If you're a co-sleeper like I am, you will have gone through various emotions last week when the papers were full of 'bed-sharing increases SIDS risk' headlines.
My first thought when I saw a headline, was "Oh, god, how am I going to get my son to settle in his own cot?" then I thought, "Oh, god, now a bunch of people are going to start telling me that I'm going to kill my son."
Then I read the articles and realised that I still have nothing to worry about.
If you read Ben Goldacre's Bad Science Guardian column, you'll already be aware that newspaper articles about science research can range from 'misrepresented' to 'flat-out wrong' with the occasional 'pretty close actually', so it's no surprise that the articles written about this research turned out as worrying as they did.
Reading the NHS's article and the BMJ's extract on this makes things a bit more clear.
First, they compared SIDS deaths with two separate control groups. One was an entirely random sample of babies which was the 'normal risk control group'. The other was made up of babies at high risk of SIDS- ie young, socially deprived, multiparous mothers who smoked- which was the 'high risk control group'. These were some of the findings:
- 21 of controls.
- 24 of controls.
- 60 of controls.
- 26 of controls.
- 28 of controls.
- 29 of controls.
So as far as this particular study is concerned (and remember SIDS is very rare and the number of cases studied was very small, so it isn't entirely reliable), ignoring the co-sleeping element to start, if you didn't smoke when you were pregnant the risk of SIDS is very small indeed. We don't know how many SIDS deaths had more than one of these risk factors involved at once which, of course, would increase the risk considerably.
Now, the co-sleeping bit... In this study 54 in the control groups. Of these cases, 31 of the normal risk control group), 17 of the normal risk control group).
What we don't know about the co-sleeping element is what percentage of the co-sleeping SIDS cases also had the other- perhaps more significant risk factors like a mother who smoked during pregnancy or were sleeping on their front.
I invite you all (as long as you're in the UK) to listen to an interview with Professor Peter Fleming, one of the researchers on this study, on the BBC's iPlayer. The interview start at 2 hours 9 minutes in (just drag the controller up to the correct time to listen).
For those of you who can't or don't want to listen here are just a few notes I took from the interview. They are not all word-for-word.
2 circumstances are very hazardous indeed- 1. sofas 2. drink or drugs then shared a bed.
Don't drink, drugs, smoke, the best place to feed your baby is in bed not a sofa...
Most deaths are in deprived households... though it's not just deprived households, but the sleeping environment which is the problem.
The advice is the same as with drinking and driving. We don't say if you drink you should never drive a car. We say, don't drive when you've been drinking.
If you choose to sleep with your baby - don't drink, take drugs or smoke - not just in bed, but just being a smoker increases the risk.
We're not suggesting overlying is the problem with drinking or drugs. It's the parents' inability to respond to subtle cues from the baby.
If you are going to breastfeed, you WILL fall asleep sometimes. You need to make the environment in which you do that as safe as possible.
Humans have been bed-sharing for half a million years, we've always done this. So to say 'what we've done for half a million years is wrong' seems to me to be completely inappropriate. There are things we do in 21st century Western society which pose risks for natural processes therefore one way around that is to say 'put the baby in a cot' because it avoids some of those risks. The other is to address those and to say 'I'm going to breastfeed my baby and keep the baby close to me all the time', but in doing that, you have to make sure that the environment in which you do that is as safe as possible.
Important - infections, heat-stressed, can make mechanism for waking baby up fail - a combination of these can cause cot death.
Interviewer: "A quarter of mums are not persuaded that choosing to bedshare can increase the risk of cot death. Is that a worrying statistic?"
Professor Fleming: "Not at all because it's one with which I'd completely agree. Bringing your baby into bed with you as a planned way of looking after the baby, we do not have evidence that that in itself is a risk and so we'd go along with those parents. We can say that overall as a population it's safer to put your baby in a cot because of all these risk factors, but if you as a parent understand what the factors are and go to lengths to make sure that your baby sleeps safely with you-- that is, no alcohol, no drugs, no tobacco, firm mattress, bedding that can't slip over the baby's head, the baby well away from pillows and duvets and breasfeeding your baby-- then we do not have evidence that that choice would increase the risk.... It's a difficult set of circumstances to always maintain, but nevertheless it is not in itself a risk."
In short, sleep safely with your baby.
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