Science
‘We can’t just teach abstinence’: How advice on bed-sharing with a baby is evolving
When Emily Little gave birth to her first child, sleeping together with her baby in bed was a given — despite all the public health messages telling her not to.
“I knew it was something that I wanted to do,” said Little, a perinatal health researcher and science communications consultant who has studied cultures around the world that bed-share. Little was drawn to the skin-to-skin closeness she could maintain with her baby throughout the night, and the ease of breastfeeding him without getting up. It felt natural to sleep the way mothers and babies had slept “since the beginning of human history,” she said.
So she began to research ways to reduce the risk to her baby. Bed-sharing has been found to be less risky for full-term infants in nonsmoking, sober homes who are exclusively breastfed: Check. Only the breastfeeding parent should sleep next to the baby: Check. Since babies are less likely to suffocate on firm mattresses and without loose bedding, Little replaced her pillow-top mattress and got rid of all of her blankets and extra pillows. Because babies could fall off the bed or into a gap between the bed and the wall, Little pushed the bed up against the wall, and filled in the gap with foam.
Emily Little shares her bed with her baby after breastfeeding. Little is a perinatal health researcher who created a discussion guide for parents and healthcare providers to address the nuances of bed-sharing.
(Tanya Goehring / For The Times)
Still, Little’s decision conflicts with advice from pediatricians and public health advocates, who warn that bed-sharing increases the risk that a baby will die during the night. For decades, U.S. pediatricians and public health officials have been warning that the only way to avoid sudden unexplained infant death (SUID) is to stick to the “ABCs of safe sleep” — always have the baby sleep Alone, on their Back, in a separate Crib empty of any pillows, blankets, stuffed animals and crib bumpers. One controversial campaign even depicted a baby lying next to a meat cleaver, sending the message that parents could be deadly weapons when sleeping next to a baby.
And it worked: The rate of sleep-related infant death declined significantly after the safe sleep campaigns began in the 1990s. But in recent decades, the rate has plateaued and even started to tick upward again, at the same time that bed-sharing has become more popular among parents. So some advocates are instead shifting to a “harm reduction” approach that acknowledges parents want to sleep with their infants and offers tips on how to make it as safe as possible.
“Abstinence-only messaging hasn’t worked, and parents often aren’t honest with their pediatricians when they’re asked. We all need to acknowledge that it’s practically inevitable,” said Susan Altfeld, a retired University of Illinois- Chicago professor who studied bed-sharing. “Developing new messages to educate parents on what specific behaviors are especially risky and what they can do to reduce those risks have the potential to effect change.”
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A shifting message on infant bed-sharing
About 3,700 infants die suddenly and unexpectedly each year in the U.S, a number that has remained stubbornly high for decades, according to data from the U.S. Centers for Disease Control and Prevention. The risk of sharing sleep surface is real: Infants who sleep with adults are two to 10 times more likely to die than those who sleep alone in a crib, depending on their specific risk factors, the American Academy of Pediatrics, or AAP, wrote in its most recent safe sleep guidelines.
Nonetheless, the percentage of parents in the U.S. who said they usually bed-share has grown, from about 6% in 1993 to 24% in 2015. And in 2015, 61.4 of respondents reported bed-sharing with their infant at least occasionally. Although more recent national data are not available, more than a quarter of mothers in California said they “always or often” bed-shared in 2020-22.
Little touts the positive aspects of bed-sharing and helps families mitigate the risks.
(Tanya Goehring / For The Times)
La Leche League International, a breastfeeding advocacy organization, offers the “Safe Sleep 7” on their website to help parents bed-share more safely. Little codified her own “harm reduction” advice for safer bed-sharing in an online discussion guide for other parents to help encourage nuanced conversation between parents and healthcare providers to help mitigate the risks of what is at least an occasional practice for most parents. She also touts the positive aspects of bed-sharing and helps families mitigate the risks.
Babies who share a bed with their mothers, for example, have been shown to breastfeed longer. Parents who plan ahead and bed-share more safely may avoid falling asleep accidentally with a baby in the most unsafe of situations — a reclining chair or sofa. And many parents feel it strengthens their bond with their baby, she said.
“Infants have the biological expectation to be in close contact with their caregivers all the time, especially in the early months,” Little said. “Denying that because we as a society are unable to have a conversation about risk mitigation and harm reduction is really doing a disservice to infant well-being and mental health.”
Pushback from safe sleep advocates
The pediatrics academy, in its 2022 guidelines, acknowledges that parents may “choose to routinely bed share for a variety of reasons,” and offers a few safety suggestions if a parent “unintentionally” falls asleep with their baby. “However, on the basis of the evidence, the AAP is unable to recommend bed sharing under any circumstances,” the guidelines state.
It’s almost impossible to assess whether a family is truly a low risk when it comes to bed-sharing, especially as many are not forthcoming with their physician about drinking, smoking and drug use, said Dr. Rachel Moon, a pediatrician and researcher at the University of Virginia medical school, and lead author of the AAP report. Even if a parent is a low risk some nights, when they have a glass of wine one evening, they suddenly tip into a high-risk category, she said.
“I knew it was something that I wanted to do,” Little, shown with her family, said about bed-sharing with her baby.
(Tanya Goehring / For The Times)
Moon said bed-sharing advice has been a topic of conversation for years in the academy, but given the evidence of risk, the group decided to warn against the practice in all situations.
“It’s not responsible for us to give [parents] permission,” said Moon, who deals with sleep-related deaths in her role as a researcher. “Every day I deal with babies who have died, and if it happened in a bed-sharing situation, [parents] regret it. I deal with this enough that I don’t want anybody to have that regret.”
Changing the messaging on safe sleep would be a “slippery slope,” said Deanne Tilton Durfee, executive director of the Inter-Agency Council on Child Abuse and Neglect, which runs L.A. County’s safe sleep campaign. “You have to be extremely clear with messaging” because many parents may not pay attention to the details, she said.
In 2024, 46 infants in Los Angeles County died as they slept, and almost all of them involved bed-sharing, Durfee said.
The reality in parents’ homes
Pachet Bryant, a mother in Mission Viejo, felt deeply committed to sleeping with her new baby from the moment she gave birth. “You’re growing a baby for nine to 10 months, and all of a sudden for them to be separated from your heart, from your presence, from your smell, can be traumatic,” she said.
But she wanted to do it as safely as possible. So when lactation consultant Asaiah Harville began to work with her, the consultant offered tailored advice to the new mother’s situation, which Bryant took “very, very seriously.” Bryant had already been doing some research of her own and was able to modify her space accordingly. She also reevaluated every night whether she felt it was safe for her baby to sleep in the bed; on nights when she was too exhausted, she put her daughter to sleep in a bassinet instead.
“We know that parents are either intentionally or unintentionally at some point going to wind up falling asleep with their baby, and we have to think about creating the safest possible environment for that,” Harville said. In the lived reality of an individual family’s home, she said, “we can’t just teach abstinence.”
This article is part of The Times’ early childhood education initiative, focusing on the learning and development of California children, from birth to age 5. For more information about the initiative and its philanthropic funders, go to latimes.com/earlyed.
Science
Diablo Canyon clears last California permit hurdle to keep running
Central Coast Water authorities approved waste discharge permits for Diablo Canyon nuclear plant Thursday, making it nearly certain it will remain running through 2030, and potentially through 2045.
The Pacific Gas & Electric-owned plant was originally supposed to shut down in 2025, but lawmakers extended that deadline by five years in 2022, fearing power shortages if a plant that provides about 9 percent the state’s electricity were to shut off.
In December, Diablo Canyon received a key permit from the California Coastal Commission through an agreement that involved PG&E giving up about 12,000 acres of nearby land for conservation in exchange for the loss of marine life caused by the plant’s operations.
Today’s 6-0 vote by the Central Coast Regional Water Board approved PG&E’s plans to limit discharges of pollutants into the water and continue to run its “once-through cooling system.” The cooling technology flushes ocean water through the plant to absorb heat and discharges it, killing what the Coastal Commission estimated to be two billion fish each year.
The board also granted the plant a certification under the Clean Water Act, the last state regulatory hurdle the facility needed to clear before the federal Nuclear Regulatory Commission (NRC) is allowed to renew its permit through 2045.
The new regional water board permit made several changes since the last one was issued in 1990. One was a first-time limit on the chemical tributyltin-10, a toxic, internationally-banned compound added to paint to prevent organisms from growing on ship hulls.
Additional changes stemmed from a 2025 Supreme Court ruling that said if pollutant permits like this one impose specific water quality requirements, they must also specify how to meet them.
The plant’s biggest water quality impact is the heated water it discharges into the ocean, and that part of the permit remains unchanged. Radioactive waste from the plant is regulated not by the state but by the NRC.
California state law only allows the plant to remain open to 2030, but some lawmakers and regulators have already expressed interest in another extension given growing electricity demand and the plant’s role in providing carbon-free power to the grid.
Some board members raised concerns about granting a certification that would allow the NRC to reauthorize the plant’s permits through 2045.
“There’s every reason to think the California entities responsible for making the decision about continuing operation, namely the California [Independent System Operator] and the Energy Commission, all of them are sort of leaning toward continuing to operate this facility,” said boardmember Dominic Roques. “I’d like us to be consistent with state law at least, and imply that we are consistent with ending operation at five years.”
Other board members noted that regulators could revisit the permits in five years or sooner if state and federal laws changes, and the board ultimately approved the permit.
Science
Deadly bird flu found in California elephant seals for the first time
The H5N1 bird flu virus that devastated South American elephant seal populations has been confirmed in seals at California’s Año Nuevo State Park, researchers from UC Davis and UC Santa Cruz announced Wednesday.
The virus has ravaged wild, commercial and domestic animals across the globe and was found last week in seven weaned pups. The confirmation came from the U.S. Department of Agriculture’s National Veterinary Services Laboratory in Ames, Iowa.
“This is exceptionally rapid detection of an outbreak in free-ranging marine mammals,” said Professor Christine Johnson, director of the Institute for Pandemic Insights at UC Davis’ Weill School of Veterinary Medicine. “We have most likely identified the very first cases here because of coordinated teams that have been on high alert with active surveillance for this disease for some time.”
Since last week, when researchers began noticing neurological and respoiratory signs of the disease in some animals, 30 seals have died, said Roxanne Beltran, a professor of ecology and evolutionary biology at UC Santa Cruz. Twenty-nine were weaned pups and the other was an adult male. The team has so far confirmed the virus in only seven of the dead pups.
Infected animals often have tremors convulsions, seizures and muscle weakness, Johnson said.
Beltran said teams from UC Santa Cruz, UC Davis and California State Parks monitor the animals 260 days of the year, “including every day from December 15 to March 1” when the animals typically come ashore to breed, give birth and nurse.
The concerning behavior and deaths were first noticed Feb. 19.
“This is one of the most well-studied elephant seal colonies on the planet,” she said. “We know the seals so well that it’s very obvious to us when something is abnormal. And so my team was out that morning and we observed abnormal behaviors in seals and increased mortality that we had not seen the day before in those exact same locations. So we were very confident that we caught the beginning of this outbreak.”
In late 2022, the virus decimated southern elephant seal populations in South America and several sub-Antarctic Islands. At some colonies in Argentina, 97% of pups died, while on South Georgia Island, researchers reported a 47% decline in breeding females between 2022 and 2024. Researchers believe tens of thousands of animals died.
More than 30,000 sea lions in Peru and Chile died between 2022 and 2024. In Argentina, roughly 1,300 sea lions and fur seals perished.
At the time, researchers were not sure why northern Pacific populations were not infected, but suspected previous or milder strains of the virus conferred some immunity.
The virus is better known in the U.S. for sweeping through the nation’s dairy herds, where it infected dozens of dairy workers, millions of cows and thousands of wild, feral and domestic mammals. It’s also been found in wild birds and killed millions of commercial chickens, geese and ducks.
Two Americans have died from the virus since 2024, and 71 have been infected. The vast majority were dairy or commercial poultry workers. One death was that of a Louisiana man who had underlying conditions and was believed to have been exposed via backyard poultry or wild birds.
Scientists at UC Santa Cruz and UC Davis increased their surveillance of the elephant seals in Año Nuevo in recent years. The catastrophic effect of the disease prompted worry that it would spread to California elephant seals, said Beltran, whose lab leads UC Santa Cruz’s northern elephant seal research program at Año Nuevo.
Johnson, the UC Davis researcher, said the team has been working with stranding networks across the Pacific region for several years — sampling the tissue of birds, elephant seals and other marine mammals. They have not seen the virus in other California marine mammals. Two previous outbreaks of bird flu in U.S. marine mammals occurred in Maine in 2022 and Washington in 2023, affecting gray and harbor seals.
The virus in the animals has not yet been fully sequenced, so it’s unclear how the animals were exposed.
“We think the transmission is actually from dead and dying sea birds” living among the sea lions, Johnson said. “But we’ll certainly be investigating if there’s any mammal-to-mammal transmission.”
Genetic sequencing from southern elephant seal populations in Argentina suggested that version of the virus had acquired mutations that allowed it to pass between mammals.
The H5N1 virus was first detected in geese in China in 1996. Since then it has spread across the globe, reaching North America in 2021. The only continent where it has not been detected is Oceania.
Año Nuevo State Park, just north of Santa Cruz, is home to a colony of some 5,000 elephant seals during the winter breeding season. About 1,350 seals were on the beach when the outbreak began. Other large California colonies are located at Piedras Blancas and Point Reyes National Sea Shore. Most of those animals — roughly 900 — are weaned pups.
It’s “important to keep this in context. So far, avian influenza has affected only a small proportion of the weaned at this time, and there are still thousands of apparently healthy animals in the population,” Beltran said in a press conference.
Public access to the park has been closed and guided elephant seal tours canceled.
Health and wildlife officials urge beachgoers to keep a safe distance from wildlife and keep dogs leashed because the virus is contagious.
Science
When slowing down can save a life: Training L.A. law enforcement to understand autism
Kate Movius moved among a roomful of Los Angeles County sheriff’s deputies, passing out a pop trivia quiz and paper prism glasses.
She told them to put on the vision-distorting glasses, and to write with their nondominant hand. As they filled out the tests, Movius moved about the City of Industry classroom pounding abruptly on tables. Then came the cowbell. An aide flashed the overhead lights on and off at random. The goal was to help the deputies understand the feeling of sensory overwhelm, which many autistic people experience when incoming stimulation exceeds their capacity to process.
“So what can you do to assist somebody, or de-escalate somebody, or get information from someone who suffers from a sensory disorder?” Movius asked the rattled crowd afterward. “We can minimize sensory input. … That might be the difference between them being able to stay calm and them taking off.”
Movius, founder of the consultancy Autism Interaction Solutions, is one of a growing number of people around the U.S. working to teach law enforcement agencies to recognize autistic behaviors and ensure that encounters between neurodevelopmentally disabled people and law enforcement end safely.
She and City of Industry Mayor Cory Moss later passed out bags filled with tools donated by the city to aid interactions: a pair of noise-damping headphones to decrease auditory input, a whiteboard, a set of communication cards with words and images to point to, fidget toys to calm and distract.
“The thing about autistic behavior when it comes to law enforcement is a lot of it may look suspicious, and a lot of it may feel very disrespectful,” said Movius, who is also the parent of an autistic 25-year-old man. Responding officers, she said, “are not coming in thinking, ‘Could this be a developmentally disabled person?’ I would love for them to have that in the back of their minds.”
A sheriff’s deputy reads a pamphlet on autism during the training program.
(Genaro Molina / Los Angeles Times)
Autism spectrum disorder is a developmental condition that manifests differently in nearly every person who has it. Symptoms cluster around difficulties in communication, social interaction and sensory processing.
An autistic person stopped by police might hold the officer’s gaze intensely or not look at them at all. They may repeat a phrase from a movie, repeat the officer’s question or temporarily lose their ability to speak. They might flee.
All are common involuntary responses for an autistic person in a stressful situation, which a sudden encounter with law enforcement almost invariably is. To someone unfamiliar with the condition, all could be mistaken for intoxication, defiance or guilt.
Autism rates in the U.S. have increased nearly fivefold since the Centers for Disease Control began tracking diagnoses in 2000, a rise experts attribute to broadening diagnostic criteria and better efforts to identify children who have the condition.
The CDC now estimates that 1 in 31 U.S. 8-year-olds is autistic. In California, the rate is closer to 1 in 22 children.
As diverse as the autistic population is, people across the spectrum are more likely to be stopped by law enforcement than neurotypical peers.
About 15% of all people in the U.S. ages 18 to 24 have been stopped by police at some point in their lives, according to federal data. While the government doesn’t track encounters for disabled people specifically, a separate study found that 20% of autistic people ages 21 to 25 have been stopped, often after a report or officer observation of a person behaving unusually.
Some of these encounters have ended in tragedy.
In 2021, Los Angeles County sheriff’s deputies shot and permanently paralyzed a deaf autistic man after family members called 911 for help getting him to a hospital.
Isaias Cervantes, 25, had become distressed about a shopping trip and started pushing his mother, his family’s attorney said at the time. He resisted as two deputies attempted to handcuff him and one of the deputies shot him, according to a county report.
In 2024, Ryan Gainer’s family called 911 for support when the 15-year-old became agitated. Responding San Bernardino County sheriff‘s deputies shot and killed him outside his Apple Valley home.
Last year, police in Pocatello, Idaho, shot Victor Perez, 17, through a chain-link fence after the nonspeaking teenager did not heed their shouted commands. He died from his injuries in April.
Sheriff’s deputies take a trivia quiz using their non-writing hands, while wearing vision-distorting glasses, as Kate Movius, standing left, and Industry Mayor Cory Moss, right, ring cowbells. The idea was to help them understand the sensory overwhelm some autistic people experience.
(Genaro Molina / Los Angeles Times)
As early as 2001, the FBI published a bulletin on police officers’ need to adjust their approach when interacting with autistic people.
“Officers should not interpret an autistic individual’s failure to respond to orders or questions as a lack of cooperation or as a reason for increased force,” the bulletin stated. “They also need to recognize that individuals with autism often confess to crimes that they did not commit or may respond to the last choice in a sequence presented in a question.”
But a review of multiple studies last year by Chapman University researchers found that while up to 60% of officers have been on a call involving an autistic person, only 5% to 40% had received any training on autism.
In response, universities, nonprofits and private consultants across the U.S. have developed curricula for law enforcement on how to recognize autistic behaviors and adapt accordingly.
The primary goal, Movius told deputies at November’s training session, is to slow interactions down to the greatest extent possible. Many autistic people require additional time to process auditory input and verbal responses, particularly in unfamiliar circumstances.
If at all possible, Movius said, wait 20 seconds for a response after asking a question. It may feel unnaturally long, she acknowledged. But every additional question or instruction fired in that time — what’s your name? Did you hear me? Look at me. What’s your name? — just decreases the likelihood that a person struggling to process will be able to respond at all.
Moss’ son, Brayden, then 17, was one of several teenagers and young adults with autism who spoke or wrote statements to be read to the deputies. The diversity of their speech patterns and physical mannerisms showed the breadth of the spectrum. Some were fluently verbal, while others communicated through signs and notes.
“This population is so diverse. It is so complicated. But if there’s anything that we can show [deputies] in here that will make them stop and think, ‘Hey, what if this is autism?’ … it is saving lives,” Moss said.
Mayor Cory Moss, left, and Kate Movius hug at the end of the training program last November. Movius started Autism Interaction Solutions after her son was born with profound autism.
(Genaro Molina / Los Angeles Times)
Some disability advocates cautioned that it takes more than isolated training sessions to ensure encounters end safely.
Judy Mark, co-founder and president of the nonprofit Disability Voices United, says she trained thousands of officers on safe autism interactions but stopped after Cervantes’ shooting. She now urges families concerned about an autistic child’s safety to call an ambulance rather than law enforcement.
“I have significant concern about these training sessions,” Mark said. “People get comfort from it, and the Sheriff’s Department can check the box.”
While not a panacea, supporters argue that a brief course is better than no preparation at all. Some years ago, Movius received a letter from a man whose profoundly autistic son slipped away as the family loaded their car at the beach. He opened the unlocked door of a police vehicle, climbed into the back and began to flail in distress.
Though surprised, the officer seated at the wheel de-escalated the situation and helped the young man find his family, the father wrote to Movius. He had just been to her training.
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