I, also, have had to face and challenge the "simple messaging" of those fighting SIDS/SUID.  It's a frustrating dialogue as usually I am quoted ONE of Helen Bell's studies that showed no difference in breastfeeding rates.  

However, just like the "simple message" that "breast is best" can come back to haunt us as it has me in the last two months when two moms (and their doctors) absolutely refused to supplement babies despite clear evidence that they were not consuming adequate calories. My thanks to WHO for their free software - http://www.who.int/childgrowth/software/en/ - that allowed me to provide graphs which, together with complete logs clearly showed the need for supplementation.  

There are additional reasons that mothers bedshare besides breastfeeding - and the maternal (and paternal)-infant interaction during these times also need to be part of the "cost/benefit" consideration.   I don't believe it is just a "cultural" or "socioeconomic" issue but a "mammalian need" to be close together during sleep.  Some have an easier time suppressing this need, some have been rationalized out of responding to that need, some (my mother for one) report grief that is physically and emotionally palpable decades later as they listen or see moms who DO share "sleep surfaces" (don't you love the new terminology?).  

The reality is, if we don't ASK mothers in an open-ended way and with different phraseology: 
- Where does your baby sleep most of the night?
- What do you do when your baby cries during the night?
- How many days a week is your baby in your bed for some part of the night? Etc....
...you will never know that babies are in bed with moms.

This means the data about bedsharing and risks to infants is very skewed (the denominator is much larger than assumed), but it also does not allow us to provide education about how to reduce the risk.  Of course babies in cribs/cots NEVER die from having an adult roll over on them - but they DO die ...despite the desire to hide it by changing the name from Crib Death to Sudden Infant Death and now Sudden Unexpected Infant Death.

As moms sense from me the willingness to listen to what their sleep arrangements are without criticism, they also are willing to hear from me what they need to watch out for and avoid (got one dad to stop smoking - an added bonus!).  THAT is public health education - not scare tactics!

So I advocate for 1) Open ended questions, 2) Validating Feelings and 3) Provide Targeted Education ...and we need to use this method also with those who have such strong feelings about the SIDS/SUID "single messaging" - LISTEN, then validate, then provide education and examples...  Maybe we will be able to find a common ground...or find some leadership who will listen to US!

Jeanette Panchula, BSW, RN, PHN, IBCLC
Vacaville, CA

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