Joanne wrote
> First, is SIDS defined in the UK as it is here in the US?
My understanding is that the SIDS definitions are pretty well
standardised.  It is a definition of exclusion, as you say when there is
no known cause, even on autopsy.

> If a baby is found dead with covers over his head, would we not
> say that's suffocation rather than SIDS?
Not if the covers were just resting lightly over the face in a way that
would not normally suffocate (I often find my 12 year old snuggled under
the bedclothers like this in the mornings!)  Under normal circumstances
babies survive these sorts of things all the time - it is just that
sometimes they stop breathing and don't start again for some unknown
reason.  Remember, the SIDS messages are about *risk factors*, and not
*causes* of death.  We don't yet know why some babies die of SIDS,
although there are lots of ideas.

> I know of a mother who passed out drunk on a waterbed ...
> Would the researchers count it as SIDS?
Possibly, if the circumstances were such that there was no evidence of the
baby actual smothering.

> Again, my understanding is that if the mother smokes, the baby is still
> better off breastfed than artificially fed.
Absolutely.  There is research on respiratory tract illnesses to support
this.

> 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.
Well done.  You have more chance of getting a mother to breastfeed with
this message than by telling her to give up smoking.

> 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.
The researchers say this because they know that co-sleeping with a smoking
parent (even one who always smokes outside the house, away from the baby)
is a known risk factor for SIDS. The baby has an increased chance of
dying.

Note it is a co-sleeping *parent*.  If the father is a smoker and the
mother a non-smoker there is still an increased risk, although I think I
read somewhere it was not as high, or only a risk if the baby slept next
to the father (eg between the parents).

I think the New Zealand data (Mitchell's study) was not just about mothers
who smoked in bed with their kids, it was more about mothers who were
smokers per se, as in the UK study.

> 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.
That is a very difficult question and we don't know the answer. Under what
circumstances is it better to run a (small) risk of your baby dying of
SIDS versus giving up breastfeeding because you can't co-sleep. The fact
is that we know that some breastfed babies who are co-sleeping with
smoking parents will die. Can you assume it will always happen to someone
else?

I am very much aware of SIDS because I live in a small community in a
state with a relatively high SIDS rate.  Probably because we are further
from the equator than the rest of Australia and have a generally lower
socio-economic level. Much unemployment. Much smoking too.

On a final note, I recall one study (NZ?) that suggested that it was OK to
sleep in the same room as a smoker, just not in the same bed.  Maybe a
compromise?