Ali asks:


>
>
>Imagine if the AAP had stated that breastfeeding reduces SIDS. What impact
>might that have had?

It would be great, but......

I think the impact of any advice is dependent on how easily it fits 
in with what parents already do, or already can do.

I suspect any AAP statement to that effect might not have a dramatic 
impact at all (apart from a rush of press articles criticising them 
for 'making mothers feel guilty', of course, which would also be the 
effect here in the UK).

For some years now, the official advice here has been for babies to 
share a room with their parents for the first six months, 
*specifically* as a protection against SIDS.

  It's in every magazine article, every leaflet, and every HCP says it.

We're in the middle of one of our periodic crises about actual *bed 
sharing* after a mother hit the headlines having lost 2 babies to 
suffocation....fairly complex story with some serious contradictions 
...but no one argues any more against room sharing.

However, I would guess rather less than 50 per cent of parents share 
a room with their babies for this length of time, and some babies (at 
a guess, 15-20 per cent) are in their own rooms more or less straight 
away, often day and night.  I spoke to a mother last week whose *five 
day old*  baby was in another room most of the time, including at 
night,  'because we don't want to start any bad habits' .

Parents also know very well that smoking in pregnancy and around 
babies is harmful and risky, specifically for stillbirth, neonatal 
death and SIDS, yet about a third of babies are in regular contact 
with maternal or paternal smoke.

Breastfeeding, room-sharing, and not smoking are huge cultural 
challenges to people (and with the smoking, you also have a physical 
addiction), in a way that using a pacifier or turning a baby onto his 
back to sleep may not be.

However, even if a pacifier  was recommended in the UK, you would 
still find many women refusing to use one, as its use is closely 
associated with social class - so this would be a cultural challenge 
to them!

Yet most of these parents love their babies, and want the very best for them.

Heather Welford Neil
NCT bfc, tutor, UK.

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