I don't have a scientific background or education, so I'm turning to the
many of you who do. I'm left with some questions after reading the BMJ
study on SIDS. First, is SIDS defined in the UK as it is here in the US?
My understanding is that it's only called SIDS if there are no obvious
causes. If a baby is found dead with covers over his head, would we not
say that's suffocation rather than SIDS? I know of a mother who passed
out drunk on a waterbed, with her two-month-old beside her. When she
awoke, the baby was face down and dead. This mother was a smoker and not
breastfeeding-- what would you say the cause of this baby's death was?
Would the researchers count it as SIDS?

The study basically says that mothers who smoke put their babies at
higher risk of SIDS by co-sleeping. Why? I am asking this because it
seems that in my area, mothers who smoke (and the rate is pretty high)
get the message (spoken or implied) from their HCPs that if they smoke,
they shouldn't breastfeed. Maternal smoking in and of itself is a risk
factor for SIDS, we've known that. Again, my understanding is that if
the mother smokes, the baby is still better off breastfed than
artificially fed. I counsel mothers who smoke to keep their intake as
low as they can, keep a closer than usual eye on baby's diapers and
weight gain, and to avoid smoking just prior to feeding. As low weight
gain is associated with maternal smoking, and as co-sleeping is often
suggested as a help in increasing milk supply, I'd like to know why the
researchers say that mothers who smoke, in essence, should not co-sleep.
Seems to me that babies born to smokers need all the help they can get.

Kathy Dettwyler said:
>  Except in places like New Zealand, where the co-sleeping moms are
> smoking in bed with their kids....
Were you jesting, Kathy, or do you really think that's the key? I know a
few mothers who smoke, and most are educated enough to be very careful
to keep baby's second-hand smoke exposure to a minimum-- smoking
outside, never in the same room with the baby, etc. Is this a cultural
thing? Here in the US, I think most people are fairly well-informed
about the risks in second-hand smoke. If people are smoking in the
bedroom, and the bedclothes and nightclothes are full of the toxins, I'd
say that could certainly be a problem, no matter where the baby sleeps.
I realize of course that bf and co-sleeping don't always go together,
but for many of us one leads to the other. If a mother is led to believe
she must discontinue one, discontinuing the other might well follow.
Thoughts?
Joanne Hamilton
LLL Leader
Foley, Alabama