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Bottle feeding and the sudden infant death syndrome
R E Gilbert1, R E Wigfield, P J Fleming
1Department of Epidemiology and Biostatistics, Institute of Child Health, London.
Insights
Bottle feeding is not a significant independent risk factor for sudden infant death syndrome (SIDS). Other factors like maternal smoking and sleeping position play a larger role in SIDS risk.
Area of Science:
- Pediatrics
- Public Health
- Epidemiology
Background:
- Sudden infant death syndrome (SIDS) remains a significant concern for infant mortality.
- Previous research has explored various risk factors, including feeding methods, but conclusive evidence on bottle feeding's independent role is debated.
Purpose of the Study:
- To investigate the association between bottle feeding and the risk of sudden infant death syndrome (SIDS).
- To determine if bottle feeding is an independent risk factor for SIDS after accounting for other known risk factors.
Main Methods:
- A population-based case-control study was conducted.
- Infants aged 1 week to 1 year who died from SIDS were compared with live controls, matched for age and time.
- Data on feeding practices, sleeping position, maternal smoking, parental employment, and gestational age were collected.
Main Results:
- Crude analysis showed higher odds of SIDS for bottle-fed infants (OR 3.1) compared to breast-fed infants.
- After adjusting for maternal smoking, parental employment, preterm gestation, and sleeping position, the association between bottle feeding and SIDS risk was no longer significant (OR 1.8 for fully bottle-fed, OR 1.2 for mixed feeding).
- Sleeping position partially explained the apparent link, as breast-fed infants were more likely to sleep prone.
Conclusions:
- Bottle feeding is not identified as a significant independent risk factor for sudden infant death syndrome (SIDS).
- Maternal smoking, preterm birth, parental employment, and sleeping position are key factors contributing to the apparent association between bottle feeding and SIDS.
- These findings emphasize the importance of addressing multiple risk factors for SIDS prevention.
Objective:
To determine whether the risk of the sudden infant death syndrome is increased in bottle fed babies.
Design:
Population based case-control study matching for age and time.
Subjects:
All babies aged 1 week to 1 year dying of sudden infant death syndrome during November 1987 to April 1989 or February 1990 to June 1991 and two live controls.
Setting:
Avon and north Somerset.
Main Outcome Measures:
Breast or bottle feeding, sleeping position, maternal smoking, parental employment, and length of gestation.
Results:
Compared with being fully breast fed, the crude odds ratio for sudden infant death in fully bottle fed babies was 3.1 and for mixed breast and bottle fed babies 1.5. These odds ratios fell to 1.8 (95% confidence interval 0.7 to 4.8) and 1.2 (0.5 to 2.7) respectively after maternal smoking, parental employment, preterm gestation, and sleeping position had been adjusted for. Sleeping position partly masked the effect of being bottle fed on sudden infant death as breast fed babies were more likely to have slept prone than bottle fed babies.
Conclusions:
Bottle feeding is not a significant independent risk factor for the sudden infant death syndrome. Patterns of maternal smoking, preterm gestation, and parental employment status account for most of the apparent association with bottle feeding.