Webchat with Professor George Haycock, FSID scientific adviser, Tues 30 June, 1-2pm

[GeraldineMumsnet]

A little while ago, following new expert advice about co-sleeping and cot death, some of you asked if we could get someone on from the Foundation for the Study of Infant Deaths (FSID).

FSID scientific adviser Professor George Haycock has kindly agreed to come on to discuss the advice, so he'll be in Mumsnet Towers next Tuesday lunchtime at 1pm .

Please post your advance questions here. Obviously he may not be able to answer all of them, but we'll make sure he sees them.

Thanks
MNHQ

i feel very strongly about this,and i am sure most mums would be willing to participate in research without offering 100 in vouchers,this could encourage parents to co sleep and everyone may not agree but it is not safe.

fabhead - completely anecdotal, but when I was co-sleeping, only twice did I ever wake up and find my child under the duvet, both times were when she had fallen asleep in the middle.
I did however, wake up in a panic at not being able to find dd next to me in bed, and frantically searched the floor and under the bed, only to then remember she as in a moses basket that night .

yes I remember that terrible feeling of waking up in a panic. I think that is why I ended up using the bedside moses basket more often than actually co sleeping as I knew the baby would be where we had last put him! Also we got a breathing monitor at about 8 weeks as I found I was just not sleeping at all worrying and it was so reassuring, if not actually protective. I think if my baby did stop breathing I would at least like to think I had got there very soon after whatever the outcome.

How do they do the research that shows that FF mothers don't do the nesting? I would have thought it was fairly instinctive for any mother? (but I don't know as a bf'er).

My DP is a very deep sleeper, I have woken up to find his arm or leg draped on me before now, so I never put our DD's in the middle when they were tinies. DD1 slept on my side with the moses basket or crib acting as a "cot side" so she wouldn't roll/fall off the edge of the bed, and only started sleeping in the middle of our bed when she was about 18 months old. Bear in mind we were "accidental" co-sleepers with DD1, doing it out of desperation or because I fell asleep feeding her until she was 18 month or so, then I read "Three in a Bed" and stopped trying to do it the "conventional" way and let her sleep in with us. DD2 slept in a side-car crib then cot from the word go, this meant she was safe beside me and there was still room for DD1 in between DP and I if she decided to join us in the night!

I am really not happy with the fact that FSIDS is accepting money for research from a dummy manufacturer and then promoting dummy use.

As a scientist (PhD theoretical physics), married to a scientist (JRF biophysics at Oxford Uni) this sort of conflict of interest would never be allowed in an academic research setting (or at least I hope it wouldn't!!!). Reputable scientific journals require researchers to sign declarations stating they have no such conflict of interests when submitting papers. No-one associated with FSIDS, which is a private charity not a branch of the NHS or a research department at a university, can be relied upon to give impartial advice on this matter.

So in an attempt to clear this up for myself I went and looked at the research papers used to justify the dummies reduce SIDS claim. The results of the study done in California cited by the Prof are not so clear cut. At the risk of boring you with detail this extract is from the paper published by them in the BMJ (British Medical Journal) ...

For example, infants who did not use a dummy and slept prone or on their sides (versus on their back) had an increased risk of SIDS (2.61, 1.56 to 4.38). In infants who used dummies, there was no increased risk associated with sleeping position (0.66, 0.12 to 3.59). While cosleeping with a mother who smoked was also associated with increased risk of SIDS among infants who did not use a dummy (4.5, 1.3 to 15.1), there was no such association among those who did (1.1, 0.1 to 13.4)

So do we conclude that cosleeping with a smoker is OK if a dummy is used? The actual theory as to why the dummy may be reducing deaths given by the researchers themselves is the raised surface of the dummy holds the mattress or bedding away from the baby and reduces the risk of suffocation. Clearly if the child were not face down or covered in bedding the dummy would not be significant. It has nothing whatsoever to do with sucking. Also this dummy research does not look at non-smoking, cool room, no excess bedding, full term, sleeping in same room as parents babies with dummies versus the same without. I will endeavour to look up every reference the Prof gave to check the small print in them too but I doubt they will be very different.

PLEASE be very careful with believing what a Professor in anything tells you who then throws a load of statistics in to back it up. I'm not saying he's lying, I'm saying he is selectively interpreting the scientific reports he quotes to justify what FSIDS are promoting.

FSIDS lists its completed research including an epidemiological study on the long term changes in trends in SIDS. The conclusion is that 86% of SIDS deaths occur in smoking households and that 50% of the deaths occurred in cosleeping arrangements (37% in a bed 11% on a sofa). As around 50% of the British population smoke more SIDs occur in smoking households than would purely by chance (which would be 50%) so smoking clearly is a factor that is correlated with SIDs. Cosleeping at night in bed with a baby would only be a risk factor for SIDs if much less than 37% of the population with a small baby ever coslept for all or part of the night. Hmmm.

There are no reliable statistics on this as people deny cosleeping when asked and HVs don't go round collecting data on it. Of the dozen or so mums at the children's centre I know, a mixture of breast and bottle feeders, I would say 60-70% have mentioned regularly sharing their bed with a baby. If that were a national trend cosleeping would not be a correlated risk with SIDs.

Just to show you how selective FSIDS can be - 61% of SIDs occur in male babies, when did you last hear them advising you to pay special attention to boys?

One last word on correlations. A correlation is not a cause. I teach this fact as part of the new GCSE science syllabus to year 10s. For example when I get home in the evenings after work and turn the TV on, the sun sets. This is a correlation. Assuming that the one caused the other would mean my TV can control the Earth and the Sun. Just because 37% of SIDs occurred with babies in a bed doesn't mean the sleeping arrangement caused them to die.

Really interesting chat, thanks everyone.

I co slept with DD until she was 3 and a half but I am not co sleeping with DS who is 12 weeks due to the latest safety info. it actually works out ok tho as DS sleeps in a cot next to us and when he wakes up DP gets him out and hands him to me and I feed lying down. When he is done DP puts him back to his cot so i don't even have to sit up in bed
I think I will co-sleep with DS when he gets a bit older and out of the real SIDS danger zone.
Read some interesting stuff that said SIDs was occuring a lot more at weekends and public holidays. I wonder why this is? Also boys are more likely to die of this than girls, what is the reason for this I wonder.

RaA, thankyou so much for your insight. It makes me very, very worried though, about the conflict of interests and the motivating factors behind interpreting the stats the way the FSIDS has done. I feel very shocked tbh.

I have just read this thread in its entirety, and been glued to it. My personal opinion of FSIDS has been dented by what I've read; I think there is a big conflict of interests, and selective interpretation of results which allows distortion and sensationalising of facts (especially by the media). Disappointing and worrying, and definitely not 'good science'.

this and

this make interesting reading.

Don't think many people will agree with me here but just read through this thread and, ignoring the gaps in the statistics for the moment, it seems as if, like the other risk factors for SIDS, no one really knows why bed-sharing leads to an increase in deaths, it just does. And even if the risk is extremely small compared to smoking for example, as an organisation set up to prevent cot-deaths it is perfectly reasonable for FSIDS to tell people that if they bed-share this does increase the risk. Of course parents then have to weigh up the information and decide themselves if other risks such as unplanned co-sleeping mean that bed-sharing is the preferred option, but that is our choice.
Also, re the dummy-manufacturers-sponsoring-research issue this doesn't mean it should be discounted. I work for a small charity that is largely funded by companies that at times promote the exact opposite to us, we take the view that as we can do good work with that money and it would never persuade us to compromises our policies then there is no problem. While it would be great to get all of our funding from the public this just isn't going to happen.

Really interesting views here though, and I would be keen to see the exact statistics on the number of SIDS out of the total number of bed-sharers.

I would love to do some research on the area but I think I would find it extremely hard to be working in the area of SIDS. I do realise the research needs to be done to help others but it must be very difficult to do. Even in my general research with pregnant mums and new mothers things can be difficult, let alone focusing on tragedy.

I think we need more co sleeping research though. Anyone out there in the psychology / childhood / medical social sciences interested in doing something .

Must stop basing research career on things I read on mumsnet lol

Standing ovation for RachaelandAgatha fantastic explanation of the conflict of interests and how the stats are not as convincing as they seem.

I understand what you are saying misshairspray but I think most peoples issue is that the advice is so broad. Many studies even class co sleeping as falling asleep on a sofa. There is no study that looks specifically at planned co sleeping with all the safety measures taken, just the mum in bed, the baby isnt ill, the baby is breastfed, other risk factors not in place - so how can we say definitively say co sleeping carries a risk? Yes in general I accept that cosleeping might carry a small risk but its the fact that the term is so broad - and for me at least, what the studies class as co sleeping I do not do. DD has always slept in my bed though.

Also, if for example not co sleeping means that the mum is too exhausted to breastfeed...which carries the bigger risk - co sleeping or not breastfeeding.

I agree that as they dont know what causes it then the risk should be highlighted - but the indepth research then needs to be done. No one can definitely say that co sleeping is a risk for all mums based on the evidence we have.

Also, if we had more detail we could work out an odds ratio when the co sleeping situation is ideal. Parents could then judge whether in that situation, for example, it is worth a risk of 0.2% increase or something.

Am rambling now sorry

RachaelandAgatha - great correlation example. I always teach my students

'99% of serial killers ate bread in the week before they committed their crimes....does this mean bread turns you into a psychopath?'

Foxytocin, yes, very interesting! Just goes to show that data/stats can be interpreted a number of ways and that the research into dummy use and SIDS is far from conclusive.

Have to say I think the prof did a fantastic job despite some really difficult behaviour by some people on the thread. He did his best to explain why he was saying what he was, and was also very clear when he didn't have the data. TBH am a little shocked at how some posters interacted when he was being completely open and patient, and had clearly put a lot of work into appearing here.

Hi, I've just read a lot of this thread, but couldn't see if the Prof answered the question about safety of side car cot as opposed to in bed co-sleeping. Anyone know? Thanks

The difficulty with the stats is that they do show more than mere correlation - no study would be published in a peer reviewed journal that reported correlation and only that. With any epidemiological, observational study (as opposed to an intervention one, where people were ordered to co-sleep or not - which is not ethical) you are going to have to control for variables, to make sure the only thing that's different among your population is the place the baby was sleeping.

Trouble is, some studies control for this, but not whether the parent was present; or whether the baby was breastfed for whatever length of time; or whether the co-sleeping was on a sofa or bed; or whether safe practices were followed. Cot death is so rare, you need sample populations of thousands of babies with whatever data is asked for at the time, and you can't go back to your sample and say, 'whoops, we forgot to ask you this important question about duvets'.

We've already seen if you take smoking (in pg and postnatally) out of the situation, you can slash cot death rates in half any way. This is, BTW, a correlation....not a direct cause and effect. But it's a correlation with a plausible explanation, so we accept it, more or less, as something parents should be advised not to do, in order to reduce the risk of SIDS.

We don't have the data (as far as I can see) to take less-than-safe co-sleeping practices out of the equation, unfortunately. There is a study waiting to be done, and until it is, no one can be clear.

Fantastic thread; am sorry I missed the webchat part.

Re: other cultures and co-sleeping, I'm a bit disappointed that it got interpreted as developed v developing countries, where there are lots of other factors. Maybe I invited that by talking about Thailand (which isn't that undeveloped). There are plenty of non-western cultures that co-sleep and are economically developed - e.g. Japan, which I think Sakura mentioned, Korea, parts of the middle east...

I also think there's a huge difference between the detailed, more nuanced answers given here by Prof. Haycock and the advice on the FSIDS site and that infamous poster. The studies cited don't justify the tone of either of them.

And thanks to Rachael for this paragraph -

"FSIDS lists its completed research including an epidemiological study on the long term changes in trends in SIDS. The conclusion is that 86% of SIDS deaths occur in smoking households and that 50% of the deaths occurred in cosleeping arrangements (37% in a bed 11% on a sofa). As around 50% of the British population smoke more SIDs occur in smoking households than would purely by chance (which would be 50%) so smoking clearly is a factor that is correlated with SIDs. Cosleeping at night in bed with a baby would only be a risk factor for SIDs if much less than 37% of the population with a small baby ever coslept for all or part of the night. Hmmm."

Do we think that less than 37% of the population with a small baby ever co-sleeps? Can we find out? That doesn't seem like too hard a survey to design/ carry out, does it?

Very good thread. Thank you MNHQ, and please pass on thanks to Prof. Heycock. It was really good to see a guest who engaged with the serious questions and didn't try to talk down at all.

And I too really want to know what proportion of the population co-sleep

Princess, I think the 'cow' bit might be a bit unwise but I think it's reasonable to write a letter and point out the effect of this remark, which on you has been profound