My plan this weekend had been to enjoy a relaxing weekend away with the family. However, Friday I was made aware of a new report coming out today on the “dangers of bedsharing”. Needless to say, this weekend changed. We were luckily able to view a copy of the article in advance and the group of researchers I have worked with on other posts and I wrote a response. This is it. It has been shared as a press release generally and given specifically to the BBC (the study is a UK one). We shall see how the media responds in the days to come, but it’s nice to know that at least we’re not one step behind this time!
SIDS: Risks and Realities
We commend Carpenter et al (2013) for examining risks associated with incidence of SIDS but question their conclusions as unsubstantiated because of faulty and missing data, as well as confounding of criteria used to define bedsharing and risks—a challenge in any meta-analysis.
Their study examines some of the most salient risk factors for SIDS events—infant sleep position, parental use of cigarette smoking, infant birth weight and age. These risks have been well-documented as increasing risk of SIDS events. Thus, it is not surprising or informative to note that these factors remain risks in a re-evaluation of these findings.
While the risks examined do contribute significantly to increasing possibility of SIDS (see Chart 1 below), so do other factors such as bedding and temperature (see Box below for lists of risks not considered). Without consideration of these risks, it is not possible to determine that one variable, such as bedsharing itself isinherently responsible for risk remaining in this study. Nor is it possible to say that one of the variables within the nighttime care routine, such as breastfeeding, is not protective.
Chart 1. Adjusted Odds Ratios from Carpenter et al. (2013)
In addition to these major limitations in making broad, sweeping statements about risk based on this meta-analysis, there are two addition issues that are of significant concern in the paper as a whole. We address these herein.
The first is the treatment of breastfeeding. Buried deep in the last section of the paper is the recommendation that breastfeeding be supported as a mechanism for protecting infant health, the construction of the hypotheses explored here lead to a very different framework. In attempting to examine whether breastfeeding is protective against risk of SIDS when parents bedshare seems to jumble the role of breastfeeding in a manner that undermines one of the stated objectives of the authors… to address health costs associated with early infant care by reducing SIDS events. Further the authors seem to overlook the AOR for bottlefeeding and SIDS risk (see Chart 2).
Read the rest of the press release here.
Watch Dr. James McKenna address the Science of Co-Sleeping:
