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UNICEF UK Baby Friendly Initiative statement on new research into Sudden Infant Death Syndrome and bed-sharing

Following the publication of new research on risk factors involved in Sudden Infant Death Syndrome (SIDS) and subsequent media coverage, UNICEF UK Baby Friendly Initiative has issued the following statement. The SWISS study, designed to investigate the factors associated with SIDS in 0-2 year-olds, draws a clear link between increased risk of SIDS and alcohol or drug use when co-sleeping with a baby, particularly on a sofa.

The study, examining 80 SIDS infants and two control groups, one randomly selected, one of babies at high-risk of SIDS, showed that many of the deaths in a co-sleeping situation could be explained by “a significant multivariable interaction between co-sleeping and recent parental use of alcohol or drugs (31 per cent v 3 per cent random controls) and the increased proportion of SIDS infants who had co-slept on a sofa (17 per cent v 1 per cent).” Other significant factors included pillow use, swaddling, smoking during pregnancy, whether the infant was preterm and whether the infant was in fair or poor health for the last sleep.
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Mother-Infant Cosleeping, Breastfeeding and Sudden Infant Death Syndrome: What Biological Anthropology Has Discovered About Normal Infant Sleep and Pediatric Sleep Medicine

James J. McKenna, Helen L. Ball, Lee T. Gettler
Yrbk Phys Anthropol 50:133–161, 2007.

Abstract

Twenty years ago a new area of inquiry was launched when anthropologists proposed that an evolutionary perspective on infancy could contribute to our understanding of unexplained infant deaths. Here we review two decades of research examining parent-infant sleep practices and the variability of maternal and infant sleep physiology and behavior in social and solitary sleeping environments. The results challenge clinical wisdom regarding normal infant sleep, and over the past two decades the perspective of evolutionary pediatrics has challenged the supremacy of pediatric sleep medicine in defining what are appropriate sleep environments and behaviors for healthy human infants.
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Miért nem szabadna sohasem egyedül aludniuk a kisbabáknak?

Az együttalvás körüli vita áttekintése a SIDS, a közös ágy és a szoptatás relációjában

James J. McKenna and Thomas McDade: Why babies should never sleep alone: A review of the co-sleeping controversy in relation to SIDS, bedsharing and breast feeding c. cikkének magyar nyelvű összefoglalója.
(PAEDIATRIC RESPIRATORY REVIEWS (2005) 6, 134–152)

Bevezetés

A kiságy, matrac, ágynemű NEM az evolúció terméke – ellentétben az együttalvás és a testkontaktus során megvalósuló védelmező anyai magatartással, amely azért jött létre, hogy a kisbabákat védelmezze és táplálja éjszaka is! Annak ellenére, hogy a nyugati világban tekintélyes orvosok vagy rendőrök figyelmeztetnek a veszélyeire, egyre több nyugati szülő tér át a legalább részleges együttalvásra.
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Alvási pózok és viselkedésmódok azoknál a családoknál, ahol a kisbaba együtt alszik a szüleivel (otthoni környezetben)

Sleep Arrangements and Behavior of Bed-Sharing Families in the Home Setting
Sally A. Baddock, Barbara C. Galland, Barry J. Taylor and David P.G. Bolton
PEDIATRICS Vol. 119 No. 1 January 2007, pp. e200-e207

Absztrakt

CÉLOK: Együttalvó családoknál az alvási pózok és viselkedési formák mennyiségi analízise, hogy jobban megértsük az együttalvás kockázatát és előnyeit, illetve azt, hogy hogyan befolyásolja ezeket a viselkedési formákat a csecsemő kora és a szoba hőmérsékletének változása.

MÓDSZEREK: 40 csecsemőt vizsgáltak, akik legalább 1 szülővel aludtak együtt min. 5 órán át éjszakánként. A csecsemők otthonában éjszakai videofelvételt készítettek a családról és a kisbaba életfunkcióit folyamatosan figyelték és rögzítették.
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Sleep Arrangements and Behavior of Bed-Sharing Families in the Home Setting

Sally A. Baddock, PhD, Barbara C. Galland, PhD, Barry J. Taylor, MBCh, FRACP and David P.G. Bolton, MRCP, PhD

PEDIATRICS Vol. 119 No. 1 January 2007, pp. e200-e207

Abstract

OBJECTIVES. We aimed to provide a quantitative analysis of the sleep arrangements and behaviors of bed-sharing families to further understand the risks and benefits as well as the effects of infant age and room temperature on bed-sharing behaviors.

METHODS. Forty infants who regularly bed shared with ≥1 parent ≥5 hours per night were recruited. Overnight video of the family and physiological monitoring of the infant was conducted in infants’ homes. Infant sleep position, potential for exposure to expired air, head covering and uncovering, breastfeeding, movements, family sleep arrangements, responses to the infant, and interactions were logged.
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Differences in Infant and Parent Behaviors During Routine Bed Sharing Compared With Cot Sleeping in the Home Setting

Sally A. Baddock, Barbara C. Galland, David P.G. Bolton, Sheila M. Williams, Barry J. Taylor

PEDIATRICS Vol. 117 No. 5 May 2006, pp. 1599-1607

Abstract

OBJECTIVES. To observe the behavior of infants sleeping in the natural physical environment of home, comparing the 2 different sleep practices of bed sharing and cot sleeping quantifying to factors that have been identified as potential risks or benefits.

METHODS. Forty routine bed-sharing infants, aged 5–27 weeks were matched for age and season of study with 40 routine cot-sleeping infants. Overnight video and physiologic data of bed-share infants and cot-sleep infants were recorded in the infants’ own homes.
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Why babies should never sleep alone: A review of the co-sleeping controversy in relation to SIDS, bedsharing and breast feeding

James J. McKenna and Thomas McDade

PAEDIATRIC RESPIRATORY REVIEWS (2005) 6, 134–152

Summary

There has been much controversy over whether infants should co-sleep or bedshare with an adult caregiver and over whether such practises increase the risk of SIDS or fatal accident. However, despite opposition from medical authorities or the police, many western parents are increasingly adopting night-time infant caregiving patterns that include some co-sleeping, especially by those mothers who choose to breast feed. This review will show that the relationships between infant sleep patterns, infant sleeping arrangements and development both in the short and long term, whether having positive or negative outcomes, is anything but simple and the traditional habit of labelling one sleeping arrangement as being superior to another without an awareness of family, social and ethnic context is not only wrong but possibly harmful.
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Infant Arousals During Mother-Infant Bed Sharing: Implications for Infant Sleep and Sudden Infant Death Syndrome Research

Sarah Mosko, Christopher Richard, James McKenna

PEDIATRICS Vol. 100 No. 5 November 1997, pp. 841-849

Abstract

Objective. Normative values for infant sleep architecture have been established exclusively in the solitary sleeping environment. However, most of the world’s cultures practice some form of parent-infant cosleeping. In addition, no previous polysomnographic studies in infants examined the frequency of electroencephalogram (EEG) arousals. This is the first study to assess (a) EEG arousals in infants and their relationship to sleep stages; (b) the impact on arousals of mother-infant bed sharing; and (c) the temporal overlap of infant with maternal arousals during bed sharing.

Methodology. Three nights of polysomnography were performed in 35 breastfeeding mother-infant pairs when the infants were 11 to 15 weeks old.
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