Sleep researcher Helen Ball asked me to forward this because she is having trouble posting to the list at the moment. From: Helen Ball [mailto:[log in to unmask]] Subject: FW: co-sleeping when parents are smokers Arly asks some very relevant questions about smoking and co-sleeping in follow up to Elises's original post asking: I would like to know more about the exact parts of co-sleeping that are more dangerous for these babies than sleeping alone in a crib is. Proximity of adult(s)? Proximity of adult who smokes? Pillows? Mattress type? Blankets? Is there a way to modify the sleep arrangements to lessen the risk? This study was done in a Maori population -- do the results hold true in other groups? I suspect no one knows any of these answers yet... Has anyone else been following this aspect of the co-sleeping research, and what do you say to parents who are smokers? As a researcher these are questions I am asked after every talk I give on bed-sharing -- but the only current 'answers' are to use common sense -- there is as yet no research data to clearly address these issues. There are very few of us working directly on bed-sharing research. Yesterday my research staff and I tried to work out when we could realistically start a project on smoking and bed-sharing (something that has been on our 'list' for a couple of years already) -- and given our current project load it didn't look likely for another 2 years at the soonest -- which would mean 4 years from now before we had any real answers! In the UK the nationwide CESDI study found a 12x risk of SIDS in babies who bed-shared with parent(s)who smoked compared to babies who bed-shared with parents who didn't smoke (bed-sharing babies of parents who didn't smoke had basically the same risk of SIDS as babies who slept in cots in the rooms of parents who didn't smoke -- room-sharers of smokers had a 5x increased risk of SIDS). A recent paper in Archive of Disease in Childhood (James et al 2003) reported that of 9 bed-sharing infant deaths in Wirral, 7 were to babies of smokers, and 11/14 non-bedsharing infant deaths were to babies of smokers. In some bed-sharing cases alcohol and sofa-sleeping were also involved. That there is an increased risk of SIDS (and possibly accidental suffocation) to babies of smokers who bed-share compared with bed-sharing non-smokers is clear. What we don't know is why. We don't know whether it is to do with environmental contamination (on clothes, skin, breath of smokers etc). We don't know whether the relevant chemicals (if there are any) are transmitted via breastmilk also (perhaps bed-sharing breastfed infants receive the highest dose -- getting it via breastmilk and via close physical contact all night??). We don't know if the 'mechanism' is behavioural rather than chemical (e.g. one question we hope to answer is whether smoking parents and their infants differ in their sleeping/bed-sharing characteristics fron non-smoking parents and their infants -- e.g. sleep more deeply, reduced awareness of infant etc.) The only published info I know of so far is a paper by Franco et al (1999) who reported that prenatal exposure to cigarette smoking was associated with decreased arousal during sleep in infants. This suggests to me that smoke exposure prenatally (and postnatally?) is affecting infant neurophysiology controlling sleep. I think (from memory) that there are some publications reporting that smokers generally sleep more deeply than non-smokers -- if so we maybe have a situation of a less-responsive-than-normal baby sleeping with a less-responsive-than-normal parent giving rise to situations where SIDS/suffocation might arise. What do I say to parents who are smokers -- well first off, don't smoke! If they can't/won't do that, don't bed-share unless they are willing to accept a 12x increase in the risk of SIDS (in the UK this means going from 1 chance in 2000 to 1 chance in 167). Some parents are willing to accept this level of risk. Do the benefits of breastfeeding (which generally implies at least some bed-sharing)outweigh the increased risk of SIDS for babies of smokers?? Who knows?! There are no easy answers to these questions -- so the safest options at the moment seem to be a) if you have a baby don't smoke b) if you have a baby and you smoke don't bed-share c) if you have a baby and you smoke and you choose to bed-share -- you are on your own -- there is no research data yet that can demonstrably help you further reduce the level of risk you have chosen to accept. Sorry this is a long post -- as Elise originally suspected -- there are more questions than answers. Helen __________ Dr Helen Ball, Parent-Infant Sleep Lab, Dept Anthropology, University of Durham. *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. 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