Hi all
I'm a little behind in my digests, but read that a researcher called
Fleming in the UK had dismissed the protective effect of
breastfeeding on the incidence of SIDS.

The reference that Fleming is using is probably:
Gilbert RE, Wigfield RE, Fleming PJ, Berry PJ, Rudd PT 1995, Bottle
feeding and the sudden infant death syndrome. BMJ 310:88-90

This was
A UK population-based case controlled study which examined infant
feeding and relationship to SIDS. The study
examined 98 cases of SIDS and compared them with 196 controls. The
researchers examined type of milk feed at the time of death (fully
breast fed, mixed breast/bottle and fully bottle-fed), and calculated
odds ratios for type of feeding, and when the confounders of sleeping
position, maternal smoking, gestation at birth and employment status
were considered. They concluded that  `Babies who had been fully
bottle-fed from birth seemed to be at greater risk of the sudden
infant death syndrome than babies who had been fully breastfed.
However, this effect was not significant once confounding due to the
prone sleeping position, maternal smoking, parental unemployment and
preterm gestation had been taken into account'. The researchers felt
that bottle-fed babies were more likely to have mothers who smoke, to
be born preterm and to come from poorer families, and this would
explain the higher incidence of SIDS in bottle-fed babies. The study
is a fairly small one (98 cases) and does not compare exclusively
breastfed babies with babies who are partially or fully bottle-fed as
a group. Solids are also not taken into account, and maternal smoking
is only recorded during pregnancy and not lactation.
I agree with Katherine Dettwyler that the work that Doren Fredrickson
has done is the only one to examine breastmilk in a 'dose' related
way - eg that the more bm a baby gets, the better the effect is (be
that protection from SIDS, disease etc). To make breastfeeding an all
or none event is missing much of the importance of breastmilk as
medicine.
I'm going nomail today for a week or so, so have a Happy Christmas
everyone!



Fiona Coombes MBBS IBCLC               [log in to unmask]
Nursing Mothers' Association of Australia Breastfeeding Counsellor
Lactation Consultant, Family Physician
Perth Western Australia