Co-sleeping - when is it safe?

I'm usually happy to lurk in the background on lacnet  but thought it might
be useful to revisit this study on co-sleeping which shows how easy it is
for research findings to be reported in a way that is misleading.

 Fleming, PJ et al. 1996: Environment of infants during sleep and the risk
of the sudden infant death syndrome. BMJ, vol 313, no 7051, 99.191-195.

This case controlled study involved 195 babies who died and 780 matched
controls, from 3 regions in England. The Medline abstract reports amongst
other findings;  'The use of a dummy had an apparent protective effect
(0.38; 0.21 to 0.70). Bed sharing for the whole night was a significant
risk factor for infants whose mothers smoked (9.25; 2.31 to 34.02). No
protective effect of breastfeeding could be identified on multi variate
analysis.' 

The abstract, however omitted an additional piece of information (which
appeared in the full paper) namely that there was no significant difference
in risk in bed sharing for babies whose mothers were non-smokers (OR 2.27;
CL 0.41 to 12.54). This omission turned out to be important because the
research was subsequently reported in a Lancet commentary with a picture of
a mother and baby sleeping together and the caption: "Co-sleeping - not
advisable." Subsequent correspondence retracted this statement but not
everyone will see this.

It further states that the findings about dummy sucking should not be used
to claim that dummies prevent cot death as there was no difference in the
proportion of the babies who died, and controls who routinely used a dummy,
but they weren't using them in their last sleep.

Phyll Buchanan
Breastfeeding Supporter
The Breastfeeding Network, near Reading, UK

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