Belfast Telegraph

Monday 29 December 2014

Doctors must be clear over evolving advice on cot deaths

Cot risks: Parents feel at fault
Cot risks: Parents feel at fault

So, the lives of 120 babies would be saved each year if only heedless, careless parents listened to those decisive, consistent medical experts and stopped taking their babies to bed with them?

Okay, so I've put in the angry, sarcastic adjectives, but it feels like that's the basic thrust of the news about cot death. Very little mention has been made of just who it was who advised the parents to sleep with their babies in the first place – none other than the medical profession.

Few people are more vulnerable to expert advice than anxious new parents – especially mothers. Of course, they listen to and do what doctors, nurses, midwives, health visitors and the rest tell them is best. They are embarking on life's most challenging task and it's learn-on-the-job. There is no training.

In the 1970s, when my children were born, cot death was terrifyingly common. Everybody knew a family who had lost a child to cot death.

As young mothers, we were firmly instructed to put our infants on their tummies to sleep. They told us that a child on its back could, if sick, choke on its own vomit.

In fact, there was, as later research showed, a strong correlation between babies sleeping face down and cot death. By the 1990s, parents were told never to put a child to sleep belly-down.

When I visited a new mother in a maternity wing in 1997, I was struck by the dictatorial tone of notices around the ward. There was no acknowledgement that advice had changed dramatically in the light of new information.

And now the same thing has happened again. My generation was told never to take a baby to bed in case you fell asleep and smothered him, or her.

Then, about 15 years ago, the medical people started to advise parents that sleeping with a baby is sensible because the infant can feed easily almost at will without much disturbing the mother.

New research from the London School of Hygiene and Tropical Medicine has shown that, actually, 40% of the UK's 300 annual cot deaths would be prevented if babies slept in cots next to the mother's bed.

Of course, medical research is ongoing. Nobody knows all the answers. That's the nature of knowledge and its acquisition.

Lives are saved every day as a result of new understanding about the causes of avoidable death and, thank goodness, 'only' 300 babies a year now die in the UK in their cots.

But it's hard to forgive the 1984-style arrogance when, suddenly, advice changes dramatically and frightened parents are made to feel as if they are at fault because they are simply doing what they were told the week before last.

Yes, I know that the medical profession is fearful of litigation, but it would be much easier to respect official advice if only more were humble enough openly to acknowledge that they, like the rest of us, are fallible.

No-one is wrong. We are all moving forward together in trying to stamp out devastating horrors such as cot death.

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