> > The best available evidence on the effect of bedsharing in breastfeeding
> > mums is http://bmjopen.bmj.com/content/3/5/e002299.full , which looked
> > specifically at the risk in breastfeeding mums when allowing for other
> > risk factors, and still found an increase in SIDS risk for young babies
> > who bedshare as compared to room sharing. It didn't control for amount
> > of breastfeeding, but it's hard to see why that would make enough of a
> > difference to eliminate all risk.

> > (Obviously, at this point you're talking about extremely small absolute
> > risks anyway; I don't agree with the 'never bedshare' conclusion that
> > the authors of the article have reached. However, the evidence clearly
> > doesn't support bedsharing being something we should advocate as
> > protective against SIDS.)
> > Best wishes,
> > 
> > Sarah

> This may be best available but it's not very good- imputing data on drug
> and alcohol consumption (the original studies having not collected this
> data) and excluding male infants from the control and as you say not
> controlling for intensity of breastfeeding. All of these factors have a
> big impact on SIDS risk and make it impossible to draw any conclusions
> about the risk of SIDS where an infant is exclusively breastfed,
> regardless of gender and where there is no parental alcohol or other
> drug consumption.

> Karleen Gribble

Yes. As well as considering "breastfed" to be a homogeneous group -
which we very much know it's not! - this meta-analysis also only looked
at bedsharing at last sleep, as far as I can tell (it's hard to winkle
out), so routine bedsharers and occasional (e.g. when ill/cranky) are
mixed up together. 

There doesn't apper to be any controlling for bed environment at all,
even though they note the issues of rebreathing and thermal stress in
the possible pathophysiologies. And I can't see anything about
controlling for parental sleep disorders or prescription drugs, unless
I'm missing something?

As the authors themselves note/imply, their aim is to look at
whole-population messages, while here we're working on teasing out much
more nuanced issues. There's a lot more bang for the buck in working on
smoking/bedsharing problems than in guilting/harassing/etc breastfeeders
with zero other risk factors who are taking appropriate care with their
co-sleeping environment.

I'd personally also like to see a little more public health time given
to the risks of separate-room sleeping, something which I don't really
ever recall seeing memorable public service announcements on.

Lara Hopkins

Karleen Gribble <[log in to unmask]> wrote:

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