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From:
Sulman Family <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Fri, 7 Nov 1997 22:49:18 -0600
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In an article by Ford RPK et al, "Breastfeeding and the risk of sudden
infant death syndrome," International Journal of Epidemiology
1993;22(5):885-890, statements are made that strongly support the role of
breastfeeding as protective against SIDS.  This study evaluated the data
from the New Zealand cot death study.  There were 485 cases of SIDS in the
3 years of the study (Nov. 1987 - Oct. 1990), and 1800 controls.  Full
analysis was done for 356 cases and 1529 controls.  They evaluated the
feeding method at hospital discharge, the first 4 weeks of life, and during
the last 2 days of life of the SIDS babies, as well as categorizing
breastfeeding as exclusive, partial, any (a combination of exclusive and
partial groups) or none.

There were marked differences between the cases and the control group.  For
SIDS cases, 86% were breastfed during the first week, 63% at 6 weeks, 50%
at 13 weeks, and 36% at 6 months.  For the controls, it was 92% in the
first week, 77% at 6 weeks, 69% at 13 weeks, and 58% at 6 months.  For SIDS
cases, 48% were exclusively breastfed at the end of 4 weeks, but 65% of
controls were.  25% of cases were exclusively breastfed at 16 weeks, and
60% of controls. The divergence between cases and controls persisted when
confounding variables were taken into account.  The authors conclude that
"Infants not breastfed were nearly twice as likely to die of SIDS...We
conclude that breastfeeding does have a significant association for a
lowered risk for SIDS and that this effect seems to persist for several
months. We found that cases compared to the control group failed to
establish breastfeeding as well, that breastfeeding was stopped earlier and
that exclusive breastfeeding was poorly maintained.  Finally, 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....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."

My question is, why does breastfeeding continue to be left off so many of
the  lists of actions to be taken to protect babies against SIDS?  The
authors cite an earlier U.S. study that looked at 757 SIDS cases and found
an identical protective effect of breastfeeding.  So why is there a "back
to sleep" campaign that downplays the role of breastfeeding?

Anne Altshuler, RN, MS, IBCLC and LLL leader in madison, WI
e-mail address:  [log in to unmask]


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