At 09:08 AM 8/7/00 EDT, you wrote:
>Alice,
>I have talked with Pediatricians and OT/speech therapists who say placing the
>baby on their stomachs is the best position for Reflux.  By the anatomical
>design of our esophagus and stomach, they are in better alignment when prone
>than supine.

I am suspecting that the "epidemic" of reflux in the Milwaukee area might
be caused by the back to sleep orders.  I expect that side lying is
preferred over supine for the health of the infant's internal organs. (I
believe that this is evidenced based.)  Babies are more comfortable and
their organs function better when they are lying curled up similar to the
fetal position than they are lying flat on their backs. And they may know
something. They are also comfortable and their systems function better when
they are held.

I wonder if the favorable statistics on SIDS deaths since the Back To Sleep
campaign took into consideration the feeding experiences of the babies.  If
most of the babies were formula fed, which would be the case in the U.S.,
then prone sleep would be a greater hazard to them because of the longer
time they spend in deep sleep, from which they can't adequately arouse
themselves. So the dramatically reduced incidence of SIDS would reflect the
preferred sleeping position of babies who are engaging in abnormal,
extended, sleep patterns. "If you feed your baby artificial baby milk, then
you must assure that she sleep on their backs."

Then, of course, there is the issue of isolated sleep. On this side line,
if parents are encouraged to let their babies cry themselves to sleep and
to force them to sleep alone throughout the night, are we sure that those
sobbing babies will fall down and obediently roll over onto their backs for
"safe" sleep? Or, if they awake in the night lonely and needy, will they
remember not to curl up in the fetal position or roll onto their tummies to
be "held" by the crib sheet?

The one thing that the Back To Sleep campaign shows us is how effective
blanket endorsement of a given behavior is when it comes from the medical
community.  Too bad that they didn't choose artificial feeding as the risk
factor to focus world-wide attention on.

Pat Gima, IBCLC
Milwaukee, Wisconsin
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