Duration of Breastfeeding and Risk of SIDS: An Individual Participant Data Meta-analysis

John M.D. Thompson, Kawai Tanabe, Rachel Y. Moon, Edwin A. Mitchell, Cliona McGarvey, David Tappin, Peter S. Blair, Fern R. Hauck. Pediatrics Vol. 140 No. 5 November 01, 2017

CONTEXT: Sudden infant death syndrome (SIDS) is a leading cause of postneonatal infant mortality. Our previous meta-analyses showed that any breastfeeding is protective against SIDS with exclusive breastfeeding conferring a stronger effect.The duration of breastfeeding required to confer a protective effect is unknown.

OBJECTIVE: To assess the associations between breastfeeding duration and SIDS.

DATA SOURCES: Individual-level data from 8 case-control studies.

STUDY SELECTION: Case-control SIDS studies with breastfeeding data.

DATA EXTRACTION: Breastfeeding variables, demographic factors, and other potential confounders were identified. Individual-study and pooled analyses were performed.

RESULTS: A total of 2267 SIDS cases and 6837 control infants were included. In multivariable pooled analysis, breastfeeding for <2 months was not protective (adjusted odds ratio [aOR]: 0.91, 95% confidence interval [CI]: 0.68–1.22). Any breastfeeding ≥2 months was protective, with greater protection seen with increased duration (2–4 months: aOR: 0.60, 95% CI: 0.44–0.82; 4–6 months: aOR: 0.40, 95% CI: 0.26–0.63; and >6 months: aOR: 0.36, 95% CI: 0.22–0.61). Although exclusive breastfeeding for <2 months was not protective (aOR: 0.82, 95% CI: 0.59–1.14), longer periods were protective (2–4 months: aOR: 0.61, 95% CI: 0.42–0.87; 4–6 months: aOR: 0.46, 95% CI: 0.29–0.74).

LIMITATIONS: The variables collected in each study varied slightly, limiting our ability to include all studies in the analysis and control for all confounders.

CONCLUSIONS: Breastfeeding duration of at least 2 months was associated with half the risk of SIDS. Breastfeeding does not need to be exclusive to confer this protection.

 

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Breastfeeding and vitamin D

The UK Royal College of Paediatrics  and Child Health guidance on breastfeeding has been warmly welcomed in both the medical and lay spheres | Archives of Disease in Childhood

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Breastfeeding has undoubted benefits and should be singularly promoted and encouraged. However, in their position statement, the college omits to mention the importance of vitamin D supplementation for breastfed children and lactating women in the UK. This is an important measure to support women and children and ensure their health during this period. Hypovitaminosis D is exceedingly common in the UK with rates as high as 20% for adults and 8%–24% for children depending on gender and age

Full reference: Uzoigwe, C.E. & Ali, O. (2017) Breastfeeding and vitamin D. Archives of Disease in Childhood Published Online First: 14 September 2017.

Royal College of Paediatrics and Child Health: Position Statement on breastfeeding in the UK

Royal College of Paediatrics and Child Health, August 2017

This reportBaby's Healthcare highlights that the UK has one of the lowest rates of breastfeeding in Europe, and only 34% of babies are receiving some breast milk at 6 months. Recommendations include development of a national strategy to change negative societal attitudes to breastfeeding

Skin-to-skin contact improves breastfeeding of healthy babies

Early skin-to-skin contact improves breastfeeding of healthy full-term babies. | National Institute for Health Research

Skin-to-skin contact is the direct contact between a naked baby and the mother’s bare chest. It can occur before or after the baby is cleaned following birth.

This review found that about a quarter more women who have this contact with their babies are still breastfeeding at one to four months after birth compared with those who don’t. The evidence that skin-to-skin contact may also help to stabilise the baby’s heart and breathing rates and blood sugar levels after birth was based on fewer trials and less strong.

These findings support UK good practice to promote immediate skin-to-skin contact after birth to improve breastfeeding rates. It remains one of the important steps recommended by NICE and UNICEF aimed at improving the low rates of breastfeeding in the UK. Other measures include providing a favourable environment, support and education.

Full reference: Moore ER, Bergman N, Anderson GC, Medley N. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev. 2016;11:CD003519.

New resource to reduce barriers to breastfeeding

Public Health England (PHE) and NHS England have conducted a survey which found that of the three-quarters of the new mums who start breastfeeding, only 40% were still breastfeeding two months later.

To help dispel some of the concerns women have about breastfeeding, PHE’s Start4 life programme has launched a new interactive Breastfeeding Friend (BFF) ChatBot. The BFF can be accessed through Facebook messenger and provides personal support for mothers at any time of the day or night. The ChatBot works as a live chat tool which is able to respond to questions about breastfeeding posed by the user.

Read more on this at Public Health England

Early Solid Food Introduction: Role in Food Allergy Prevention and Implications for Breastfeeding

Abrams, E.M. et al. The Journal of Pediatrics | Published online: 3 March 2017

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Food allergy is estimated to affect 2%-10% of the population worldwide.1 The US Centers for Disease Control and Prevention reported an increase in food allergy prevalence in the US from 3.4% to 5.1% between 1997 and 2011.2 As a result, the focus in food allergy research has shifted from treatment to prevention

Read the abstract here

Application of the EBP Process: Maximizing Lactation Support with Minimal Education

Ullman, F.M. et al. Journal of Pediatric Nursing. Published online: 26 January 2017

The many advantages to providing breast milk instead of engineered infant formula for both the medically fragile and healthy term infant are well documented (Lawrence & Lawrence, 2016; Mcguire, 2011). Historically, educational efforts within neonatal intensive care units (NICUs) focused on critical diseases and conditions, as well as the highly technological management of fragile neonates. The International push to promote both the value and superiority of breast milk for infant feeding began over 3 decades ago (WHO, 1981).

Read the abstract here