HI Sarah -- sorry I think I missed your reply here. 

>Thanks, Helen. For some strange reason it's not referenced on Pubmed, so at least now I know why I couldn't find it. Anyway, >have got it from the local hospital library now.

Glad you were able to track it down.

>As far as I can see it shows SIDS risk from bedsharing to be unaffected by feeding method (which we know anyway from his >follow-up meta-analysis).

That's not what is illustrated in Fig 3 though -- that shows a greater difference between cumulative deaths by sleep location for his 'bottle fed' category and 8 and 12 weeks, for instance. In the MVA don't these relatively small differences get swamped by much bigger risks?  The follow-up analysis/paper (2013) did not include all the same studies/data, and combined individual patient-level data from multiple studies with heterogeneous variable definition (and much missing data), so I'm not persuaded this later reanalysis is any more reliable than any of the other data we can currently bring to bear on this question.

>I'll explain where I'm coming from on this one. Given that we know that strict anti-bedsharing advice carries the risk of >backfiring with a fussy baby (mum becomes so exhausted trying to avoid bedsharing yet not being able to settle the baby that >she ends up falling asleep on the sofa with the baby and creating an avoidable tragedy), it worries me that pro-bedsharing >organisations are so ready to give precisely this advice to formula-feeding mothers. These are mothers who a) may be reduced >to horrible states of exhaustion and b) may be unintentionally putting their babies at more risk by being flat-out advised not to >bedshare rather than being advised on minimal-risk bedsharing as possibly the better option if the alternative is proving >exhausting. 

Yep, I agree completely with all of this when mum and baby are exhausted. I think the chance of unintentional/uninformed bedsharing by a breastfeeding mum is greater tho because of the sleep inducing nature of oxytocin surge. But that doesn't mean women who are not breastfeeding do not also need bedsharing safety info.

>So this is an issue I want to blog about. It angers me that not only is this prescriptive advice being given to formula-feeders on >such horribly poor evidence, but that this is being done by the very people who are so ready to champion bedsharing for >*breastfeeding* mothers, protest overly restrictive rules, and argue vociferously against the validity of any study that shows >bedsharing in general to be associated with increased risk. 

Certainly an issue worth pointing out -- the same also pertains to women who smoked in pregnancy or had a premature delivery. They also are equally likely to be exhausted and fall asleep with their baby but are told they must never do so because the 'evidence' for them although still poor quality is somewhat stronger. This is one of the lines of argument used by those who advocate the 'just don't bedshare message' -- that it is fairer to be equally prohibitive to all than to deliver mixed-messages based on odds ratios that don't actually translate to an individual person/family level. I think, therefore, the issue is more complex than a distinction by feeding type, and would and do argue that all parents have a right to information about 'bedsharing' (cosleeping) hazards and safety issues such as the greater risk associated with sofa-sharing, and how to reduce their risks when bedsharing as much as possible, since we know almost everyone will find themselves doing it at some point.

On ISIS we say (and have always said) that the evidence is not yet sufficiently clear to say whether never-breastfeeders should consider avoiding bedsharing in favour of a bedside cot etc. (although I am aware my position on this has been misrepresented elsewhere...). https://www.isisonline.org.uk/hcp/where_babies_sleep/parents_bed/how_parents_bedshare/bedsharing_and_nonbreastfeeders/ 

Looking forward to reading your blog post!
Regards,
Helen 

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