The risk of SIDS generally lessens as babies grow past the peak risk period of 0—6 months. For decades, researchers have been working to identify factors that increase and decrease the risk of SIDS. A study found that exclusive breastfeeding for the first 2 months of life helped reduce the risk of SIDS by 50 percent.
It's important to note that the relationship between breastfeeding and SIDS is dose dependent , meaning the more a baby breastfeeds, the greater the protection against SIDS. Therefore, the AAP encourages mothers to breastfeed as much as possible, for as long as they can to help reduce their baby's risk. Most often, this occurs during sleep. Studies suggest breastfeeding reduces SIDS risk by improving a baby's overall health and reducing potential stressors. Benefits include a reduced incidence of anaemia and associated complications postpartum 17 ; prolonged return of menstruation 18 and a lower incidence of pregnancy ; reduced Type 2 Diabetes especially for women who experienced gestational diabetes 1, ; and a lower incidence of breast and ovarian cancer 1,, Breastfeeding offers economic benefits for the family and for society as a whole.
Infant formula feeding has significant cost implications within a family budget, and society in general benefits considerably through the reduced occurrence of common childhood illnesses known to be improved by breastfeeding The World Health Organisation summarises a consensus of the extensive research stating that breastfeeding is the most cost-effective, health-promoting and disease-preventing activity that new mothers can perform 3,, Despite universal agreement that breastfeeding reduces infant morbidity and mortality worldwide 8,21 until recently epidemiologic studies had reported inconsistent findings on the protective effects of breastfeeding in relation to SIDS 5,10, Between and however, research into the potential causal and preventative relationships between SIDS and breastfeeding reported findings that were inconclusive once confounding factors were controlled for in study analyses 10, Between research studies, variation in subject selection criteria, definitions used in different countries for SIDS and SUDI, definitions for breastfeeding exposure, and adjustment for potential confounders such as sleep position, smoking status, head covering and socioeconomic status, have each contributed to the difficulty in rigorously evaluating the evidence to determine if breastfeeding was an independent protective factor for reducing the risk of sudden infant deaths 1,5, The National SIDS Council of Australia was therefore impelled to remove breastfeeding from the national recommendations as a specific protective factor for SIDS in the revision of the Reduce the Risk messages 10,23 , although the recommendations continued to support breastfeeding as the optimal source of nutrition for babies.
Since , more studies have measured breastfeeding in similar ways. Several meta-analyses similarly conducted studies which allow pooling of data; regarded as highest level of scientific evidence in which the true effect of a factor can be better determined have now been conducted and have consistently found a strong association between a baby receiving breast milk and a reduction in the risk of SIDS 1,5,, Alm et al demonstrated a relationship, although weak, between breastfeeding and SIDS reduction in their case control study The Agency for Healthcare Research and Quality report 1 reaffirmed health risks associated with formula-feeding and early breastfeeding cessation and included a meta-analysis examining SIDS risk which addressed the limitations identified in previous studies and systematic reviews.
However results for exclusive breastfeeding or specific durations were not reported. In a German case-control study, Vennemann and colleagues examined risk factors for SIDS and the relationship with breastfeeding. Exclusive breastfeeding at 1 month of age halved the risk while partial breastfeeding at the age of 1 month also reduced SIDS risk; after adjustment the reduction in risk was not significant.
Breastfeeding survival curves showed both partial breastfeeding and exclusive breastfeeding were associated with a reduced risk of SIDS. Most recently, Hauck and colleagues conducted a meta-analysis to address this relationship. Studies were grouped according to the exclusivity and duration of breastfeeding.
For babies who received any amount of breast milk for any duration the univariate summary odds ratio SOR was 0. But certain risk factors do exist. Some babies are more at risk than others. For example, SIDS is more likely to affect a baby who is between 1 and 4 months old, it is more common in boys than girls, and most deaths occur during the fall, winter and early spring months. While the cause of SIDS is unknown, many clinicians and researchers believe that SIDS is associated with problems in the ability of the baby to arouse from sleep, to detect low levels of oxygen, or a buildup of carbon dioxide in the blood.
When babies sleep face down, they may re-breathe exhaled carbon dioxide. Normally, rising carbon dioxide levels activate nerve cells in the brainstem, which stimulate the brain's respiratory and arousal centers. The baby then wakes up, turns his head, and breathes faster to get more oxygen. SIDS babies, however, may fail to rouse. The model holds that SIDS occurs when three conditions exist simultaneously:.
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