Duration of Breastfeeding in Reducing the Risk of SIDS

Author:
Jessica Tomaszewski, MD
Primary Care Pediatrics, Nemours Children’s Health System, Wilmington, Delaware

Citation:
Tomaszewski J. Duration of breastfeeding in reducing the risk of SIDS [published online November 28, 2017]. Consultant360.

The results of a new study show that breastfeeding for at least 2 months reduces the risk of sudden infant death syndrome (SIDS) by half.

Previous research has shown that breastfeeding confers a protective effect against SIDS—an effect that is stronger with exclusive breastfeeding. However, no studies have been conducted to determine the specific duration of breastfeeding that is required to see such benefits.

To investigate this association further, Dr John M. D. Thompson and colleagues analyzed 2267 SIDS cases and 6837 control infants from 8 SIDS case-control studies that included breastfeeding data. Individual study analysis and pooled analyses were performed, focusing on various factors such as infant sleep position, maternal prenatal smoking, pacifier use, and more.

In multivariable pooled analysis, breastfeeding for less than 2 months was not protective (adjusted odds ratio [aOR], 0.91; 95% CI, 0.68-1.22). Any breastfeeding, whether exclusive or inclusive, for 2 months or longer did have a protective effect, which increased with longer duration (aOR at 2-4 months, 0.60; 95% CI, 0.44-0.82. aOR at 4-6 months, 0.40; 95% CI, 0.26-0.63. aOR at >6 months, 0.36; 95% CI, 0.22-0.61).

Interestingly, the stratified and pooled analyses of the univariable effects of exclusive breastfeeding did show a protective effect with a duration of less than 2 months, but when these data were examined in the multivariable analysis for potential confounders, no statistically significant protective effect was observed (aOR, 0.82; 95% CI, 0.59-1.14).

The major limitation of this study comes from the basic nature of a meta-analysis in that the data about the variables studied were all collected in slightly different ways. This made it challenging or at times impossible to examine all of the confounders in the study.

The mechanism by which breastfeeding offers a protective effect against SIDS is not fully understood, but this study shows that at least 2 months of breastfeeding decreases the risk almost in half. This study also reassures families that partial or inclusive breastfeeding gives children this advantage against SIDS. Concerted efforts by health care providers should focus on the maintenance of the breastfeeding relationship to help families reach that crucial 2-month period and beyond.

Reference:

Thompson JMD, Tanabe K, Moon RY, et al. Duration of breastfeeding and risk of SIDS: an individual participant data meta-analysis [published online October 30, 2017]. Pediatrics. doi:10.1542/peds.2017-1324.