Dear Nikki:
Before a meeting that Leigh Anne O'Connor attended on safe sleep (we have one person in the NY City Department of Health who NEVER responds to my questions - like a politician she sends back nonanswers). I told Leigh Anne to point out that it is not actually SAFE SEX, it is SAFER SEX and you cannot use one approach.  You need multiple approaches and many strategies to achieve the objective of SAFER SEX.  So, to with SIDS.  Quite frankly, I find that the pro crib establishment doesn't understand that babies sleep during the day and no one even considers where they are sleeping.  If you went for SAFER SLEEP, you would be giving more appropriate information to those who choose to put their baby in a separate room which is by far, the LEAST SAFE option -- with a 36% higher risk of death as opposed to 16% higher with bed sharing (which we all know encompasses many of the risk factors that have been identified).  The single message public health campaign here in New York City actually BACKFIRES because parents put their baby in a separate room thinking that was "YOUR BABY SHOULD SLEEP ALONE" means.  I think sometimes health care practitioners don't really know that much about how to effect change on a population level.  But then again, it doesn't work on an individual level either.  You have to look at the individual situation, look at the obstacles, propose DOABLE actions.  Clearly sleeping alone is not doable because parents will keep on doing it despite the scare tactics far worse than any breastfeeding NAZI has ever used.  So, therefore, the better approach is making ALL potential sleeping places safer while trying to discourage the least safe (e.g. crib in a separate room).

Best, Susan

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