I apologize in advance for not having the author's names or place and date of publication of this study.  The data were presented at a SIDS conference in Norway this fall, and I heard them from obstetrician Gro Nylander (she made the video Breast is Best), when she presented them at a day course on BF Tuesday 30 November in Tønsberg, Norway.  I will get the reference and post it when it is available.  In the meantime, here are the relevant statistics.  NOTE: the smoking referred to in the study was not just smoking while in bed with the baby.  The effect was seen if mother smoked.  Period.  If father smoked as well, all the negative effects were strengthened, but mother's smoking was most influential.

The relative risk of SIDS was calculated using non-smoking, non-bedsharing as the starting point, with a relative risk of 1 (one).
There was no significant difference in risk of SIDS for nonsmoking bedsharers relative to that.
If mother smoked and didn't bedshare, the baby's risk of dying of SIDS was 4 times higher than for nonsmokers who didn't bedshare.
If the mother smoked and shared her bed with the baby, the baby's risk of SIDS was 9.6 times higher than if she did neither, or more than twice as high as if she continued to smoke but slept in a separate bed from the baby.

The relative risk of SIDS for smoking and breastfeeding was also calculated, using non-smoking breastfeeders as the starting point, relative risk of 1.
Not smoking and not breastfeeding gave a relative risk of 1.8.
Smoking and breastfeeding gave a relative risk of 3.2.
Smoking and not breastfeeding gave a relative risk of 7.4.

These effects combine, so that a smoking, bedsharing mother who does not breastfeed, places her infant at a 13.8 times higher risk of dying of SIDS.  Women have a right to know this, and we have an obligation to tell them, so their babies may benefit from it.

I try to give this information as unemotionally and non-judgmentally as possible, while not mincing words.  (This is the challenge, folks!)  My impression from the way parents respond is that they understand my motivation is to protect as many babies as possible from dying and as many parents as possible from the tragedy of losing a baby.  Smoking is within parents' control.  Tobacco is a plant.  It has no will of its own.  It can't force anyone to use it.  Parents understand that as well as anyone else.

After seeing these figures, I am considering making large posters for my office, with bar graphs showing the relative risk of SIDS for each combination of behaviors.  Can anyone give me a good reason not to?  I am very open for comments!

Rachel Myr

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html