very likely done just that.

Comments

  1. conscious mother says:

    My deepest sympathy goes to Amanda and her family.

    With regards to co-sleeping and the Sask Health system, there are many benefits to co-sleeping, however, whether a mother/family co-sleeps should not be the decision of the Hospital. Once a mother/family has reviewed the resources and research available, they should decide whether it is right for her family and this decision should not be influenced by the hospital. I was blessed with 2 safe and peaceful deliveries at home and did not have the influence of nurses/doctors on the decision to co-sleep. We have co-slept since the birth of both of our babies and our bed is open to our babies whenever they need someone to sleep with.

    In a province that is slowly opening up to natural parenting, offering readers both view points would be appropriate. An important factor in healthy pregnancy and birth is informed mothers making decisions (rather than the hospital/health system).

  2. Hi Tammy, Iam the Mother of Amanda Brass and Grandmother of Cambria. I just wanted to let you know how much I appreciated reading your article on the heartbreaking situation. You can tell you wrote it with compassion. There are alot of circumstances that led to Cambria’s passing..that the public is not aware of. We are still waiting for Coroners report. In Amanda’s written statement, that was obviously not written in its entirety…we had thanked Saskatoon for there involvement in making changes. Please don’t add this to your comments, as I just wanted you to know how much I appreciated your article.

  3. howard brass says:

    Although our family appreciates your sympathy for Cambria’s death, we resent the fact that you yourself have used the story as a political tool.

    For your information WE contacted the NDP to assist us setting up a press conference, because we felt our story needed to be heard by the public to prevent another tragedy happening. They were very helpfull and sympathetic to us during a very difficult time in our lives.

    This is in contrast to the Premiere, Minister of Health ans SaskParty treating us like a political hot potato. There were no condolences offered when we attended the legislative assembly question period. No one would look us in the eye and shifted in their seats like eels on a hotplate when Cambria’s death was brought up by the opposition. It was only after they found out that Amanda was issuing an unflattering press release regarding the Minister and government that he tried dilligently to contact Amanda. Likely to diffuse any bad press before it hit the media.

    Of course the critical incident report found that there were no staffing shortages, as it was an internal review and citing staffing shortages would be an admission of guilt on their part. This report contradicts the fact that every nurse that we spoke to told us that they were short staffed when Cambria died. They also told us that they had begged not to have the nursery removed from the unit and that a baby would die as a result. Their pleas fell on deaf ears and the rest we know now is history. This was only 4 months after implementing the rooming-in model of care.

    One nurse told us that based on their staff and the number of mothers and babies, it can take her as much as 7 hours to get around to some patients. A baby can be brain dead in 4-5 minutes due to lack of oxygen. The official tally on the time a nurse gets from one patient to another is 50-60 minutes. This is still almost an hour late if something goes wrong like in Cambria’s case.

    It is easy to be flippant about the details about the staffing with this situation unless you were there. These nurses were outraged and traumatized. No one listened to them. How many people are put in a situation where they have to go to work short staffed, wondering if a client will die and then feeling personally responsible for it when it actually happens??

    We believe that the health district was premature in issuing a report with recommendations to prevent another baby’s death, considering that the final coroner’s report has not been completed. How can they make recommendations when they have no idea what the cause of death was? This report being issued and the primary focus on no co-bedding has led to assumptions and innuendos regarding Cambria’s death. There is evidence that there may have been other factors that may have contributed to her passing.

    People can list all of the “positives” of the rooming in model, but one nurse told us in her 19 years working with a nursery, a baby never died under these circumstances. After only 4 months of a rooming in model, our baby died. Simple as that. We have heard stories of other babies deaths, but we are not sure if they are authentic.

    We realize that Mr.Gormley and the SaskParty (and likely you) are all for privatization of everything, including health care. I have heard the stories about private clinics being approved, paving the way for American style health care. From what I’ve heard some of these clinics are being operated by business people closely affiliated with the SaskParty.

    The profit margin required in a private system inflates the cost of administration to 30% as opposed to 3% in a public system. How does adding a 30% profit margin make something more efficient?? It is very difficult for a public and private sytem to operate side by side. The private system is more lucrative and poaches doctors and resources, leaving the public system to atrophy. After Cambria’s death, I believe that we are beginning to see the start of cuts to the public system. Why in such a prosperous “have” province are there shortages of nurses in such a vital area of health care? We believe that Cambria was a casualty in these cuts to health care.

    Again we appreciate your sympathy, but next time please do use our family’s tragedy for your talk radio propaganda.

  4. howard Brass says:

    Why was my comment not posted?!

  5. Dana Brass says:

    Well said Howard.

  6. Really? says:

    I understand that emotions are running high so my only comment is that the comments by Howard either confirm 1) that there was an attempt to politicize this tragedy for what gain only Howard knows (half your letter is an attatck on the current government who has actually increased the number of nurses working in the province) or 2) you were niave to think that the NDP wouldn’t play politics with it. Either way, to claim this blogger is using this story as a political tool, especially in light of the way you and your family have approached the issue is laughable.

    I understand the desire to assign blame when something unimaginable happens. However, it was more than likely a result of a confluence actions that resulted in the tragedy (mom falling asleep, no familiy member with her, nurses not checking, etc) as opposed to some sinister privitization of health care plot you allude to.

  7. Leigh Robstad says:

    Hi Tammy. As I mentioned in my last comment, there are a lot of contributing factors that lead up to Cambrias death that the public is not aware of. I take offence in your comment that having no family members with Amanda is one of them. First of all, I was awake and with Amanda for 36 hrs. Her and I were exhausted! Cambria was born at 1130pm. I stayed with Amanda until 130am. The ONLY reason I left her was to go home and get the car seat and an outfit and maybe a couple hrs of sleep. Amandas father was with Amanda up until a half hour before this tragedy happened. When one leaves another in the hospital (even if only for a couple of hrs) we are to assume the one we are leaving is in safe hands. So for you to even suggest that Amanda not having any family with her…for only a half hour…is a contributing factor is very insulting and a very cruel remark.

  8. howard brass says:

    I find it ironic that people feel they have the right to comment on a series of events, when a) They have no idea what the specific details are surrounding that event and b) They make assumptions of what events occured and why. The coroner’s report has still not been completed, so to make the assumptions you have made are just that…assumptions. Are you a coroner? Have you reviewed the medical records??In regard to staffing shortages and other factors of our health care falling short, just go speak with the nurses on the Mother/Baby Unit at the General Hospital. They will set you straight.

  9. Sorry Tammy…I thought you made that comment.

  10. Amy Ferris says:

    There is a world of difference between rooming-in and co sleeping in a narrow hospital bed with side rails and co sleeping in a responsible and safe manner. Being your ever flaky hippie friend I’m sure you can guess that I co slept with all my babies, though Pippa moved out early since she wasn’t digging it. The research I’ve done (and I’ve done a lot) shows no increased risk with co-sleeping if it’s done properly by responsible parents who are using common sense. I’ve can’t even imagine a nurses being so blatantly ignorant as to suggest co sleeping in a hospital bed. This situation is both shocking and tragic. The preferred system would be one that provided options for new moms. The choice to room-in or use the nursery briefly.

  11. I would never expect a nurse to be with every mother during every minute she is with her baby, and I would not expect any nurse to suggest co-sleeping in a hospital bed of all places, just hours after delivery. As a mother who has co-slept successfully, I can’t fathom it. When I delivered my babies at Saskatoon Royal University Hospital 7 and 5 years ago, the nurses wouldn’t even let me walk around while holding my own child. I wasn’t all that happy about it but I understood why. As for sleeping, I was told to keep my baby in the bassinet while I slept. I completely agreed but this was as an experienced co-sleeper. My first baby slept in the nursery most of the time at RUH.

    I loved co-sleeping with my children at home, but I’m a light sleeper. I also never allowed my husband to sleep next to them or with them because he was such a heavy sleeper. (The only night I did, he let my daughter roll off the bed onto the floor which had blankets on it thank goodness). Co-sleeping is not for everyone but I think it’s a choice that families should make for themselves, after they get home from the hospital. It’s also not something that should be taken lightly, much like deciding whether to let your baby sleep on their tummy or back.

    My question is, how can any nurse think it’s OK for an exhausted post-delivery mom to sleep risk-free with her baby in a hospital bed? And I also don’t understand how this couldn’t have happened whether there were 50 nurses on duty or 5? Again, nurses aren’t expected to watch each patient for each and every minute.

    Politics should have nothing to do with this. It should never have had anything to do with it. Whether the NDP was called by the family first or not doesn’t change that this horrible tragedy was used to the NDP’s advantage and an attack against the leading party ensued. If people really want to get into the politics of it, let’s question why the nurseries are being shut down in the first place. Could it be because government funding doesn’t materialize out of thin air? That our pockets are being dug into deeper and deeper while our health care system gradually loses functionality? As someone who has had to deal with the health care system many many times all throughout my life because of chronic illness, I can honestly say it’s nothing to boast about. Neither is the American system for that matter. There are more than two systems by the way…

    Ultimately though, the politics debate doesn’t matter. This unfortunate event could have occurred in a private or public hospital, or whether the NDP were in power or the Sask Party. We’re human and things can’t always go right. Possible nursing shortages aside, the subject of co-sleeping versus rooming-in should be discussed and the differences and risks clearly defined. I would have thought an experienced nurse would know better.

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