Madam, - Your front-page report of Friday, December 5th regarding parents co-sleeping with infants was not an accurate reflection of the study findings. The seven-fold increased risk of Sudden Infant Death Syndrome (SIDS, also known as "cot death") quoted from Dr McGarvey's study is applicable mainly to bed-sharing parents who smoke. The risk of SIDS amongst non-smoking parents, if avoiding alcohol or any sleep-inducing substance, appears to be negligible.
It is true that co-sleeping deaths are becoming a much bigger feature of SIDS than previously, but this is an expected consequence of successful research.
Here in the UK we conducted a "Back to Sleep" campaign. This carried several important messages, but the one that appears to have got across to parents is to place infants on their backs to sleep. When parents bed-share, very few place infants on their tummies. This was a practice almost exclusive to cot-sleeping and therefore the environment in which the decline of SIDS has been most dramatic.
Thus, as the number of SIDS deaths continues to fall, the numbers of bed-sharing SIDS have not risen but have become increasingly to the fore.
In SIDS research we are now at a crossroads and must consider carefully before advocating whether parents should avoid or continue to bed-share. The current evidence of risk does not suggest the actual number of bed-sharing SIDS deaths have risen nor that the findings can be generalised to the whole population. If we discourage bed-sharing, this may indeed reduce the number of SIDS deaths. Alternatively it may just change the environment in which these SIDS infants die or drive the practice of bed-sharing underground. This is to say nothing of the wider implications of negating any beneficial effects associated with bed-sharing, such as increased breast-feeding and important mother-infant contact at such an early age.
In reducing the number of SIDS occurring in a cot we did not advocate that parents should avoid using the cot but looked at the particular risks within this environment. Is bed-sharing any different? - Yours, etc.,
Dr PETER S. BLAIR, Medical Statistician, Bristol, England.