I thought I'd follow up on some posts I sent a few months back
 about our state perinatal organization's printed stand on bedsharing.  This
article used Ezzo as a reference, among other things.  Because of my post to
this list, I got some wonderful help with references and such to refute
their stand that bedsharing is never appropriate and that women should be
told never to do it.  After a few posts from me and others, and even some
from out of state (thanks Patty Donoho-Carey!), they agreed to retract their
reference to Ezzo and have just published my letter-to-the-editor in their
newsletter.  There will even be a meeting between our SIDS Alliance and
James McKenna, as well as a few other interested parties (our breastfeeding
committee president among them) to work out an official document to give to
parents on what constitutes safe bed-sharing and what is not safe!  So, that
is a plus.  However, alongside my letter-to-the-editor is a
"point/counterpoint" (mine being the 'point')letter from an MD who is
'director, Children's apnea & Sleep Disorders Center' at our local
children's hospital (I've posted about them before, terrible on
breastfeeding support!).  Among other things, this is some of what she says,

<<A list of hazards can provide guidelines, but cannot be considered all
encompassing.  One also runs the risk of being paternalistice or worse,
culturally biased, if one gives permission for one group of parents to sleep
with a child and not another who might not possess the resources to meet the
criteria for safe sleeping.  No one has shown that adhering to any set of
guidelines about bedsharing changes the outcome....>>
 It seems to me to be far more paternalistic to assume that we can "give
permission" to any parent, as though they are children and must abide by our
directives.  And worse, that we must tell them all to behave the same way
because, perhaps some don't have resources to practice the behavior safely.
And as for cultural bias, it seems to me she is practicing this by assuming
one culture would have more of a problem with this than another.  It
certainly does not preclude them from telling parents what types of cribs
are safe or unsafe!

(About Dr. McKenna's research)<<Any protective effect of bedsharing or any
advantage of "light sleeping" versus" "deep sleeping" for infants with
breathing problems is purely speculative.  One could also speculate (and the
sleep literature would support this) that by creating this type of sleep
deficit, hormonal secretion patterns, growth, and immunological function may
be disrupted with negative effects on development.>>
Honestly, mere logic would tell you that, since this co-sleeping with
attendant sleep/wake patterns at night, has been going on for thousands of
years, if there was a "negative effect on development" it (the behavior)
would have died out, right?  That statement just doesn't make sense and
really shows the cultural bias that exists here in the states.

<<The optimal amount of time and frequency of breastfeeding has not been
established.  Dr. McKenna did not mention whether children who fed longer or
more fequently gained weight better, sustained fewer infections or became
obese compared to the other infants studied.  While there are certainly good
reasons to breastfeed your child, recent studies do not show any protective
effect of breastfeeding on SIDS occurrence. It does not appear to me to be a
reason to recommend bedsharing.>>
Huh!  This really shows her ignorance.  What about the New Zealand Cot Death
Study or the new research that has just come out showing breastfeeding as
preventive of SIDS?  I think she shows her bias against breastfeeding, even
though she does give it lip service.

She ends her (much longer than this) letter with: <<From a public-health
standpoint, a simple and direct message is the best way to inform people of
a preventable risk for death.  Until the cause of SIDS is determined, my
message is "Back to Sleep is Best," do not smoke, do breastfeed and put your
baby to sleep in his own crib in your room.>>
I know the attitude of our SIDS Alliance here is embodied by the
well-intentioned woman who runs it, that being "If I can save just one baby
from dying....  (This woman experienced a SIDS death herself.)  There are a
lot of emotions tied up in this, I know, but it seems to me they are looking
at one aspect of an issue, and not seeing anything else, like the damage
they might inflict on many families by taking this inflexible stand in order
to perhaps save that "one baby" who might just as well have been saved if
his mom had been given safe sleeping information!

Whew!  Now I'm steaming! This physician will be at the meeting with James
McKenna in June.  Should be interesting.  I'll let you know what happens!

Marsha

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Marsha Glass RN, BSN, IBCLC
Mothers have as powerful an influence over the welfare of future generations
as all other earthly causes combined.
C. Abbot
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

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