Breastfeeding can reduce SIDS risk nearly as much as pacifier use can

Baby Pacifier

Considering the breathlessness of the news reports, you might imagine that the results of a new study tell us the best way to reduce SIDS.

According to the Daily News:

If we want to reduce SIDS, our efforts should be applied to promoting pacifier use and discouraging co-sleeping.

Babies who are breastfed for at least two months after they’re born reduced their risk of dying from Sudden Infant Death Syndrome by half, according to a new study…

The researchers are using their findings to call for “ongoing concerted efforts” to increase the rates of breastfeeding worldwide …

According to WebMD:

But the study also found moms don’t need to breast-feed exclusively to reap that benefit. Even partial breast-feeding will do, the 20-region study found.

“What is, perhaps, surprising is that there does not appear to be any benefit of exclusive breast-feeding over partial breast-feeding in relation to SIDS, though there are many other benefits associated with exclusive breast-feeding,” explained study author John Thompson, from New Zealand’s University of Auckland.

Tara Haelle, writing for Forbes, notes:

Any breastfeeding for 2-4 months reduces the risk of SIDS by about 40%. That means for every 10 non-breastfed babies who were going to die of SIDS, four of them would survive if all of them were breastfed instead.

That’s almost as much as the reduction in SIDS provided by pacifiers!

Breastfeeding and dummy use have a protective effect on sudden infant death syndrome by Alm et al. is a literature review on the protective effect against SIDS of both breastfeeding and pacifier use.

We found 11 observational studies that consistently showed a risk reduction of about 50% if the infant used a dummy.

There were also two meta-analyses that gave approximately the same odds ratio of about 0.5.

In other words, for every 10 non-breastfed babies who were going to die of SIDS, five of them would survive if all of them used pacifiers.

Breastfeeding your baby is nearly as good as a pacifier!

Of course, the protective effect of pacifiers or breastfeeding is dwarfed by the harmful effect of bed sharing. While pacifier use and breastfeeding appear to decrease the risk of SIDS by 50% and 40% respectively, bedsharing increases the risk of SIDS by 400% or more.

[I]n all 11 case-control studies reporting an association between bed sharing and SIDS, the risk of SIDS was increased in infants who bed shared; no study found a protective efect. The largest analysis to date was pub-lished in May 2013,91 with 19 studies from nine datasets across the UK, Europe, and Australasia and totalling 1472 cases of SIDS and 4679 controls. The individual level analysis showed that even for infants at low risk (that is, breast fed and with parents who neither smoked nor used illicit drugs or alcohol), bed sharing was associated with a fvefold increased risk of SIDS in the frst three months of life (adjusted odds ratio 5.1, 95% confdence interval 2.3 to 11.4), compared with infants placed for sleep in a supine position in a cot in the parents’ bedroom…

In other words, for every 10 babies who were co-sleeping when they died of SIDS, nearly nine of them would have survived had they been in their own beds.

Here’s a graphical representation of the relative benefits of breastfeeding, pacifiers, and putting the baby to sleep in his own bed:

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It seems to me that if we really want to reduce SIDS, our “ongoing concerted efforts” should be applied to promoting pacifier use and discouraging co-sleeping.

Women who nurse their infants can be assured that breastfeeding helps a little bit, too.

  • Breastfeeding also has some other benefits. At least part of the source of the infant gut microbiome (GMB) comes from breastfeeding.

  • Felicitasz

    “nearly”?
    Dr Amy, you will get murdered in your bed ;P

  • breynolds

    SIDS caused by vaccines, get smart, don’t vaccinate

    • Azuran

      Yea sure, every health organization out there are spending a lot of time and money with the ‘back to sleep’ campaign and all the education they provide mother about promoting breastfeeding, room sharing, smoking, safe sleeping habits and everything else they can do to reduce the risks of SIDS. Then they turn around and hide the ‘risks’ of vaccination.
      Makes total sense.

      Vaccinated children have a lower rate of SIDS. The one who needs education here is you.

      • breynolds

        health organizations spend money to make you sick…sicker you are the more drugs they make to keep you sicker

        • I wasn’t aware that WHO or the CDC made drugs these days. When did that start?

        • Azuran

          So, does that mean I should start smoking? Because if health organizations are trying to make me sick, and they are telling me not to smoke, does that mean smoking is good for my health?
          What about drinking?
          Should I eat raw chicken?

          • momofone

            Definitely raw chicken! And I hope you haven’t fallen for the whole wash-your-hands nonsense.

          • KeeperOfTheBooks

            Sad but true:
            My parents were very into not following the basic rules of food safety. In dad’s case, “some feminazi at the health department wasn’t gonna tell HIM what to do,” so he wouldn’t wash his hands or food prep surfaces after handling raw meat. In my mother’s case, anyone who suggested it was unsafe to eat food left on the back of the stove for 3+ days because she never got around to sticking it in the fridge was just “being unreasonable and picking on her and setting IMPOSSIBLE standards and whyyyy are they all out to be so meeeeean to her.” Neither of them ever washed their hands after using the bathroom, nor did they teach us to do so.
            I’m sure you’re all stunned to hear that when I initially took over food prep and then left home for good, the incidents of food poisoning decreased…substantially.

          • Heidi

            Heck, I thought my family was a bit too lax on food safety, but that takes the e. coli cake.

        • StephanieJR

          So how does the Scottish government make money when all our prescription drugs are FREE? Really, tell me. I’m waiting.

          • Wren

            They probably make even more money than the English do, where some people do have to pay for drugs.

            I get so frustrated by antivaxers who don’t get that there is a whole rest of the world where things work differently than the US, and somehow vaccine studies there show vaccines work and don’t cause all of the ills they claim either. It’s like the people claiming c-sections are only done so the doctor earns more money or so the doctor can leave and go play golf. Neither would be a factor on the NHS, but we still, thankfully, have c-sections.

        • MI Dawn

          So my employer, a health insurance company, pushes vaccines because they want more sick people to spend money on??? That makes no sense. One would logically think they would NOT want to have that money going out the door. Yes, we are not-for-profit, but we still need to make enough money to pay our bills. And most health insurance is FOR-PROFIT so one would think they would avoid anything that causes them to lose money.

          Yet, all insurance companies prefer vaccines over the illnesses they prevent. I wonder why. Curious, that.

    • momofone

      Sources?

      • breynolds
        • momofone

          That’s not the way it works. You’ve made a claim, so you back it up.

          • breynolds

            do your own research i am not a snowflake/libtard.

          • momofone

            You’re also clearly not a user of correct grammar or punctuation, and you resort to namecalling because you have nothing of substance to say.

            By the way, you haven’t “done research”; you’ve read something on the internet probably written by someone with exactly as much real knowledge about this as you (unless they know even less, which, though hard to fathom, is possible).

          • shay simmons

            “Do your own research” is a tacit admission you don’t have anything to back up your assertions.

        • Azuran

          HAHAHAHAHAHAHA you just posted A GOOGLE SEARCH?

          • Does s/he even realize that all those links say that vaccines are NOT linked to SIDS?

          • crazy mama, PhD

            It’s like they’re purposely trying to satirize anti-vaxxers. “I did my research… by opening a web browser and clicking one button.”

        • Azuran
    • Nick Sanders
    • yugaya

      Ah, the obligatory antivaxx idiots are here.

    • breynolds

      here, you can search the deaths caused by vaccinations connected to the govt. database. screw you provaxxers! and i don;t give a damn about my punctuation or otherwise.
      http://www.medalerts.org/vaersdb/index.php

      • momofone

        Your punctuation isn’t the issue, but your apparent desire to be taken seriously is; if you write like a seventh-grader you undermine any credibility you might otherwise have (though the more of your comments I read, the less this seems to be an issue).

      • Wren

        Do you understand how the VAERS system works?

    • I’m assuming that this is sarcasm.

    • Platos_Redhaired_Stepchild

      anti vax bs

  • Ginger Saunders

    Breast-feeding has benefits for both mother and child. Many respiratory problems are alleviated for the baby; and the emotional closeness allows the baby to bond well with the mom, resulting in a more tender-hearted tot. The benefits for the mom include faster weight reduction, and less incidence of breast cancer. Five grown kids later–the time and effort was well worth it!

    • Roadstergal

      “Many respiratory problems are alleviated for the baby”

      Please provide citation.

      “resulting in a more tender-hearted tot”

      Please provide citation.

      “faster weight reduction”

      Please provide citation.

      Just… in general, provide citations.

      • LaMont

        (Can I also say I legit nearly gagged at the phrase “tender-hearted tot”. Like, who’s both judgmental enough to rate children, and simultaneously living in a cutsey 1890s ad?)

        • Roadstergal

          All I could think of was cardiomyopathy. 😮

        • The Bofa on the Sofa

          Bah, if your child isn’t sufficiently tender-hearted, you just need to marinate them longer in brine before cooking. Although I do like to add an enzymatic tenderizer to my marinade.

        • Cat

          A friend was demonstrating to me the other day the fact that, when she says to her breastfed toddler “Mummy loves you. Do you love Mummy?”, he shouts “no!” and then falls about laughing at her hurt reaction. He’s actually a sweet kid and evidently does love his mother, but exclusive breastfeeding clearly didn’t make him any more sensitive than the average small child.

    • LaMont

      FIB is trying to say that babies should be *fed enough*. No one is arguing to eliminate breastfeeding. That said, this fetishization of the female body functions is a little gross, and completely unsubstantiated. Are you trying to say that women who can’t breastfeed for whatever reason are bad mothers, or that their children turn out to be sociopaths so they should just die or never have been born? What is the point here?

    • Heidi

      I guess those tots will need all the help they can get regarding”tender-heartedness” when they’re being raised by mean people who would be so heartless to imply not breastfed babies are less than.

    • Tigger_the_Wing

      I have five grown kids, and seven grandchildren, and I defy anyone to look at a single one and tell me which was breastfed, and for how long. Also, faster weight reduction can be a bad thing – I lost weight during my hell of a third pregnancy, and was positively skeletal when I left the hospital with one surviving baby (around 100lbs at 5’7″). All my offspring are the kindest people you could wish to meet – I have no idea what you mean by a ‘tender-hearted tot’. I’ve met EBF ‘tots’ who are little monsters and will bite and kick to be able to steal a toy from another.

      As far as breast cancer is concerned, I intend to keep getting mammograms (back down to every second year, thankfully, after a few years of annual ones following a scare) because ‘ less incidence’ isn’t no incidence.

      • Wren

        I had horrific morning sickness (all day for 9 months sickness is a better description) with both of my kids. I left the hospital weighing less than the day I got pregnant. Then breastfeeding made me ravenous and I gained weight. Don’t claim I didn’t do it long enough either. I breastfed my second for nearly 3 years.

        Breastfeeding 3 kids didn’t prevent my mother from getting breast cancer either.

        My kids are close to both me and their father, while he never breastfed them at all.

        And you know what, I’ve never bottle fed a young baby without holding the child with lots of cuddles and closeness.

        • Merrie

          Entertainingly enough, my oldest did not like to be held when she was getting a bottle. It was usually my husband watching her while I worked. Typically she ended up lying on the changing table while he fed her the bottle, because he couldn’t get her to take it in any other position. I nursed so I had to hold her. She seemed to like that okay though, as she nursed constantly well into her second year. Now at 6 she is still a very snuggly, affectionate kid. But sure, bottlefeeding interferes with bonding? Tell me another one.

    • crazy mama, PhD

      I’m breastfeeding my second kid literally as I type this. I like it; it works for my family. But how does it increase “emotional closeness” with my baby? I’d be holding and snuggling him just as much giving him bottles. And I find playing with him, smiling and cooing and whatnot, to be much more of a bonding experience.

      The implication that my love comes from my boob is frankly kind of creepy.

    • momofone

      “For me.” You forgot that part.

    • MI Dawn

      Uh…I didn’t lose ANY weight until I stopped breastfeeding. And as for the tender-hearted tots…well, both of my kids are very tender hearted. But, I did hold them close and smile and talk to them while they got their bottles, as did their father. So maybe being held close and loved is more important than the method the food comes from.

      • The Bofa on the Sofa

        Am I the only one who keeps thinking “tator tots”?

        • Heidi

          Yuck, tots are best crunchy, not tender.

          • Petticoat Philosopher

            But you do want the “heart” to be tender–crunchy on the outside, soft on the inside!

          • Heidi

            Hearts of tot, right next to hearts of palm at your local grocer. Great in salads!

    • yugaya

      Ah, the obligatory lactavist idiots are here as well. Breastfeeding “resulting in a more tender-hearted tot? Citation needed.

    • Who?

      I didn’t know that breastfeeding made mum more flexible, but it’s good to see you can pat yourself on the back so adroitly.

    • Platos_Redhaired_Stepchild

      What a bunch of nonsensical twaddle. You would have bonded with your kid if you’d given them a bottle too. And they would have turned out no less tender hearted. Boob nipples are not so magical they can cure congenital lung diseases.

  • 70something

    In 1973 I was pregnant. My co-worker had lost a son at 3 months to “SIDS” when she went to wake him in the morning in the crib. She and her son did not fit any of the social economic parameters of most SIDS deaths and she breast fed. Basically none of this research has determined anything in almost 45 years. You still have no real answer as to why her healthy son died.

    • LaMont

      Not having *all* the answers is not equivalent to having *no* answers. Factors that increase likelihood of something are not all *necessary* to trigger that result. Are you trying to say that scientists should stop researching out of respect for the tragedy of mysterious deaths, rather than try to keep figuring out more things and prevent them in the future?

    • Heidi

      I think we’ve come a pretty long way with identifying SIDS causes. Could you say with certainty that they wouldn’t have figured out a cause of death if the baby died now instead of the 70s? Recommendations and safe sleep practices have definitely been modified since I was born in the 80s. I was put on my stomach, had blankets on me, probably had bumper pads on my crib, and was babysat by a chain-smoker. But I also think they are getting closer to finding genetic causes of SIDS that likely predispose a child.

    • yugaya

      That is not true. We now know a lot more about how sleep environment risks trigger SIDS -babies in the past were likely to be overbundled, at risk of overheating, sleeping on a sleep surface that was too soft and compromised their arousal for instance. Babies decades ago were sleeping with pilllows and blankets, placed on their sides or stomach . Compared to a bare crib with only a fitted sheet, a flat, firm mattress and baby placed on it on their back with no blankets, pillows, positioners or bumpers, babies in the past were routinely placed at multiple sleep environment risks. That is what research has done for the past 45 years, it has shown that incidence of SIDS in safe sleep environment is a number close to zero. Your friend could thanks to it find some answers if someone like a local child death review team went through the circumstancs of the death with her.

      My grandmother lost one of her daughters at three months to a “cot death”. That cot is family heirloom, together with the traditional bedding that goes into it. It is not safe.

    • Platos_Redhaired_Stepchild

      I was born in the 70’s. Big push during those years for mothers to put baby face down while sleeping to help drain mucus away from lungs. We now know that sleeping face down increases risk of SIDS greatly and put baby face up in crib with no blankets.

      • I think 70something is conflating two very different statements: “We don’t know how a particular baby died who died 45 years ago” and “In the last 45 years, we haven’t figured out any additional risk factors for SIDS.” The first statement is true, but says nothing about the state of scientific research; the second is not true.

  • Jillian Johnson

    I’d be curious to know how many of these deceased babies with “SIDS” passed away from accidental starvation or being smothered by their breastfeeding mother. When Landon died, because the autopsy took more than 6 months to get the results, automatically they threw him into the SIDS category. How many parents never looked at the autopsy and accepted a response of unknown causes – SIDS? More than we know, I’m sure.

    • CSN0116

      I have only ever seen two cases of ‘SIDS’ in my albeit limited time in a ME’s office. Both were suffocated by a mother’s breast whilst she was breast feeding in bed and fell asleep.

      • MI Dawn

        I saw one case of SIDS while working in a newborn nursery. Baby was alive at 5 am when the lab tech drew a bili level, dead at 5:30 when I went to pick him up to feed him. I’ll never forget it, and it’s been 28 years.

        • Tigger_the_Wing

          My eldest son could have been just such a statistic. I’d put him down in his cot next to my hospital bed after feeding him, and after a while I noticed that he’d stopped breathing. My instincts stepped in – I’d worked for a veterinary surgeon in my teens, and then in medical research between leaving school and marriage – and, without even thinking about it, I used the same technique I’d used dozens of times to resuscitate rabbits under general anæsthetic. He started breathing again and it was only later that I thought to mention the episode to anyone else.

          He was getting jaundiced, which is quite common in early babies, and I thought that might have been a factor, possibly caused by the fact that I’m O neg and he’s B pos like his dad. But that was in 1981, right at the time that mothers were being told to put our babies to sleep in the prone position, because we were told that SIDS was probably caused by inhaling vomit, and that almost certainly was the major factor.

        • KeeperOfTheBooks

          *shudder*
          I am so sorry you had that experience. It sounds utterly horrible.

          • MI Dawn

            It was horrible. We coded that baby for 45 minutes. He was supposed to go home that day. I went home from work, cuddled my 1 year old, and cried. And woke up every little bit of time I was home to make sure she was still breathing.

          • KeeperOfTheBooks

            I can only imagine, and I’d have done the same thing.

    • AnnaPDE

      Thank you for pointing this out.

      SIDS in general parlance is the “seemingly healthy baby was alive one moment, dead the next, and we can’t figure out why” scenario, and this unpredictability is why it’s so damn scary and why parents lap up every single little risk factor and protective measure, no matter how contrived.
      It would be interesting to know how the SIDS numbers are currently counted.

      In contrast, being suffocated under something or someone is just that: accidental suffocation. Same with collapse due to dehydration/hypoglycemia. Neither of these two well-understood causes is mitigated by, for example, letting the baby suck on a dummy, or not smoking in the house. (Even though these things might be correlated to preventative circumstances, such as having the baby sleep in their own safe bed.)

      • Tigger_the_Wing

        SIDS seems to be the automatic assumption when a baby dies – and it is hard, then, to change people’s memory of the event when the true cause is found.

        Everyone remembers that my granddad’s death was caused by his car crashing head-on into a bus, when it was actually his death – from a brain hæmorrhage – which caused the car to swerve across the road into the oncoming bus’s path.

    • swbarnes2

      I think by definition a SIDS death has no signs of suffocation or starvation, or anything like that. Though there’s always a chance that a coroner might falsify a record, and tell parents that a death was SIDS when they know it was an accident like suffocation or strangulation, to spare their feelings and public reputation.

  • fiftyfifty1

    I have never believed that breastfeeding helps prevent SIDS. It seems like confounding. What we call “SIDS” seems to be multifactorial. 2 main contributors appear to be:
    1. Sleep risks. Positions that limit baby’s oxygen.
    2. Neurological risks. Subtle neurologic differences that lead to fatal disturbances of cardiac or respiratory rhythms.
    Who is more likely to put their baby to sleep on a couch, a chair, a shared bed, on their stomach, with whatever bedding? Poor people. Who is less likely to breastfeed? Poor people.
    Who might have trouble breastfeeding due to a discoordinated suck-swallow (and thus get switched to formula)? A baby with subtle neurologic differences.

    • Roadstergal

      I agree with you – the more I look at the ‘recommendations,’ the more I think it’s just pushing societal issues onto the individual.

      In addition to what you mention, poor people are also much more likely to live in areas with sometimes drastically lower-quality air. It leads to a higher incidence of respiratory issues like asthma, so might it have an influence on SIDS?

      • fiftyfifty1

        Yes, poor air quality. We do know smokers have a higher risk. Of course smoking is a marker for poverty, and also a marker for “health is not my top priority” so there could be confounding there too.

        • The Bofa on the Sofa

          I agree with all this. All these correlations, can we figure out a mechanism that solve the issue of causality?

  • Momof3

    The second to last sentence is not accurate. “It seems to me that if we really want to reduce SIDS, our “ongoing concerted efforts” should be applied to promoting pacifier use and discouraging co-sleeping.” Co-sleeping should be changed to bed sharing. Babies sleeping in a safe, separate sleep surface is the issue, not what room they are in.

    • “Bed sharing” might be clearer, but I think that’s what co-sleeping means in this context.

  • Dinolindor

    Is it the act of breastfeeding, or the baby’s ability to suck properly that is the mechanism of protection? (I’m just thinking of my son who chewed rather than sucked, and so I pumped and bottlefed breast milk. It can’t be the breastmilk that provides the protection right? I would think the mechanism is something about the biology/mechanics of the method of sucking needed to properly transfer milk from a breast?)

    • Azuran

      Well, since many unrelated things happen to reduce the risk of SIDS, SIDS is clearly not a single entity but a mix of different things so its really hard to pinpoint,
      Its entirely possible that the ability to suck is correlated.
      Or the pacifier makes it less likely for a baby keep their face pressed against something because its uncomfortable.
      Or maybe babies with a pacifiers tends to wake up more often because the pacifier falls so their sleep is lighter.
      Breastfed babies are perhaps more likely to be in their parent’s room, and might be used to more night feedings than bottle fed babies so the might wakes up more and sleep more lightly because of the noise.
      Breastfeading does slightly reduces the risk for respiratory illness, which probably plays a role.
      Babies with health problems that make breastfeeding more difficult are also probably at higher risk for SIDS.

      • fiftyfifty1

        “Breastfeading does slightly reduces the risk for respiratory illness, which probably plays a role.”
        Yes, respiratory infections probably play a role. How breastfeeding reduces these illnesses is unclear. Is it an actual effect of the breastfeeding or mainly confounding from the fact that babies that go to daycare where they are exposed to colds are more likely to be bottlefed?

        • crazy mama, PhD

          My anecdotal evidence on this:

          First kid, breastfed for 17 months: Got his first cold the week he started daycare at 8 months old.

          Second kid, currently 2 months old, also breastfed: Has already had two colds brought home from preschool by his big brother.

          • Empress of the Iguana People

            My bf’d kid got his first cold at 4 weeks; thanks Grandpa and Gramma!

          • Azuran

            My breastfed baby had never caught any illness in 6 months…. Then she had her first swimming class, (her first time being around other babies), and instantly caught something.

          • Allie

            Ha! I’m sure big bro will continue to be a confounding factor for many years to come : )

          • Tori

            My first was mix fed from a couple of weeks of age, no colds until after 9 months. My second exclusively breastfed, cold in second week of life courtesy of older sibling.

          • Sue

            Yep – which confirms that respiratory viruses are mostly determined by exposure.

      • Dinolindor

        What I’m trying to get at is – what is the mechanism for the effect? The milk itself or the action required by the baby? And more narrowly, do the researchers care to find the mechanism? (Kind of like epidurals – women who have more difficult labors are more likely to ask for an epidural, thus altering the data collected. So babies who come to breastfeeding more naturally, is there a physiological reason that makes breastfeeding easier for them that is coincidental to avoiding SIDS? I understand the answer is unknown. I guess I just hope someone with the ability to research this is asking that question.)

        • Azuran

          It’s probably not the milk itself. It might be SOME part mechanism, but most is probably just confounding factors that affect both breastfeeding and risks of SIDS like poverty.

          Sadly, studying the cause and association is close to impossible since it is still rare. You’d basically need to study and closely monitor millions of children for months to have a statistically significant number of cases, and there are way too many variable.

          • Roadstergal

            I can’t even think of a far-fetched mechanism where it would be the milk itself.

          • Azuran

            Magic

    • yugaya

      “Is it the act of breastfeeding, or the baby’s ability to suck properly that is the mechanism of protection?” Probably not because thumb sucking was not found to be protective like pacifiers.