>There is a case-control SIDS/pacifier study from Kaiser Permanente out on
>BMJ Online First, which despite its serious limitations, one of which is the
>woefully lacking information about the breastfeeding status of the babies
>involved, is being touted in the mass media (The Guardian, and at least one
>Norwegian news website) as proof that pacifiers save lives.
>In the Norwegian text the journalist who reported it has even said that the
>SIDS rate would be one in twenty thousand if all babies used pacifiers.  I
>can't figure out where she got those figures from as they don't appear in
>the article as far as I can tell.


She's extrapolated, I think, from the supposed 90 per cent reduction 
of risk highlighted in the press release sent out to journalists 
(including myself), which is in the results section of the paper.  I 
suspect she is working on a figure of one SIDS in every 2000 births, 
and worked it out from there....but this is a huge leap from this 
relatively small sample, especially small for a case control study 
with so many variables (ill-defined, as you point out, not only with 
regard to breastfeeding but also with regard to co-sleeping - what 
does co-sleeping mean...same room, same bed, with one adult, with two 
adults, with a sibling, or what? )

It has been all over the UK media, and NCT, UNICEF and the Foundation 
for the Study of Infant deaths have all issues statements pointing 
out (with varying emphasis) that no guidance can change on the basis 
of this study.

I would point out out that the UK case control study of 1999 had 
twice the number of cases and found that pacifiers made no difference 
at all...except, possibly, to babies who were used to having one and 
then didn't on the night they died.

Once again, the media have run with a 'sensation' which the BMJ has 
(in my view, irresponsibly) done little to clarify.


Heather Welford Neil

NCT bfc, tutor, UK

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