The Foundation for the Study of Infant Deaths (FSID) announces its latest advice that breastfeeding your baby can reduce the risk of cot death. The advice, released to launch FSID's cot death awareness drive Save a Baby Month which runs from 1-31 May, is based on research which showed that babies who were at least partly breastfed were one-third less likely to die as a cot death than babies who were never breastfed (1).

FSID Director, Joyce Epstein, says: "There are so many reasons why breast is best, but there are none that can be stronger than potentially saving your child's life. We encourage every new mum to breastfeed."

Angela Griffin, FSID's celebrity patron, breastfed both of her daughters and says: "Realising you're the only person in the world who can give your child exactly what they need is such a great feeling."

Sally Inch, infant feeding specialist at Oxford Radcliffe NHS Trust, says: "The more we discover about breastfeeding, the more important it becomes. Not only does breastfeeding provide the baby with all the nutrients needed, in a form that cannot be replicated artificially, but a baby who is breastfed is at reduced risk of infections (particularly gut, ear, chest and urine infections) and less likely to be hospitalised as a result." (2)

Any breastfeeding, even a few days, is better than none, but most authorities including the Department of Health now recommend that babies be exclusively breastfed for at least six months and that breastfeeding is continued, with the addition of appropriate weaning foods, for as long as the mother and baby want.

If you need breastfeeding advice or support, please contact your midwife, health visitor, local baby café or peer supporter, or ring the National Breastfeeding Helpline on 0844 20 909 20.

Notes

Go to http://www.fsid.org.uk/breastfeeding.html for more information about cot death and breastfeeding.

Research background

(1) Several published studies have found that breastfeeding protects against the risk of Sudden Infant Death Syndrome (SIDS). One meta-analysis of 23 reports (i) concluded that formula fed infants were more than twice as likely to die from SIDS than breast fed infants with an adjusted odds ratio of 2.11 (95% CI 1.66-2.68).

Recently the USA Agency for Healthcare Research and Quality (AHRQ) performed a more stringent meta-analysis (ii) incorporating 6 studies in which SIDS was rigorously defined and the duration of breastfeeding specified. They found that ever breastfeeding reduced the risk of SIDS compared with never breastfeeding, with an adjusted odds ratio of 0.64 (95% CI 0.51-0.81). It is therefore clear that breastfeeding should be recommended as a protective measure against SIDS, in addition to the other well known reasons for promoting the practice.

(2) Breastfeeding and hospitalization for diarrheal and respiratory infection: The study (iii) was a population-based survey (sweep 1 of the United Kingdom Millennium Cohort Study). Data on infant feeding, infant health, and a range of confounding factors were available for 15,890 healthy, singleton, term infants who were born in 2000-2002. The main outcome measures were parental report of hospitalization for diarrhea and lower respiratory tract infection in the first 8 months after birth.

Seventy percent of infants were breastfed (ever), 34% received breast milk for at least 4 months, and 1.2% were exclusively breastfed for at least 6 months. By 8 months of age, 12% of infants had been hospitalized (1.1% for diarrhea and 3.2% for lower respiratory tract infection). Data analyzed by month of age, with adjustment for confounders, show that exclusive breastfeeding, compared with not breastfeeding, protects against hospitalization for diarrhea and lower respiratory tract infection. The effect of partial breastfeeding is weaker.

Population-attributable fractions suggest that an estimated 53% of diarrhea hospitalizations could have been prevented each month by exclusive breastfeeding and 31% by partial breastfeeding. Similarly, 27% of lower respiratory tract infection hospitalizations could have been prevented each month by exclusive breastfeeding and 25% by partial breastfeeding. The protective effect of breastfeeding for these outcomes wears off soon after breastfeeding cessation.

Research papers

(i) McVea KL, Turner PD, Peppler DK. The role of breastfeeding in sudden infant death syndrome. J Hum Lact. 2000; 16: 13-20.

(ii) Ip S, Chung M, Raman G, Chew P, Magula N, DeVine D,et al. Breastfeeding and maternal and infant health outcomes in developed countries. Evidence report/technology assessment No. 153 (prepared by Tufts-New England Medical Center Evidence-based Practice Center, under contract No. 290-02-0022) Agency for Healthcare Research and Quality; 2007. p. 1-186. http://www.ahrq.gov/clinic/tp/brfouttp.htm

(iii) Quigley MA, Kelly YJ and Sacker A. Breastfeeding and Hospitalization for Diarrheal and Respiratory Infection in the United Kingdom Millennium Cohort Study, Pediatrics 2007;119;e837-e842 http://www.pediatrics.org/cgi/content/full/119/4/e837

About FSID

The Foundation for the Study of Infant Deaths is the UK's leading baby charity working to prevent sudden deaths and promote infant health. FSID funds research, supports bereaved families, promotes baby care advice, and works to improve investigations when a baby dies. FSID runs a Helpline (020 7233 2090) for parents and professionals seeking advice on safe baby care. The Helpline also supports bereaved families.

Foundation for the Study of Infant Deaths