Breastfeeding, SIDS & Guilt - At what cost?

Many parents are surprised to learn that not breastfeeding has been linked with increased rates of SIDS.  Despite it's importance, it is often never mentioned at antenatal classes or by Health Professionals; so one day I decided to ask one why.

"Tell mothers not breastfeeding makes their baby more likely to die?" she stuttered red faced, although I had suggested something earth shattering.  Heavens no we couldn't tell them that! Imagine how guilty they would feel if they decided not to breastfeed!  And me?  I was firmly moved mentally into the "breastfeeding loony" camp.

And there it is again, guilt - the new black.  The guilt culture extends to more areas of parenting than any poor unsuspecting new parent could begin to imagine, but at what cost?

A meta analysis of 23 SIDS studies revealed 19 studies found not breastfeeding increased the risk of SIDS. The combined analysis indicated that artificially-fed infants were twice as likely to die than their breastfed peers. 

A recent German study found that artificial feeding at one month, was associated with double the risk of SIDS. Artificial feeding and only partial breastfeeding in the month prior to death were also linked with increased incidence. In this study 73% of SIDS deaths were before 6 months and being artificially fed doubled the incidence at all ages throughout infancy.

The link between feeding method and SIDS is no secret - in fact it's recognised by FSID.

How breastfeeding is protective is still topic of hot debate, as the cause of SIDS is multifactorial; studies have been adjusted to rule out social, economic and cultural differences, yet the link is clear.  Research suggests that infection, combined with immature brain stem (in the form of periodic breathing) at a critical time of development, may cause the major proportion of SIDS cases.

As artificially fed infants have no passive immunity from their mother, they are far more likely to suffer infection and experience slower maturity of the central nervous system.  They also sleep more deeply, with a study finding that during the active sleep phase, breastfed infants are significantly more rousable than formula-fed infants at two to three  months of age.  Dr Brian Palmer D.D.S has found a link between SIDS and suboptimal development of the facial muscles and jaw, caused by the unnatural sucking action from a bottle.  Breastfeeding encourages a wide palate and so an unobstructed airway, which means protection may be as much down to the act of breastfeeding as breastmilk itself.

It could even be down to a totally different mechanism altogether!  Evidence has shown that when breastfeeding mothers safely share their sleeping space with their infant (without a barrier) the mum displays protective behaviours  But because co-sleeping guidelines would get far too tricky if they had to explain "safe co-sleeping" and "only for breastfeeding mother"s and so on.  They fail to explain all this to mum in the "don't cosleep" schpiel.  Which given co-sleeping is closely linked to improved breastfeeding rates, which in turn lowers risk of SIDS - is really rather ironic.

But whilst everyone was told "place baby on backs at the foot of the crib, use appropriate bedding and ensure the room temperature remains at 18 degrees", how many got the lowdown on the links with infant feeding?

When there is evidence suggesting more than a casual link, and no unbiased evidence suggesting otherwise - why is this?

Over the years I've started wondering about guilt, and I think for the most part our emotions are our own, there are few occasions when someone can make you feel something.   What I mean is, take this article - a first time pregnant mum might think wow, didn't know that.  A breastfeeding mum might feel wow, glad I stuck with it and be reassured.  A mum who has felt she has little choice but to stop breastfeeding might feel guilty.  But which of those did I cause? 

Can passing evidence based accurate information cause anything, or is it far more likely that it's down to the person receiving the information?  Lets take the non breastfeeding mum again - within that group you might have someone who knew all this, decided to formula feed anyway (ie decided for them the risks were still comparatively small, and compared to their current situation were a better option) or you might have the mum that didn't know and wished she had as she had decided not to bother trying, because she had been sold the concept formula was "just as good".  Or you might have the mum who tried everything and the support failed her, who instead of blaming those who should have helped her, fruitlessly blames herself....another in an identical situation might rightly blame those who were supposed to inform her, and not blame herself for something she didn't even know!  It all depends on the person receiving the information...

For me the guilt culture has gone too far when it stops us giving mums the information they need to make their "choice" - the thing so many claim is a mother's right.  What about a mother's right to the facts?  Isn't it insulting to mothers to assume all would feel the same emotion upon receiving the facts?  Perhaps they could ask the mother whether she would like to know the facts as we best understand them, or the airy fairy version they think you can handle?  At what point will someone take legal action because information was withheld from them?

As we always say "an informed choice is a happy choice."

Here is the link to the original blog.

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Aug. 16, 2010 at 6:17 PM

I don't believe this and it is sad that anyone who has lost a child to SIDS and didn't BF that reads this might blames themselves. I honestly think they do NOT know 100% why babys pass away from SIDS. I have a nephew I never met that passed away from SIDS. I never met him cause he was my sil's son and I didn't know my husband then. He passed away at 18 months.

I don't believe that all these things below will reduce the risks. SIDS is something no one is 100% sure on... It can reduce the risks but not stop them so I don't think they know for sure.

The National Institute of Child Health and Human Development’s "Back to Sleep" campaign has developed information for parents about ways to reduce the risk of SIDS.

Always place babies on their backs to sleep—Babies who sleep on their backs are less likely to die of SIDS than babies who sleep on their stomachs or sides. Placing your baby on his or her back to sleep is the number one way to reduce the risk of SIDS. Photo of sleeping baby on her back.

Use the back sleep position every time—Babies who usually sleep on their backs but who are then placed on their stomachs, like for a nap, are at very high risk for SIDS. So it is important for babies to sleep on their backs every time, for naps and at night.

Place your baby on a firm sleep surface, such as a safety-approved* crib mattress covered with a fitted sheet—Never place a baby to sleep on a pillow, quilt, sheepskin, or other soft surface.

Keep soft objects, toys, and loose bedding out of your baby’s sleep area—Don’t use pillows, blankets, quilts, sheepskins, or pillow-like bumpers in your baby’s sleep area. Keep all items away from the baby’s face.

Avoid letting your baby overheat during sleep—Dress your baby in light sleep clothing and keep the room at a temperature that is comfortable for an adult.

Crib safety information from the Consumer Product Safety Commission.

What does a safe sleep environment look like?

To learn more about safe sleep environment and reducing the risk of SIDS, check out the NICHD publication Reduce the Risk of SIDS: What does a safe sleep environment look like?
PDF logo PDF 194 KB

What groups are most at risk for SIDS?

Babies who are placed to sleep on their stomachs or sides are at higher risk for SIDS than babies who are placed on their backs to sleep. African-American babies are more than two times as likely to die of SIDS as caucasian babies. American-Indian/Alaska Native babies are nearly three times as likely to die of SIDS as caucasian babies.

Will my baby develop flat spots on his or her head from back sleeping?

For the most part, flat spots on a baby’s head go away a few months after the baby learns to sit up. There are other ways to reduce the chance that flat spots will develop on your baby’s head, such as providing "tummy time" when your baby is awake and someone is watching. "Tummy time" not only helps prevent flat spots, but it also helps a baby’s head, neck, and shoulder muscles get stronger.

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Aug. 16, 2010 at 6:25 PM

I love it! I wrote a blog post about SIDS once, about how I wasn't entirely sure that the "Back to Sleep" campaign was the sole contributor. Check it out if you're interested:



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Aug. 16, 2010 at 8:24 PM

I have to say, my friend lost her 4 month old daughter to SIDS about 8 years ago. We talked alot, and very in depth about it. She told me she "would have rather known, and been aware, neurotic and felt guilt, than have been thrown under the bus like I was, not realizing what I did, and didn't do, could be a factor in SIDS". She hated that no one ever mentioned it, so she didn't even know her daughter COULD die from SIDS.

I think it is EXTREMELY important for ALL information, including the fact that breastfeeding reduces the chances of SIDS, should be passed on to every mother, new and old alike.

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Aug. 16, 2010 at 8:48 PM

Breastfeeding is proven to reduce the risk of SIDS. This is very important information to get out. Thank you for sharing!

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Aug. 16, 2010 at 9:01 PM

bow down

Yes, it has been proven that breastfeeding reduces the risk of SIDS. Thanks for sharing this great information!! 


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Aug. 16, 2010 at 9:23 PM

This is a great post!

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Aug. 16, 2010 at 9:58 PM

Awesome post! Thanks for sharing. I hope to pass this along to my friend who is pregnant and is planning on pumping and bottle feeding. Though, she isn't co sleeping, I still believe that her baby is at risk for SIDS, just like every other baby. Hopefully this will change her mind. 

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Aug. 16, 2010 at 10:16 PM

i breastfed my daughter for about the first 3 weeks of her life..and i had to switch to formula due to her acting like she wasnt getting enough to eat.. she passed away at almost 5 mos old.. she was also half native american.. i have done alot of lookin into sids since she has passed away and they do you not know for sure what causes sids!! so all of you can sit there and try saying it is proven this and that..but i know for a fact no matter what i did with my daughter when it comes to feeding her she still would not be here!!! once a baby is "programed"  for sids the baby is programmed for it!!!no matter what you do it will happen!!!!

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Aug. 17, 2010 at 1:17 AM

While I agree that information shold be shared, I feel this article was patronizing.  BF has many benefits and this may well be one of them but it is not the only thing nor the most important thing that can prevent SIDS portraying as so is just wallowing in your own pride.  There are so many reasons while people decide not to breastfeed and it seems like posts like these never really give the benefit of the doubt.  I did not BF my babies for more than a week.  I believe my decision to do so protected them from SIDS much more than continuing to BF would have.  To someone who is thinking along the lines of this post this may seem contrary.  That can be a wake up call because I am a pretty, educated, thoughtful, caring mom who only wants the best for her children and I made a very thoughtful sound decision not to BF,  Who knew(sarcasm)?

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Aug. 17, 2010 at 2:30 AM

This is great information.  Thank you for placing it here for us to see. 

AT some point people will need to realize that no matter how good of a reason for not choosing to breastfeed my be, it does not excuse your child from the increased risk and consequences.  Some moms have no choice, and that's were doc should be presenting the option of prescribed donors milk. 

This information is not to degrade or point fingers at mothers.  I do not feel that it is them who has failed.  Most moms, even those who have breastfed, are unaware of the benefits.  We have a wealth of information at our fingertips via the Internet, but 20 yrs ago, that was a different story.  Medical science made faulty assumptions about women's bodies, and through misinformation created generations dependant on formula companies.

We do live in a societly were we do whatever we can to accomadate a persons choices, regardless of the risks its poses to our children.  IF the information presented here was in regards to car seats, mothers would be ranting about the benefits of ERF, to prevent injury or death in the event of a car crash.   Presenting information such as this is not to patronize, but to empower woman with education so that their decision to breastfeed, or formula feed, was based on information, and not a cultural trend.

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