Taking a closer look at the SIDS scare
It's strange how fear-based the sleeping positions have become, and for me, the inconsistencies in popular suggestion-- the only "truly safe" way to sleep a baby (according to AAP) is on his back, with a sleep sack not a blanket, nothing in the crib, in a warm room... but then you get all the other suggestions from other "experts" like swaddling and sleep positioners, baby wearing, swings, carseats, etc... technically those shouldn't feel any "safer" than tummy sleeping, since they are all outside of the technical safe recommendation... but there's this fear-mongering about tummy sleeping.
As a parent who will be inundated with articles (thanks to the blog scene), citing studies and statistics, The #1 most important thing to know is the difference between causation and correlation. We are not suggesting that the study had no value, nor that great good has come of it, but only that in order to make an informed decision we must sometimes listen to what's not being said, read between the lines, and try to grasp a broader understanding of issues. All of life is mitigating risks. This is one that we prefer to take because of the great benefits that come with tummy sleeping.
Look at the statistics... http://www.heracliteanriver.com/?p=97
Study on SIDS
What is SIDS and what causes it?
In 1990 a study was done that listed tummy sleeping as one of fifteen possible causes of SIDS. The others included a too soft mattress, excess blankets, not using a pacifier and parents that smoke. In 1992 American Academy of Pediatrics (AAP) published a statement recommending that healthy infants be placed on their backs for sleep. Bear in mind that at the time of the study, the amount of incidents of SIDS was one half of one percent of the population of babies. It was not, and never has been, an epidemic. The study looked at 3000 incidents and showed things they had in common. It is not surprising that babies on their tummies was a commonality. For some generations mothers in the U.S. were being encouraged to sleep their babies on their tummies.
In the last decade there has been an estimated 40% decrease in SIDS, nationwide. The promoters of the “back to sleep” campaign (which ironically is what a baby has difficulty doing – going back to sleep on his back) have touted this decrease as a direct result of babies sleeping on their backs. I personally, strongly question that conclusion for two important reasons. The first is that all the other possible causes of SIDS that were listed as an equal probable cause have also greatly improved over the decade. Mattresses are firmer, parents are not putting bumper pads or fluffy blankets in the crib, smoking has decreased and pacifiers are promoted at birth. Who is to say that any of those things are not the direct correlation of the decrease of SIDS?
The other thing that is important to remember is that Sudden Infant Death Syndrome (SIDS) is the unexpected, sudden death of a child under age 1 in which an autopsy does not show an explainable cause of death. Over the past decade technology has greatly improved in the medical field and conditions are being diagnosed that were never found before. That factor alone could explain the decrease.
As reported in Pub Med Health in Aug 2009, the cause of SIDS is still unknown, although there are several theories. Many doctors and researchers now believe that SIDS is not a single condition that is always caused by the same medical problems, but infant death caused by several different factors. These factors may include problems with sleep arousal or an inability to sense a build-up of carbon dioxide in the blood. Almost all SIDS deaths occur without any warning or symptoms when the infant is thought to be sleeping.
SIDS is most likely to occur between 2 and 4 months of age, and 90% occur by 6 months of age. It occurs more often in winter months, with the peak in January. There is also a greater rate of SIDS among Native and African Americans.
The following have been linked to an increased risk of SIDS:
As a parent who will be inundated with articles (thanks to the blog scene), citing studies and statistics, The #1 most important thing to know is the difference between causation and correlation. We are not suggesting that the study had no value, nor that great good has come of it, but only that in order to make an informed decision we must sometimes listen to what's not being said, read between the lines, and try to grasp a broader understanding of issues. All of life is mitigating risks. This is one that we prefer to take because of the great benefits that come with tummy sleeping.
Look at the statistics... http://www.heracliteanriver.com/?p=97
Study on SIDS
What is SIDS and what causes it?
In 1990 a study was done that listed tummy sleeping as one of fifteen possible causes of SIDS. The others included a too soft mattress, excess blankets, not using a pacifier and parents that smoke. In 1992 American Academy of Pediatrics (AAP) published a statement recommending that healthy infants be placed on their backs for sleep. Bear in mind that at the time of the study, the amount of incidents of SIDS was one half of one percent of the population of babies. It was not, and never has been, an epidemic. The study looked at 3000 incidents and showed things they had in common. It is not surprising that babies on their tummies was a commonality. For some generations mothers in the U.S. were being encouraged to sleep their babies on their tummies.
In the last decade there has been an estimated 40% decrease in SIDS, nationwide. The promoters of the “back to sleep” campaign (which ironically is what a baby has difficulty doing – going back to sleep on his back) have touted this decrease as a direct result of babies sleeping on their backs. I personally, strongly question that conclusion for two important reasons. The first is that all the other possible causes of SIDS that were listed as an equal probable cause have also greatly improved over the decade. Mattresses are firmer, parents are not putting bumper pads or fluffy blankets in the crib, smoking has decreased and pacifiers are promoted at birth. Who is to say that any of those things are not the direct correlation of the decrease of SIDS?
The other thing that is important to remember is that Sudden Infant Death Syndrome (SIDS) is the unexpected, sudden death of a child under age 1 in which an autopsy does not show an explainable cause of death. Over the past decade technology has greatly improved in the medical field and conditions are being diagnosed that were never found before. That factor alone could explain the decrease.
As reported in Pub Med Health in Aug 2009, the cause of SIDS is still unknown, although there are several theories. Many doctors and researchers now believe that SIDS is not a single condition that is always caused by the same medical problems, but infant death caused by several different factors. These factors may include problems with sleep arousal or an inability to sense a build-up of carbon dioxide in the blood. Almost all SIDS deaths occur without any warning or symptoms when the infant is thought to be sleeping.
SIDS is most likely to occur between 2 and 4 months of age, and 90% occur by 6 months of age. It occurs more often in winter months, with the peak in January. There is also a greater rate of SIDS among Native and African Americans.
The following have been linked to an increased risk of SIDS:
- Babies who sleep on their stomachs
- Babies who are around cigarette smoke while in the womb or after being born
- Babies who sleep in the same bed as their parents
- Babies who have soft bedding in the crib
- Multiple birth babies (being a twin, triplet, etc.)
- Premature babies
- Babies who have a brother or sister who died of SIDS
- Mothers who smoke or use illegal drugs
- Teen mothers
- Short time period between pregnancies
- Late or no prenatal care
- Situations of poverty
So what does this all mean?
Prone sleep position/ Tummy sleeping DOES NOT CAUSE SIDS. There has been a correlation shown in statistics but we know that correlation does not equal causation. Please keep that in mind as you consider this issue.
Physical Therapist Stephanie Pruitt, PT, CKTP wrote a book called The Truth About Tummy Time. Here is a brief overview of her assessment of SIDS.
http://www.abouttummytime.com/stories.php?story=11/11/03/6309424
We consider this one a must-read: A very thorough look at the statistics about SIDS that are used to make the recommendation to back-sleep. Note from the author: contains a bit of semi-technical discussion on statistical methodology. If you just care about the problems with the SIDS recommendations, skip down to the next section on “Correlation is not causation.” If you want to see some examples of how SIDS studies exaggerate some claims, obfuscate data, and neglect various considerations in statistical analysis, read on.
http://www.heracliteanriver.com/?p=97
Another, shorter, overview that includes how recommendations change based on specific conditions in babies
http://doctorstevenpark.com/sids-back-sleeping-and-sleep-apnea
Please also read well thought through decisions by parents:
http://incaseyouarecurious.blogspot.com/2012/08/why-i-chose-to-sleep-my-baby-on-her.html?showComment=1359263492823
and how the AAP recommendation for supine sleeping contributes to the "Fear-based parenting" that we address in our introduction
http://naturaltothecore.wordpress.com/2013/02/14/revisiting-sids-and-back-sleeping-part-1/
Additional theories that we hope will give insight into understanding and preventing SIDS
http://wtkr.com/2014/01/24/researchers-may-have-found-a-cause-of-sudden-infant-death-syndrome/
http://www.healthychild.com/has-the-cause-of-crib-death-sids-been-found/
Physical Therapist Stephanie Pruitt, PT, CKTP wrote a book called The Truth About Tummy Time. Here is a brief overview of her assessment of SIDS.
http://www.abouttummytime.com/stories.php?story=11/11/03/6309424
We consider this one a must-read: A very thorough look at the statistics about SIDS that are used to make the recommendation to back-sleep. Note from the author: contains a bit of semi-technical discussion on statistical methodology. If you just care about the problems with the SIDS recommendations, skip down to the next section on “Correlation is not causation.” If you want to see some examples of how SIDS studies exaggerate some claims, obfuscate data, and neglect various considerations in statistical analysis, read on.
http://www.heracliteanriver.com/?p=97
Another, shorter, overview that includes how recommendations change based on specific conditions in babies
http://doctorstevenpark.com/sids-back-sleeping-and-sleep-apnea
Please also read well thought through decisions by parents:
http://incaseyouarecurious.blogspot.com/2012/08/why-i-chose-to-sleep-my-baby-on-her.html?showComment=1359263492823
and how the AAP recommendation for supine sleeping contributes to the "Fear-based parenting" that we address in our introduction
http://naturaltothecore.wordpress.com/2013/02/14/revisiting-sids-and-back-sleeping-part-1/
Additional theories that we hope will give insight into understanding and preventing SIDS
http://wtkr.com/2014/01/24/researchers-may-have-found-a-cause-of-sudden-infant-death-syndrome/
http://www.healthychild.com/has-the-cause-of-crib-death-sids-been-found/
