Linda wrote:
> Recently I have seen a study making the rounds on internet newsgroups.  It
> supposedly was a recent British study that compared co-sleepers and
> non-co-sleepers with an eye toward the incidence of SIDS deaths.

There are two recent studies published in the British Medical Journal. You can
download both of them in full from their web site: www.bmj.com/bmj/

Environment of infants during sleep and risk of the sudden infant death
syndrome: results of 1993-5 case-control study for confidential inquiry into
stillbirths and deaths in infancy. Peter J Fleming, Peter S Blair, Chris Bacon,
David Bensley, Iain Smith, Elizabeth Taylor, Jem Berry, Jean Golding, John
Tripp.  BMJ No. 7051 Volume 313, July 1996

Smoking and the sudden infant death syndrome: results from 1993-5 case-
control study for confidential inquiry into stillbirths and deaths in infancy.
Peter S Blair, Peter J Fleming, David Bensley, Iain Smith, Chris Bacon,
Elizabeth Taylor, Jem Berry, Jean Golding, John Tripp.   BMJ No. 7051
Volume 313, July 1996

I was particularly interested in these studies because they were the primary
research cited by the Australian group which has recently removed
"breastfeeding" from the key SIDS prevention campaign in this country.

These UK studies drew on a population of 17 million people, with 195 SIDS
deaths in the study period and 780 matched controls.

They found that prone and side sleeping positions both carried increased risks
of death compared with supine (the side sleeping babies who died had rolled
prone). Also, 64% of SIDS group versus 33% controls were found with covers over
their heads, and of these, more SIDS group babies were sleeping under duvets.

Bed sharing and room sharing - Routine bed sharing with parent(s) (two or more
nights a week) was commoner among babies who died (26%) than controls (14.2%).
During the last sleep this difference was significant only for those who had
been in bed with the parent(s) for more than one hour (25.7% versus 15.3%
controls) or for the whole night (14.9% versus 4.0%). For most this was their
usual practice; very few did so because the baby seemed unwell. Most of the
index (SIDS) mothers who shared their bed also smoked (86.2% versus 35.5%
controls). In a subgroup analysis the risk associated with bed sharing was not
significant for non-smoking mothers but highly significant for mothers who
smoked.

Use of dummies - There was no difference in the proportion of the babies who
died and controls who routinely used a dummy, but for the last or reference
sleep there was a significant excess of control infants (52.8%) who used a
dummy compared with babies o died (39.8%).

Breast feeding or bottle feeding - More of the control infants (60.3%) than the
babies who died (45.1%) had ever been breast fed, but the protective effect did
not increase with increasing duration of breast feeding. However, bottle
feeding was strongly a ociated with lower socioeconomic status and with
smoking. No protective effect of breast feeding was identifiable when all other
factors were controlled for. (My comment - this does not mean breastfeeding was
not protective, just that it got swamped as a variable. As I understand it,
there were not enough babies who were died who had no other risk factors ie
non-smoking mothers, supine sleeping no bedding over the face, to get reliable
data on feeding method as an independent variable.)

My comments:
I think there are two messages in the SIDS data.  One is that there do appear
to be clear SIDS risk factors related to sleep position, bedding covering the
face and parental smoking that are more powerful than breastfeeding and
bedsharing, as beneficial a we know these latter two are.

The second is that we need to get the SIDS campaign into perspective. SIDS is
a tragic problem that gets lots of popular attention. However, one should
always be wary when one health message gets isolated and promoted separately
to all the other health messages. People can see the popular message and think
that is all they have to do. Just because breastfeeding doesn't protect our
kids from drowning accidents, that doesn't mean it is not worthwhile.