7 ms·

It’s most definitely the medical establishment. There are similar issues with the “back to sleep” campaign - the risk of SIDS apparently is indeed Slightly low

It’s most definitely the medical establishment. There are similar issues with the “back to sleep” campaign - the risk of SIDS apparently is indeed Slightly lower for babies sleeping on their back, but it is only very slightly lower, and some babies will not sleep on their back unless they are exhausted which causes other non trivial issues. If you actually look into the “back to sleep” study data, it is much, much weaker than proponents imply it is. And yet, every nurse in the hospital kept telling us with religious fervor to not even think of letting the baby fall asleep on their stomach. I was so impressed that I was sure the evidence was overwhelming. But after a week with a hardly sleeping newborn (relatively speaking), I decided to look into it myself. You should to, rather than trust the “experts”. (Or a random internet post like mine, for that matter)

asdfasgasdgasdg 7y ago
I went and looked at a few studies. I did not find the same weakness of evidence that you described. E.g. [1] seems decently strong, to take just one example, although I'd be happy to be shown my error. I do agree that folks should examine the research for themselves, since it's so easy to do once you get practice. I also agree that the research on screen time is extraordinarily weak, and that there isn't really a good reason it has a causal negative impact on children as yet. [1]: https://www.nejm.org/doi/full/10.1056/NEJM199308053290601 https://www.nejm.org/doi/full/10.1056/NEJM199308053290601
- beagle3 7y ago
  I am away from home on phone at this second, and likely have not kept my 10 year old notes, but from memory: Strongest predictor of SIDS was mom’s education level, followed by whether or not she was smoking; stomach/back was third. It’s the strongest one that can (easily) be changed, but something is very fishy about the data. Proponents point out the inverse correlation between sleeping on back and SIDS, starting at the time the recommendations were made, as proof that this is a causal relationship. However, inclusion of time prior to recommendation shows that SIDS is inverse correlated to time; and sleeping on back is positively correlated with time only after recommendations were made. Also, it’s possible data in the last 10 years paints a different picture - but at the time, the case for causal “back to sleep” was very flimsy.
  - asdfasgasdgasdg 7y ago
    Fwiw the study I linked to is case controlled. It does not rely on the population timeseries you mentioned. I don't know the downfalls of case controlled trials, but they are not the same as population timeseries data I am certain.
- beagle3 7y ago
  Can't find my old notes, but found this graph on a quick google: https://www.cdc.gov/sids/data.htm https://www.cdc.gov/sids/data.htm Note the decline in SIDS rate, which starts in 1988 (see e.g. https://pediatrics.aappublications.org/content/105/3/650 https://pediatrics.aappublications.org/content/105/3/650 ), before the recommendation (1992) and "back to sleep" campaign (1994) and though it does track the decline of belly sleeping position, I found in the past graphs of belly sleeping from before 1986 in which it was essentially uncorrelated (or even inverse correlated, if you go back enough - but I don't trust that data). But what's more alarming, is that although there is a continuing decline in SIDS, if you look at the combined SUID (Sudden Unexpected Infant Death) rate, it is essentially flat since 1996 (following a decline from 1990 as visible in the CDC graph, and which goes much farther IIRC). As a data scientist, this hints either (a) change of classification system that was not properly noted, or (b) that there's an underlying reason which causes infant death, which may manifest in different ways depending e.g. on whether the infant sleeps on their belly or their back. As a new parent, this was terrifying (is anything really ever safe?) but also reassuring (the expert advice might technically be true, but seems to be useless). I've found this over and over in many other cases - e.g., statins seem to reduce the change of a heart attack, but do nothing for (or even slightly increase) all cause mortality. Also financial advisers give advice which is technically correct but often useless. Experts rarely qualify the limits of their advice, and that goes double when it is delivered 2nd hand (by nurses or even doctors who never bothered to look at the data but just parrot the official recommendations).
  - asdfasgasdgasdg 7y ago
    > As a data scientist, this hints either (a) change of classification system that was not properly noted, or (b) that there's an underlying reason which causes infant death, which may manifest in different ways depending e.g. on whether the infant sleeps on their belly or their back. As a data scientist, you should really consider more than these two causes. For example, perhaps some other cause of infant deaths was rising during that same period. Or, perhaps there is a change in classification, AND there has been a saturation point reached in terms of how the existing public health initiatives can affect population behaviors. You really just cannot reason from coarse, population level death rates like this to a specific condition or cause. Also: https://www.cdc.gov/sids/data.htm https://www.cdc.gov/sids/data.htm The graph on that site very clearly shows that most of offsetting increase is caused by strangulation and suffocation, not an actual unexplained cause. It appears to be mostly a change in classification. Finally, I really want to point out that we should not expect that a public information campaign would decrease SIDS rates to zero. After all, we can see in this thread that there are still plenty of parents who put their babies to sleep on their tummies. As far as most people know, the data could show that SIDS is 100% caused by prone sleeping and people would still doubt the evidence and put their child to sleep prone. SIDS rates would still not drop to zero, and that would not be evidence against the hypothetical cause.
CalRobert 7y ago
I would be interested in seeing a data set for the risk of SIDS from cosleeping (even on the baby's back) vs. the risk of various other problems from indescribably exhausted parents and a baby who will scream bloody murder for hours and hours and hours and hours if you try to get them to sleep alone in a crib. Also, not to be all hippie but would we not have evolved to want to be held as infants? What species just leaves its young to sleep without physical contact?
- beagle3 7y ago
  You won’t find it, likely. Also, on the recommendation against co-sleeping, I went looking for the actual data. What I found was not SIDS related, but deaths from being squashed, and quite a few of them. I managed to find a few case studies, and they all included a parent under the influence (alcohol mostly in cars I found) and obese parents. Regardless of how true it is, the establishment cannot make a recommendation of the “Co sleeping is ok if you don’t drink, not overweight, and a light sleeper” kind, as many of the people in those categories are in denial of being in those categories. so it will be “co sleeping is always dangerous”.
  - gvjddbnvdrbv 7y ago
    Here in Norway they make that exact recommendation.
    - beagle3 7y ago
      I'm impressed. In the US, such a recommendation would be disastrous and whoever made it would be sued to oblivion .... But then, you nords leave your babies to sleep in the snow which is perfectly healthy but would get you a visit from child protection services in the US (did not hear of such a case, but have heard of cases for letting 9-year old kids walk from school or play basketball without parental supervision)
      - ComputerGuru 7y ago
        ...which inevitably leads to things like this when the two worlds come into contact: https://www.theguardian.com/us-news/2017/nov/26/anette-sorenson-denmark-new-york-baby-left-outside https://www.theguardian.com/us-news/2017/nov/26/anette-soren...
pergadad 7y ago
You seem to have preconceptions that you defend without evidence. There's no 'medical establishment' that purposefully gives bad advice. There are pieces of advice that are later found to turn out wrong, but on average you'll be better off trusting the experts. Don't trust blindly but 'did my own reaearch' is usually codeword for 'read a few mommy blogs'.

asdfasgasdgasdg 7y ago

I went and looked at a few studies. I did not find the same weakness of evidence that you described. E.g. [1] seems decently strong, to take just one example, although I'd be happy to be shown my error. I do agree that folks should examine the research for themselves, since it's so easy to do once you get practice. I also agree that the research on screen time is extraordinarily weak, and that there isn't really a good reason it has a causal negative impact on children as yet. [1]: https://www.nejm.org/doi/full/10.1056/NEJM199308053290601 https://www.nejm.org/doi/full/10.1056/NEJM199308053290601

beagle3 7y ago
I am away from home on phone at this second, and likely have not kept my 10 year old notes, but from memory: Strongest predictor of SIDS was mom’s education level, followed by whether or not she was smoking; stomach/back was third. It’s the strongest one that can (easily) be changed, but something is very fishy about the data. Proponents point out the inverse correlation between sleeping on back and SIDS, starting at the time the recommendations were made, as proof that this is a causal relationship. However, inclusion of time prior to recommendation shows that SIDS is inverse correlated to time; and sleeping on back is positively correlated with time only after recommendations were made. Also, it’s possible data in the last 10 years paints a different picture - but at the time, the case for causal “back to sleep” was very flimsy.
- asdfasgasdgasdg 7y ago
  Fwiw the study I linked to is case controlled. It does not rely on the population timeseries you mentioned. I don't know the downfalls of case controlled trials, but they are not the same as population timeseries data I am certain.
beagle3 7y ago
Can't find my old notes, but found this graph on a quick google: https://www.cdc.gov/sids/data.htm https://www.cdc.gov/sids/data.htm Note the decline in SIDS rate, which starts in 1988 (see e.g. https://pediatrics.aappublications.org/content/105/3/650 https://pediatrics.aappublications.org/content/105/3/650 ), before the recommendation (1992) and "back to sleep" campaign (1994) and though it does track the decline of belly sleeping position, I found in the past graphs of belly sleeping from before 1986 in which it was essentially uncorrelated (or even inverse correlated, if you go back enough - but I don't trust that data). But what's more alarming, is that although there is a continuing decline in SIDS, if you look at the combined SUID (Sudden Unexpected Infant Death) rate, it is essentially flat since 1996 (following a decline from 1990 as visible in the CDC graph, and which goes much farther IIRC). As a data scientist, this hints either (a) change of classification system that was not properly noted, or (b) that there's an underlying reason which causes infant death, which may manifest in different ways depending e.g. on whether the infant sleeps on their belly or their back. As a new parent, this was terrifying (is anything really ever safe?) but also reassuring (the expert advice might technically be true, but seems to be useless). I've found this over and over in many other cases - e.g., statins seem to reduce the change of a heart attack, but do nothing for (or even slightly increase) all cause mortality. Also financial advisers give advice which is technically correct but often useless. Experts rarely qualify the limits of their advice, and that goes double when it is delivered 2nd hand (by nurses or even doctors who never bothered to look at the data but just parrot the official recommendations).
- asdfasgasdgasdg 7y ago
  > As a data scientist, this hints either (a) change of classification system that was not properly noted, or (b) that there's an underlying reason which causes infant death, which may manifest in different ways depending e.g. on whether the infant sleeps on their belly or their back. As a data scientist, you should really consider more than these two causes. For example, perhaps some other cause of infant deaths was rising during that same period. Or, perhaps there is a change in classification, AND there has been a saturation point reached in terms of how the existing public health initiatives can affect population behaviors. You really just cannot reason from coarse, population level death rates like this to a specific condition or cause. Also: https://www.cdc.gov/sids/data.htm https://www.cdc.gov/sids/data.htm The graph on that site very clearly shows that most of offsetting increase is caused by strangulation and suffocation, not an actual unexplained cause. It appears to be mostly a change in classification. Finally, I really want to point out that we should not expect that a public information campaign would decrease SIDS rates to zero. After all, we can see in this thread that there are still plenty of parents who put their babies to sleep on their tummies. As far as most people know, the data could show that SIDS is 100% caused by prone sleeping and people would still doubt the evidence and put their child to sleep prone. SIDS rates would still not drop to zero, and that would not be evidence against the hypothetical cause.

CalRobert 7y ago

I would be interested in seeing a data set for the risk of SIDS from cosleeping (even on the baby's back) vs. the risk of various other problems from indescribably exhausted parents and a baby who will scream bloody murder for hours and hours and hours and hours if you try to get them to sleep alone in a crib. Also, not to be all hippie but would we not have evolved to want to be held as infants? What species just leaves its young to sleep without physical contact?

beagle3 7y ago
You won’t find it, likely. Also, on the recommendation against co-sleeping, I went looking for the actual data. What I found was not SIDS related, but deaths from being squashed, and quite a few of them. I managed to find a few case studies, and they all included a parent under the influence (alcohol mostly in cars I found) and obese parents. Regardless of how true it is, the establishment cannot make a recommendation of the “Co sleeping is ok if you don’t drink, not overweight, and a light sleeper” kind, as many of the people in those categories are in denial of being in those categories. so it will be “co sleeping is always dangerous”.
- gvjddbnvdrbv 7y ago
  Here in Norway they make that exact recommendation.
  - beagle3 7y ago
    I'm impressed. In the US, such a recommendation would be disastrous and whoever made it would be sued to oblivion .... But then, you nords leave your babies to sleep in the snow which is perfectly healthy but would get you a visit from child protection services in the US (did not hear of such a case, but have heard of cases for letting 9-year old kids walk from school or play basketball without parental supervision)
    - ComputerGuru 7y ago
      ...which inevitably leads to things like this when the two worlds come into contact: https://www.theguardian.com/us-news/2017/nov/26/anette-sorenson-denmark-new-york-baby-left-outside https://www.theguardian.com/us-news/2017/nov/26/anette-soren...

pergadad 7y ago

You seem to have preconceptions that you defend without evidence. There's no 'medical establishment' that purposefully gives bad advice. There are pieces of advice that are later found to turn out wrong, but on average you'll be better off trusting the experts. Don't trust blindly but 'did my own reaearch' is usually codeword for 'read a few mommy blogs'.