American Academy of Pediatrics picks a fight

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They issued new guidelines for avoiding SIDS that recommends parents not share their bed with infants to decrease the risk for SIDS.

Report from NPR.

I'm sorry, but this stinks. Discouraging a practice widely understood to be good for the child on the basis of vague suggestions that it may increase the risk of SIDS is silly. This from the same people who have had parents flipping over their infants like pancakes from year to year as the "evidence" that certain sleeping positions cause SIDS changes.

Rob at Mirror of Justice has more:

...I guess my subsidiarity-driven skepticism is twofold. First, even though the AAP policy does not amount to legal coercion, the group's stature and the bright-line confidence with which they paint the issue as a non-negotiable element of baby safety may effectively negate the decision-making authority of many parents. Second, while 2000 SIDS deaths a year are a tragedy, I'm not sure the possibility of harm warrants the absolute condemnation of co-sleeping and nursing at bedtime, both of which function as fundamental building blocks of many parent-child relationships. That said, would my opinion change if 10,000 babies died each year from SIDS and the deaths were directly linked to co-sleeping? 50,000 deaths? At what point does the harm warrant AAP's condemnation? At what point would it warrant state intervention?

I don't have easy answers to these questions, but I do know that when groups like AAP pronounce a one-size-fits-all approach to intimate family practices, it's not just a matter of public health; it's also a question of subsidiarity.


UPDATE: has a post about this and some good comments:


Anonymous because I AM a member of the dreaded AAP. (But rest assured, I also am a parent of massive amounts of children and therefore have developed some common sense.)

There was a dramatic decrease in deaths from SIDS when sleeping on backs was recommended. First in Europe (where patients may be more compliant) then in America when the word got out. I do think the no co-bedding recommendation is based on much weaker evidence. The co bedding deaths did have a number who were suffocated by a very asleep parent. Sometimes that parent may be presumed to have been drunk or on drugs. Please do your own careful study before deciding to follow/ignore the recomendations.

The AAP is not perfect (duh). Their policy statements are made by committees. I do not see an evil conspiracy behind this policy. Of course they are sometimes wrong and often misled by many of the same cultural ideas that mislead many Americans.


Since we don't actually know what causes SIDS, is it safe to say that the causal link (as opposed to a statistical correlation) between bed-sleeping and SIDS is unknown? So in effect, what the AAP is recommending is "don't do X, because in our sample more children whose parents did X died from SIDS than children whose parents did not do X"?

That would be a lot different from saying, "don't do X because it CAUSES SIDS." It basically means that we have to trust that the AAP knows exactly what it's doing in terms of what factors it should be controlling for in its study, and what factors it should even be considering in the first place. In a social atmosphere where the incentives are not generally lined up to maximize the well-being of children, this seems to me to significantly decrease the authoritativeness of such a study.

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Hmm... This is upsetting. I gave a talk to Network about the Married Vocation last Monday (Sr. Sarah preceeded me with her vocation story), and one of the things that I mentioned was that there may be reasons that children are afraid of the dark; Padre Pio really did have a monster under his bed, and battled with it every night. So who knows what your children really do see in the middle of the night. It's only the enlightenment philosohpy (and Edison Electric Light) that tells us that darkness is not frightening... Scripture tells us (especially John's Gospel) that there is reason to fear the dark.

And about SIDS: My mother says that one of the problems with people today is that no one actually has lost a child. In our grandparents' generation it was not uncommon for children to die young, and I think people appreciated their children more for it. If you assume that your 2.1 children are all going to live to adulthood, you start taking them for granted, and you expect that their lives should be perfect. Maybe there is no "cure" for SIDS, because babies don't come with an 18-year warranty that says they'll be alive and straight-A students that entire time. (My mother is a grade-school librarian and a little fed up with some of the attitudes from some of the parents).

Excellent point, Brandon. Considering the low rate of SIDS and the non-existence of actual evidence that co-sleeping causes SIDS, this is going to deprive a lot of families of the benefits of the benefits of the family bed for no purpose.

A commentor at's post on this claims to work for the AAP and admits that there is weak evidence that led them to recommend not using the family bed.

So LLLI has a media release regarding this. You can find it on:

Apparently no one from the AAP section on breastfeeding contributed to this "policy" statement. An excerpt:

Dr. Nancy Wight, President of the Academy of Breastfeeding Medicine, comments that this statement “represents a truly astounding triumph of ethnocentric assumptions over common sense and medical research.� Dr. Wight also states, “There are many physician members of the AAP who do not agree with these recommendations.�


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This page contains a single entry by Papa-Lu published on October 12, 2005 8:13 AM.

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