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Dr Jim Sprott On US Cot Death Research

21 February 2006

Sprott Tells Parents: Ignore Plunket And Ministry Of Health Advice On Cot Death Prevention

Cot death expert Dr Jim Sprott is advising parents to ignore cot death prevention advice issued by Plunket and the Ministry of Health.

His advice follows news yesterday that in the wake of a US study claiming that use of a dummy reduces cot death risk by more than 90%, New Zealand health officials are considering whether to add dummies to their cot death prevention advice.

The US researchers suggest that dummies may assist in keeping babies' airways open if they get into a face-down position in their cots or become covered by bedding.

According to a TVNZ report, Plunket's General Manager of Clinical Services has described the US research as "particularly important knowledge".

"Certainly dummy use is associated with reduced cot death risk," stated Dr Sprott, "but not for the reason suggested by the US researchers. The reduced risk comes about because in order to sleep a baby with a dummy, a mother will often use the face-up sleeping position so the dummy stays in place. And face-up sleeping reduces the risk of cot death, because the gases which cause cot death are more dense than air and babies sleeping face-up are less likely to ingest them."

The US study does not mean that New Zealand parents should be advised to use dummies for cot death prevention, stated Dr Sprott. "Any notion that increased dummy use would reduce the New Zealand cot death rate is incorrect. Face-up sleeping is already so widespread in New Zealand that adding dummies would not affect the cot death rate."

Instead, Dr Sprott considers that telling parents to use dummies could cause needless parental anxiety. "To those parents who feel anxious because their babies won't sleep face-up, and those who feel anxious that face-up sleeping might give their babies flat heads, a new group could be added: those who are anxious because they don't wish to use a dummy or their baby won't accept one."

Parents should ignore the advice of Plunket and the Ministry of Health on cot death prevention, stated Dr Sprott.

Dr Sprott advises parents to wrap babies' mattresses in accordance with a specified protocol, and sleep the baby in the alternating side-sleeping position. "That way cot death is prevented, and the baby doesn't develop a flat head," he stated. "And whether or not a dummy is used is irrelevant."

Mattress-wrapping for cot death prevention has been publicised in New Zealand since late 1994. Since that time the New Zealand nationwide cot death rate has fallen by 62% and the Pakeha ethnic rate has fallen by around 76%. There has been no reported cot death on a "wrapped mattress".

Dr Sprott describes Plunket's response to the US research regarding dummies as ill-considered. "New Zealand babycare advisers need to be careful when it comes to overseas cot death research," he stated. "In particular, US cot death research can be highly contradictory and inconsistent.

"Last week a US research study claimed that cot death is caused by a genetic brain defect resulting in a non-function in the baby's breathing. This week a US study is claiming that dummies will prevent 90% of cot deaths. Yet these claims are patently incompatible: using a dummy would obviously have no effect on a brain defect which caused a non-function."


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