Experts unite to warn parents of bedsharing dangers - new advice from FSID

[Caz10]

I apologise whole-heartedly if this topic upsets anyone, I really don't mean to. I am just curious to as to people's views on this.

I get the FSID email and this was their headline article.

I understand all the guidelines re if you are a smoker, been drinking etc, but this seeems to advise no co-sleeping AT ALL. I co-slept with my dd (now 18mths) quite a lot - I thought I would do so again if we had a dc2 - but that piece worries me a bit?

Just wondering what others thought?

It seems to contradict the advice coming from eg Unicef

Itr's not the job of medical scioence to give in to any biases Pooter - only to publish the facts so parents can make informed choices. I wouldn;t have it any other way.

"Co-sleeping has been the cultural and biological norm for for breastfed babies since the dawn of time"

it has - but not on memory foam/pocket sprung mattresses two feet off the floor with synthetic quilts and pillows

But I'm sure wooden cots with sprung matresses and little grobags weren't the norm either!

On the other hand neither were a few drinks and 10 benny-hennys before bed!

lots of things are different now.

I really don't think theres an evil agenda to this. Yes, it might be uncomfortable reading for some of us, but that's not the same as it being a bald criticism of our parenting methods.

It tells us there seems to be s corrolation which is significant. What we do with this information is our business. Wew have to weigh it up against the costs of no-sleep/demented parents. Sometimes that will win out and baby will come to our beds.

I think this kind of information empowers us, though I quite accept I'm probably in a minority there.

MT - I think that information presented in such a misleading and alarmist fashion discredits good evidence-based advice. In this case it may cause tragic deaths rather than prevent them, by preventing safer co-sleeping practises and making breastfeeding even more difficult.

"it has - but not on memory foam/pocket sprung mattresses two feet off the floor with synthetic quilts and pillows"

Agree. Individualised information acknowledges this and gives parents the option of making practical changes to their sleeping arrangements to make the adult bed safer for babies. Sweeping recommendations which don't acknowledge or make any attempt to accomodate biologically normal and beneficial practices (like prolonged skin to skin contact between mothers and breastfed infants) are not helpful in relation to this.

MT, the problem is this 'science' isn't very good. It's impossible to draw sensible conclusions from it and in fact there is good evidence that points to bedsharing cutting SIDS risks (see my earlier post and links).

And to think that medical science isn't prey to bias and political agendas is sadly, wishful thinking. I've had my eyes opened by moving to the US and seeing what is and isn't allowed here and how it differs from the NHS. There is a great scope of difference in how studies are designed and interpreted.

"MT, the problem is this 'science' isn't very good."

Isn't it? How so?

I am not asserting that science is not prey to any bias - that's precisely why the scientific methord was developed. And that's not to say sometimes the science moves on. But when a robust corolation is seen, it is ethical to publish it. Science is about conflict. That's why it works

If the info is presneted in the media in alarmist fashion, shoot the messenger!

cots also have memory foam or pocket sprung mattresses and synthetic quilts mt? Don't quite get the point?

Right, I'm trying to separate the interpretation (by the media in general and the FSID press release) from the science, because the interpretation is hopeless.

There are two big problems with the science.

Firstly, the sample is completely uncontrolled. If you're testing drugs, you first of all test on a healthy, fairly standardised group of people of a certain age.
The studies referenced here lump in planned, 'safe' bedsharing with unplanned bedsharing and crashing-out-on-the-sofa sleeping. The only thing in common is that the babies were asleep out of a cot. We have no idea of the socio-economic groups or other factors. One US study on cosleeping was found to focus on families living in poor financial circumstances who bedshared out of necessity without necessarily being aware of safety factors. This increases the likelihood of poor nutrition, housing, drug use, cold temperature etc. coming in to play.

The second problem is what is actually being measured. It's impossible to draw conclusions about SIDS from these studies because they measure deaths by overlayings, suffocation, falling out of bed and SIDS as the same thing.

Yes, perhaps you could say from a study that 'Sleeping in a cot is generally safer' but that's useless. You could say 'Avoiding ever eating peanuts is generally safer.' It treats all people and all circumstances as one general truism. This is where the interpretation is important and a big charity like FSID needs to be very, very careful how they interpret this limited information.

good post Carmen. It is so infuriating.

"But when a robust corolation is seen, it is ethical to publish it. Science is about conflict. That's why it works"

Yes, but confusing correllation with causation is merely cargo cult science.

We see more umbrellas when it rains - so if we advise against use of umbrellas it will rain less...

Nobody here has been critical of publishing scientific research, whatever its quality. However, issuing scaremongering non-evidence based advice to parents is unethical and may result in more tragedies if it prevents parents from learning how to co-sleep safely.

"The studies referenced here lump in planned, 'safe' bedsharing with unplanned bedsharing and crashing-out-on-the-sofa sleeping."

Where are the lists of references?

I ask becasue Durham Uni have been testing these hypothesese for years. I took part in a radomised parent/infant trial at the RVI in Newcastle 5 years ago. They have been working exhaustivly on this for years with hundereds of studies.

"The results of this qualitative and quantitative study confirm that bed-sharing is a complex phenomenon, and infants cannot simply be categorised as bed-sharers or solitary sleepers. The intersection of a range of variables causes each bed-sharing infants' sleep environment to be unique. Factors that are intrinsic to the infant (such as incipient illness) intersect with care-giving decisions (such as feeding method) and parental experience and expectations (such as uninterrupted sleep) to determine whether or not a baby will sleep in its parents' bed on any given night. An infant's bed-sharing safety is affected by parental acknowledgement of bed-sharing, understanding of bed-sharing safety, and willingness to modify their own behaviour in deference to their infant's presence in the bed."

www.dur.ac.uk/sleep.lab/projects/home/

www.dur.ac.uk/sleep.lab/

MT, the FSID quotes Wright and Cohen's studies and is clear they both include sofa sleeping. One of the most referenced studies on this is the CPSC investigation in the US which was terribly flawed (see my previous post) yet some campaigners spurred on by manufacturing lobbies have tried to call for legislation based upon it.

I wholly agree with that quote from Durham actually. Bedsharing is complex, that's why I hate this sledgehammer approach.

Hi Foxy, yes, Helan Ball, that's her. I ws part of that study with the bed side cots in the RVI, though they did do loads of them. I was actually randomly chosen to bed share, but a cot was available. My son was a ventouse delivery and had a very large haematoma on the back of his head. The hospital beds were also very narrow and high off the floor and I wasn't reashured by the panel that was provided to sopy baby falling out, so most of the time for the two nights, I sat up nursing him or just holding him, or put the cot beside my bed at head height.

I read the findings and think I remember that there were more 'potential' risks to infants found in bedsharing, but that no incident happened. I wonder if they were watching the mothers attempts to keep the babise safe in a narrow bed, and that, like me, it wasn't ideal. I think the findings were that bedside cots were just as much an enabler to breastfeeding than bed sharing, but that they also showed less 'potential'risk. Again the word potential is important.

I have the video of the two nights I spent at the RVI - it's a lovely keepsake althoiugh I got my milk in immedialty and so am crying most of the time, but still feeding, etc. Just a mess of oxytoxin!

MT: i am also v interested in rge work done at durham uni by dr helen ball. she work here is along similar avenues of interest as dr mckenna's at Notre Dame. in fact their findings are complementing each other beautifully.

dr ball is v supportive of bed-sharing for breastfeeding mothers.

the work with sidecar cots at the RVI is designed to test a way whereby the vast majority of parents will be able to co sleep safely. eg, obesity as a risk factor is elimimated.

of course these cots in a hospital setting has maximum gain with minimal instruction to staff and parents while maximising breastfeeding opportunities (and success) for babies while minimising sleep disruption to mothers.

in a presentation by dr ball which i attended last recently she discussed the findings of the RVI studies.

note that this is not saying that dr ball thinks sidecar cots are better than bed sharing.

near the end of her presentation, dr ball showed a still of two parents co-sleeping with a baby who did not normally co-sleep. it remains in my mind because she explained that the baby was sleeping in the parental bed as if the baby was a mini adult. head on pillow, face level with the adults, no protective arm around the baby etc.

well meaning parents like these are some who safe bed sharing information needs to reach.

i would hesitate lumping dr ball's work with some of the 'studies' mentioned and i would actually be interested if any citations by FSIDS were from Dr Ball.

v. good MT.

one of hte women who also volunteered was in the bassinet group and on the first night she thought 'stuff this' and brought the baby to bed with her. so she 'moved over' to the 'sidecar' group. a

you are right that there are 'potential risks' with bedsharing as opposed to sidecar cots. as well as right about sidecar cots maximising bfing as much as bedsharing does. I think for families where a sidecar cot is an added expense, don't have the room for one (us) then Bedsharing is the best thing - with full information about safe cosleeping of course.

I think sidecar cots come into their own in hospitals when a mum has had a c/s so now she doesn't have to depend on staff to pick up and return her baby to a bassinet. And of course those dinky hospital beds - it is a struggle to get a mum and baby in one of those beds without worrying if your baby will end up on the floor.

In the home it also comes into its own for new and really scared parents with no history of co sleeping in their immediate circles. It means they can have the best of both worlds. Not being terrified to bed share but also wanting to respond quickly with minimal disruption to all and this is the scenario which facilitates breastfeeding success in the long term.

oh, i meant to say I remember her mentioning about reviewing the videos with parents, if they wanted it reviewed with them. what a fabby keepsake. lucky you.

I spoke about a year ago to one of Dr Ball's new students about a similar study about to start at the RVI. She told me as part of an informal chat that she has been verbally abused by parents to be about this type of research.

me, eyebrows up, was like... why. She said she's been called a 'babykiller' for even broaching the cosleeping topic with them. It shows how deep the stigma is for co-sleeping if Heaven forbid, a relative may co-sleep and of course the ignorance.

Interesting piece on the politics of cot death here:
aims.org.uk/Journal/Vol15No4/PoliticsCotDeath.htm

Bloody hell Foxy. Thinks hte idiocracy has arrived!

Hmm, 5 out of all 15 that died that year in their parental bed, 2 on a sofa and 8 in their cot....and bedsharing is considered the unsafest? No logic is there...

Haven't read every post, so apologies if this has been mentioned before, but isn't it also the case that parents are more likely to co-sleep if the baby is ill (even if they don't usually co-sleep)? There are probably many cases where the baby died because of an illness, and were co-sleeping because they were ill, not ill because they were co-sleeping IYSWIM.

I also haven't read every post, so apologies also if someone has pointed this out, but the dangers of bed-sharing article on the FSIDs website says

"In the majority of cases of sudden infant deaths in the North East, babies have been found not in their own cots, but in adult beds surrounded by duvets and pillows or after falling asleep with a carer on a sofa."

Your LO sleeping "surrounded by duvets and pillows" is certainly not in line with bed-sharing advice. I wonder if the deaths here are actually attributable to suffocation or if overheating is a factor?

I'll be very interested in what the FSID person has to say in the web chat.