Anne Altshuler wrote: "Your post was of interest to me, as the author you
quoted, Mitchell EA, is
the third author of the article by Ford RPK et al, Breastfeeding and the
risk of sudden infant death syndrome, International Journal of Epidemiology
1993; 22(5):885-890.  This article states, very persuasively, "being
exclusively breastfed at any of the observed time intervals differentiated
between the SIDS victims and the control infants, giving them about a 50%
reduction in the chance of SIDS. The implication of this is that more
positive promotion and active community support is needed to further
enhance the level and length of exclusive breastfeeding.  Added to a
smoke-free pregnancy, and avoidance of the prone sleep position, mothers
can now be given very positive advice on how to significantly reduce the
risk of their baby succumbing to cot death." (p.889)

The authors stated that these results were significant and persisted when
confounding variables were taken into account.

So what exactly changed between 1993 and 1997, using the same data?"



I have not had access to the full text of the most recent article yet, but
as I understand it the new study occurred after an advertising campaign
regarding the previously known modifiable risk factors for SIDS was
undertaken. New Zealand breastfeeding rates have been high for some time
and I have no reason to believe that they had changed between the two
studies. Perhaps one of the Lactnetters from New Zealand could comment.
If it were not for the Australian authorities decision to drop
breastfeeding from the SIDS public education program because of a lack of
evidence I would probably be happy to run with Mitchell's previous work and
that of Doren Fredrickson. This would mean that in all good faith that I
could continue to promote breastfeeding as a possible protective factor in
SIDS. However as it stands at the moment I do not feel comfortable in doing
so.
However I would love for one of you to convince me otherwise.

Laureen Lawlor-Smith
BMBS IBCLC
South Australia

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