HI folks. This from Jim McKenna re the SIDS article I mentioned last night.
Kathleen

Hi Kathleen:
The article is not at all surprising. Bradly Thach has done everything
possible to argue against bedsharing, and to have it condemned by the
Amercian Academy of Pediatrics. Happily, he failed there,,but unfortunately
he succeeded in convincing the CPSC (NJ Scheer and Ann Brown, Drago and
Dannenberg co-workers at CPSC) to make their case and recommendation
against all bedsharing--using similar kinds of problematic and highly
limited data. He chooses to recommend against bedsharing as it occurs among
any or all circumstances--including La Leche League mothers--and attachment
parenting mothers where no risk factors are present--and where parents are
doing everything right and safe. He makes an argument which is not
supported by the most of teh recent epidemiological studies on SIDS and
Sudden unexpected death--including a major survey of 10,oo0 mothers just
completed by NICHD--in which no association of bedsharing and unexpected
death was found, including SIDS. The other study that argues against
Thach's interpretation was published in the British Medical Journal in
December (by Peter Blair) in 1999--based on data from th elargest
epidemiological study yet conducted. If you noticed---half of the deaths
Thach is reporting on died somewhere else--probably alone. Does this mean
that we should recommend that babies not sleep alone? Secondly, 60% died
on their bellies. This alone is a major risk factor for SIDS. Aside from
the 60 %--how many babies bedshared and thier mothers smoked? Another major
set of risk factors. On one hand, if the baby died on its stomach in a bed
with an adult--it becomes a "bedsharing death". If the baby died alone, in
a crib, sleeping on its stomach--it is a SIDS death due to prone
sleeping--not a death due to "solitary crib sleepin".
None of the data are accompanied by critical information related to the
condition of th e parent and whether or not they were smoking or taking
drugs--or sleeping on soft mattresses or covered the babies head--all risk
factors. All of these data are critical toi understanding the
circumstances or "factors" that increase death---it is not the "practice",
but the "factors". Thach is so rabidly against bedsharing--when it suits
his bias--- circumstances do not matter--as long as the baby could be said
to have died sleeping with a parent or someone else. It is, as you
surmised, a highly biased and socially prejudiced interprettaion of the
data. How many of those deaths were, in fact--by non-parents--and what was
their condition? There is no explanatory data provided.
The article concentrated on deaths occurring among a group for which every
risk factor for SIDS exists--everyone of them, including matneral smoking
and extreme poverty--sh seems to think it is appropriate to draw universal
inferences from a very special sample. Of course, the behavior he argues
against--id exhibited under the very least health social and physical
circumstances.
SOmeone should write immediately to the news sources--in St Louis or
wherever and point out these rather significant problems. Frankly, given
the conditions of th epopulation, I am surprised the deaths are not higher!
you are welcome to use any of these ideas.
Thanks for sharing with me the story.
hope this is of interest...pass it on, if you wish!
all my best,

Jim McKenna



Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet, Indep. Consultant
mailto:[log in to unmask]
http://homepages.together.net/~kbruce/kbblact.html
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