AAP releases new SIDS guidelines...says no bedsharing and full immunizations recommended to protect against SIDS. - Mothering Forums

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#1 of 21 Old 10-20-2011, 09:22 AM - Thread Starter
 
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This article just popped up on my facebook. It was an article shared on Facebook by the International Lactation Consultants Association page (due to the new breastfeeding recommendation, I would imagine).   I feel somewhat saddened about the recommendation against bedsharing, but do not intend to change what we do at home.  (We are a bedsharing, breastfeeding family).  By posting this I am not implying that I endorse it or not.  But I am interested,  what do you all think?

 

Here's the link to the article, and the full text pasted below: http://www.webmd.com/parenting/baby/news/20111018/new-sids-guidelines-breastfeeding-lowers-risk

_________________________

New SIDS Guidelines Say Breastfeeding Lowers Risk

Sleeping in the Same Room but Not in the Same Bed Also Recommended
By Rita Rubin
WebMD Health News
Reviewed by Laura J. Martin, MD

 

bright eyed baby

Oct. 18, 2011 -- Breastfeeding and up-to-date immunizations can lower infants’ risk of sudden, unexpected death during sleep, according to updated guidelines issued today by the American Academy of Pediatrics.

Since 1992, the pediatricians group has been advising parents to place young infants on their backs to sleep to minimize the risk of sudden infantdeath syndrome, or SIDS.

Between 1992 and 2001, the SIDS rate declined from 120 deaths per 100,000 live births to 56 deaths per 100,000 live births, according to the academy. But from 2001 to 2006, the latest year for which information is available, the rate plateaued, and SIDS remains the leading cause of death in infants 28 days to 1 year of age.

Other causes of sudden, unexpected death of infants during sleep, such as suffocation and entrapment, have become more common. Previously, some of those deaths would have been classified as SIDS.

“The AAP, therefore, is expanding its recommendations from focusing only on SIDS to focusing on a safe sleep environment that can reduce the risk of all sleep-related infant deaths,” the policy statement notes. “Many of the modifiable and nonmodifiable risk factors for SIDS and suffocation are strikingly similar.”

 

Breastfeeding Recommended to Protect Against SIDS

This is the first time that the academy has recommended breastfeeding to protect against SIDS, says pediatrician Rachel Moon, MD, chair of the academy’s SIDS task force and author of the new guidelines.

When the group last issued SIDS guidelines, in 2005, evidence showed only that breastfeeding protected infants from dying but not specifically from dying of SIDS, says Moon, a SIDS researcher at the Children’s National Medical Center in Washington, D.C.

In addition, she says, evidence shows babies who’ve been immunized in accordance with recommendations from the American Academy of Pediatrics and the CDC have half the risk of SIDS as babies who aren’t fully immunized. Previous studies have suggested that certain infections may be associated with some cases of SIDS. Whooping cough in infants has been shown to cause significant breathing problems, such as coughing and apnea, a pause in the breathing pattern. Other recommendations include using a firm sleep surface, avoiding crib bumper pads, keeping the crib free of soft objects and loose bedding, and avoiding devices marketed to reduce the risk of SIDS.

Such devices, none of which have been approved to protect babies against SIDS, include infant positioners, mattresses, crib bedding, pillows, crib tents, and baby monitors, according to the FDA. The FDA on Monday said it is asking manufacturers of these devices to drop their claims concerning preventing SIDS unless they get agency approval.

Share a Bedroom, Not a Bed

To make breastfeeding easier and minimize the risk of sudden, unexpected infant death during sleep, the pediatricians recommend mothers and babies sleep in the same room but not in the same bed.

“I think you can breastfeed successfully without bed-sharing,” Moon says. “We do want the crib right next to the parents’ bed.”

In a study reported at the American Academy of Pediatrics’ meeting in Boston on Monday, researchers reported that half of 91 cases of sudden unexpected deaths in infants in New Mexico occurred on a shared sleep surface. Some of the babies who died while sharing a bed with their parents lived in homes with cribs that weren’t being used for sleeping.

“Unfortunately, families get mixed messages,” says researcher Jessica Black, a third-year student at the University of New Mexico School of Medicine in Albuquerque. While their pediatrician might recommend sleeping separately in the same room, the La Leche League, which promotes breastfeeding, encourages bed-sharing as an option.

Moon says her task force has asked the American Academy of Pediatrics to launch a new national campaign to promote safe sleeping environments for all babies.

The new policy statement appears in the November issue of the journal Pediatrics.

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#2 of 21 Old 10-20-2011, 09:32 PM
 
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I'll be honest, this scares me. I bed-share with my son, and feel like I'm doing it safely...  but how can I really know?

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#3 of 21 Old 10-20-2011, 09:56 PM
 
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I think anything the AAP says should probably be taken with a HUGE grain of salt. We will continue not to vax, BF on demand and co-sleep. As a species, it is ultimately the formula we are evolved for. I see no reason to conduct a massive experiment on my children's physical and psychological well being because the AAP, and whoever is financially backing them these days, doesn't like it.

 

ETA: Preventing infant death while co-sleeping is likely as easy as not being intoxicated while co-sleeping.

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#4 of 21 Old 10-21-2011, 05:00 AM - Thread Starter
 
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Very well said!  It's just upsetting to me because many people don't question authority, and will blindly do whatever the AAP says (who would have thought you can't necessarily trust the pediatricians?), without realizing how much their financial backers may have a hand in swaying the recommendations they give. 

 

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Originally Posted by dogmom327 View Post

I think anything the AAP says should probably be taken with a HUGE grain of salt. We will continue not to vax, BF on demand and co-sleep. As a species, it is ultimately the formula we are evolved for. I see no reason to conduct a massive experiment on my children's physical and psychological well being because the AAP, and whoever is financially backing them these days, doesn't like it.

 

ETA: Preventing infant death while co-sleeping is likely as easy as not being intoxicated while co-sleeping.


 

 

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#5 of 21 Old 10-21-2011, 08:28 AM
 
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I'd like them to be completely transparent here and let us make a truly educated decision!  Of the babies that dies of SIDS while bedsharing, how many of them were in a bed with an intoxicated parent?  A parent on drugs or medications?  How many were on a couch?  How many were sleeping with a smoker?  How many were sleeping on waterbeds or with thick comforters?  The public needs to treated like educated individuals who are capable or examining the #s and deciding what is best for us.  I find their hand holding black and white rules insulting to my intelligence tbh...

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#6 of 21 Old 10-21-2011, 08:41 AM
 
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Quote:
Originally Posted by MrsJewelsRae View Post

I'd like them to be completely transparent here and let us make a truly educated decision!  Of the babies that dies of SIDS while bedsharing, how many of them were in a bed with an intoxicated parent?  A parent on drugs or medications?  How many were on a couch?  How many were sleeping with a smoker?  How many were sleeping on waterbeds or with thick comforters?  The public needs to treated like educated individuals who are capable or examining the #s and deciding what is best for us.  I find their hand holding black and white rules insulting to my intelligence tbh...


You know, I've met some SIDS moms and I don't think all of them were drinking druggies when their babies died. Nor were all of them bed-sharing. Let's not paint other parents in a bad light here. That would not be the intelligent thing to do.

My only guess here is that in age federal budget cuts.. someone has dreamed up some correlations to keep themselves employed. Hopefully further study will show this one is fiction.
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#7 of 21 Old 10-21-2011, 09:07 AM
 
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Prof. James McKenna (Univ. of Notre Dame) suggests that deaths associated with co-sleeping are frequently (always?) infants who are not breastfeeding.

 

This interview with him demonstrates that he differentiates between co-sleeping (broad definition) and bed-sharing (specific definition).

 

http://cosleeping.nd.edu/

 

He was on the scientific advisory panel that advised the AAP committee who made up the policy. Basically, he says that the AAP's decision was made based on the assumption that women/parents were broadly un-educable. Those of you who are concerned about bed-sharing probably have nothing to worry about, because you are educating yourselves and doing it relatively safely! When breastfeeding is involved and mothers remove all the dangerous co-factors (e.g., drugs, pillows...), then bed-sharing can be done safely.

 

"When babies die sleeping prone (face down), the cause of death is SIDS due to prone sleeping. When a baby dies prone while co-sleeping, then the cause of death is listed as SIDS due to co-sleeping."...

 

Those of you who question the SIDS due to co-sleeping because you ask what other factors are involved are the exact questions that Dr. McKenna says aren't addressed in a lot of the studies. "Bed-sharing" deaths in research is a totally diverse group of deaths, which can include couch deaths and deaths that occurred with siblings in the bed...

 


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#8 of 21 Old 10-21-2011, 09:13 AM
 
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SIDS... something that occurs that we want answers to.  So they give you answers and you believe them.  No matter what they can find a way to make it your fault.  Sudden infant death is not being suffocated by a parent or a cushion.  It's not being touched by nicotine hands.  It's not drinking the right milk. 

 

It drives me insane!  People want answer and they'll gladly except that they are somehow at fault.  Change the damn name then!

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#9 of 21 Old 10-21-2011, 07:33 PM - Thread Starter
 
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I just watched the interview with James McKenna. I encourage others to watch it. He explains his objection to the AAP's unqualified recommendation against bedsharing very well. Thank you for the link, ASusan! 

Quote:
Originally Posted by ASusan View Post

Prof. James McKenna (Univ. of Notre Dame) suggests that deaths associated with co-sleeping are frequently (always?) infants who are not breastfeeding.

 

This interview with him demonstrates that he differentiates between co-sleeping (broad definition) and bed-sharing (specific definition).

 

http://cosleeping.nd.edu/

 

He was on the scientific advisory panel that advised the AAP committee who made up the policy. Basically, he says that the AAP's decision was made based on the assumption that women/parents were broadly un-educable. Those of you who are concerned about bed-sharing probably have nothing to worry about, because you are educating yourselves and doing it relatively safely! When breastfeeding is involved and mothers remove all the dangerous co-factors (e.g., drugs, pillows...), then bed-sharing can be done safely.

 

"When babies die sleeping prone (face down), the cause of death is SIDS due to prone sleeping. When a baby dies prone while co-sleeping, then the cause of death is listed as SIDS due to co-sleeping."...

 

Those of you who question the SIDS due to co-sleeping because you ask what other factors are involved are the exact questions that Dr. McKenna says aren't addressed in a lot of the studies. "Bed-sharing" deaths in research is a totally diverse group of deaths, which can include couch deaths and deaths that occurred with siblings in the bed...

 



 

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#10 of 21 Old 10-23-2011, 07:06 PM
 
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Originally Posted by philomom View Post


You know, I've met some SIDS moms and I don't think all of them were drinking druggies when their babies died. Nor were all of them bed-sharing. Let's not paint other parents in a bad light here. That would not be the intelligent thing to do.
My only guess here is that in age federal budget cuts.. someone has dreamed up some correlations to keep themselves employed. Hopefully further study will show this one is fiction.

To be fair, I don't think that's where the PP was going.  For one thing, at the risk of putting words into someone's mouth, I believe she meant to refer to suffocation and not SIDS.  We have little control over SIDS and few explicable reasons for why it happens.    The AAP's concern with bedsharing is suffocation by a parent rolling over the baby or the baby getting tangled and smothered in blankets. 

 

And it is true that it's disingenuous to tell parents that bedsharing will result in suffocation no matter what because few, if any, of these anti-bedsharing studies control for the factors that MrsJewelsRae mentions.  Smoking, substance abuse, sleeping pills, waterbeds, hide-a-beds, formula feeding, etc. are just a few of the contraindications for safe sleep-sharing. 


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#11 of 21 Old 10-27-2011, 08:48 PM
 
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They say that half of reported deaths occurred on a shared sleep surface, but this data is only applicable if we know what percent of that population regularly co-sleeps.  If it is a minority, then the co-sleeping should be seen as a possible cause, but if half of that population or more co-sleeps, then it would mean that more children who were not co-sleeping die of SIDS.  I would want to pull up the actual research paper to make any sense of this information.

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#12 of 21 Old 10-28-2011, 09:28 PM
 
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 wow, Im surprised this sounds so new,     we have always heard this side of the story, this is what to expect from the AAP isnt it?


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#13 of 21 Old 11-05-2011, 10:36 PM
 
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I think the full immunization thing disturbs me as much or more than the co-sleeping thing. Has anyone else read the full text of the new (ish) study that shows that the more doses of vaccine a child gets in a developed country, the higher that country's infant mortality? In the text, there's an entire section devoted to SIDS which strongly suggests that SIDS deaths have not decreased, they're just reclassified. It's a really interesting paper. The full text is at http://het.sagepub.com/content/early/2011/05/04/0960327111407644.full.pdf+html


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#14 of 21 Old 11-06-2011, 01:31 AM
 
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Some pretty strong claims against the AAP here...anyone have any evidence that they're fudging their numbers due to their financial backers? And who are those financial backers--crib manufacturers? Lansinoh? After all, they recommend breastfeeding, maybe they're in the pockets of Big Lanolin.

And the thing about being medicated etc--let's be real, sleep deprivation can be quite serious on its own and many, many new parents are sleep-deprived.

I support people doing the research and making their own choices, and bed-share myself when I feel competent to so (meaning I've gotten some sleep recently). That doesn't make it the safest option.
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#15 of 21 Old 11-06-2011, 06:41 AM
 
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I too would like more info on the specifics of the deaths in cosleeping situations. I've searched, and I've yet to find any cosleeping deaths that didn't involve someone other than the mother, an armchair, couch, an obese mother, or a parent under the influence of alcohol or medications. I don't doubt that they're out there, but I haven't been able to find any, and that really makes me question this. The articles always seem to ignore the fact that in these situations, pretty basic rules of safe cosleeping weren't being followed and go straight to condemning cosleeping altogether. Like the baby who died while sleeping with his grandmother in a recliner. That isn't a matter of cosleeping being unsafe. It's a matter of cosleeping with Grandma in a Lazy Boy being unsafe. Then there's the intoxicated father who fell asleep on his baby and suffocated her. Again, not truly a cosleeping problem. Then there was the 300+ lb mama who rolled over on her baby. Tragic and my heart breaks for her, but she wasn't a good candidate for cosleeping in the first place, although she didn't seem to realize that. I'd really like to see organizations like the AAP campaigning to educate people on safe cosleeping instead of just condemning it all together. 

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Then there was the 300+ lb mama who rolled over on her baby. Tragic and my heart breaks for her, but she wasn't a good candidate for cosleeping in the first place,



This interests me. I've heard that obese mothers shouldn't bedshare before, but I've never seen an explanation for it. And, this example doesn't explain it at all. If a 125 pound mom rolled over on her baby, there's a pretty good chance the baby would be suffocated. What does the mom's weight have to do with it? (I ask, because I've bedshared with all my babies, and have been medically overweight or obese with each of them. Admittedly, I couldn't roll over at all for the first few weeks with each of them, but that's only the first few weeks.)


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#17 of 21 Old 11-06-2011, 03:27 PM
 
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This interests me. I've heard that obese mothers shouldn't bedshare before, but I've never seen an explanation for it. And, this example doesn't explain it at all. If a 125 pound mom rolled over on her baby, there's a pretty good chance the baby would be suffocated. What does the mom's weight have to do with it? (I ask, because I've bedshared with all my babies, and have been medically overweight or obese with each of them. Admittedly, I couldn't roll over at all for the first few weeks with each of them, but that's only the first few weeks.)



Apparently obese people have tendency to sleep deeper and be less aware of baby, which increases the risk of rolling onto him, so it's not really the extra weight on the baby that's the concern, but the increased risk of rolling onto him in the first place. 

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#18 of 21 Old 11-06-2011, 11:12 PM
 
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I don't buy that explanation, a lot of obese people have breathing difficulties which actually result in sleeping less deeply. The reason I've always heard is that obese women are less likely to feel that they've rolled onto their babies. I think that's unlikely too. As an obese woman, occasionally I won't notice immediately that there's a little hand under me, but I always do notice (and because I have had it happen occasionally, I always check before I fall asleep). Like most cosleeping mothers, I just don't move in my sleep when I have a newborn. I fall asleep facing them & wake up the same way (with ds1, I had to face away because of issues from the cesarean, but again, I always woke in the same position I fell asleep in).

 

I really wonder if there's any actual evidence backing up that recommendation or if it's just fat phobia rearing it's head.


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#19 of 21 Old 11-07-2011, 07:01 AM
 
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Thing is, I found a bedsharing article a while back that said the studies they've found of babies dieing due to sleep sharing, have been a play on words. It is babies that have died sleeping ALONE on an adult bed, not while they're with their parents. It was a PDF file that was backed by research; I think the article is on my fiance's hard drive, so I can put it up in a few hours.

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#20 of 21 Old 11-09-2011, 05:57 PM - Thread Starter
 
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I just can't help feeling that the statistics involved with cosleeping/bedsharing/sleepsharing and SIDS are so screwed up, and there are so many factors that aren't considered, that it's really hard to come to any conclusions about it based on those statistics.  Which, to me, is SO sad, because I feel that the babies who have died while sleeping deserve to have the details of their deaths matter (anonymously, of course), and that information used in an unbiased way to help keep other babies safe in the future.  I have never had a baby die of SIDS so I can't speak from that perspective but the idea of it truly does haunt me, as a parent. 

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#21 of 21 Old 11-17-2011, 06:26 AM
 
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This is second-hand information that I found on another forum. The poster is someone I trust, but I haven't researched it myself.

 

 

Quote:
About the AAP 'SIDS and Cosleeping' policy statement- I did some research on it: it was developed in conjunction with the First Candle organization, which is extremely anti-cosleeping- and this organization is almost exclusively funded by infant product manufacturers (many are crib manufacturers).

It's a biased statement. However, if one really reads between the lines, there's a little portion that most don't notice (actually I don't think they want you to notice, lol)- that "cosleeping, as practiced in western countries" is dangerous. There's likely quite a difference between how many parents sleep here (dangerous factors) and in cultures where bedsharing has always been a safe practice.

 


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