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For "a shitload" of years infant mortality rate was >15% too. How things used to be is not a good indicator of optimal approaches. A scientifically-minded pers

For "a shitload" of years infant mortality rate was >15% too. How things used to be is not a good indicator of optimal approaches. A scientifically-minded person should not prefer random internet commentators to doctors' when the sole argument proferred by the former is that things used to be a certain way, therefore it's ok.

Domenic_S 14y ago
A scientifically-minded person realizes that doctors people too, with their own biases, agendas, and misinformation. A scientifically-minded person would seek out research to determine the best course of action.
- jamesaguilar 14y ago
  Of course, I would never deny that people should do their own research. Based on my googling, they would probably find that there's a lot of research to back up the doctors' advice, and plenty of anecdotes to back up co-sleeping advocates. Certainly the default position should be that medical professionals know what they are talking about for folks who are not inclined to do the actual research.
  - DanBC 14y ago
    > Certainly the default position should be that medical professionals know what they are talking about In general I agree with you. When you're faced with a large amount of literature from many doctors and specialists in the field you should be able to assume that someone has done the research, and that most of the medical profession agree. It'd be great if more people could read and understand research. But we're stuck with sub-optimal reporting, and people struggling to understand what is really meant by "50% reduction in risk" or "20 times less likely to die". Having said all that: Here's an off topic rant. There are very many examples of doctors not using scientific method but relying on their "expertise".[1] This has caused significant harm to many people. Doctors tend not to talk about stuff that is obvious nonsense, and a lot of their interventions sound plausible. But that's the sneaky danger! We know woo is woo, and if people want to fund research into it good luck to them. But for things that sound plausible? That's exactly when we need good research, because common sense and expertise is fallible. This isn't from doctors trying to deceive people. It's from good clinicians who are not aware of their limits. [1] A great example is "Arthroscopic Knee Surgery No Better Than Placebo Surgery", from about 2000.
- readme 14y ago
  A person with common sense would look at the mass of a baby, and the mass of an adult human. They'd consider their tendencies to sleep heavily, and perhaps conclude that the adult could easily roll over on the baby, and kill it. Or knock it off the edge of the bed, and kill it. Hell, if you do the research there are plenty instances of people punching their sleeping partner in the face during sleep, because they were having a dream (I almost did it once, with my fist landing right next to my girlfriend's head in her pillow. I thought I was having a fist fight, but I was dreaming) So, could a human kill a baby by sleeping with it? I don't know. Could a swallow carry a coconut?
  - Volpe 14y ago
    > A person with common sense would look at the mass of a baby, and the mass of an adult human. Weight/mass has very little to do with it. The baby is never 'crushed' it is 'smothered'. Also when you smother a baby (accidentally or intentional) it squirms. So common sense would indicate the key factor is how heavily you sleep, and how easily could you role onto the baby. If the babies head is the same level as your head, the chances of rolling on top, would require some pretty intense dreaming. Knocking a baby off the bed is very unlikely to kill a baby (they are in a relaxed state, and have flexible bone structure/skull). Research indicates co-sleeping is dangerous when the adult has consumed alcohol or drugs (i.e is sleeping very heavily).
    - readme 14y ago
      I personally would be a horrible co-sleeper. I can set 5 alarms and hear none. I only wake up at the end of a sleep cycle, no matter what's happening around me.
  - Tichy 14y ago
    Incidentally I just read the child rearing chapter of Jared Diamond's latest book about traditional societies. Turns out they all tend to co-sleep, but usually they sleep on the ground or on hard mattresses. As JD points out, it is easier to notice that you have rolled onto your child with a hard mattress.
antirez 14y ago
Probably not because of co-sleeping, many researches think that co-sleeping shows a correlation without actual causality.
- jamesaguilar 14y ago
  That's not how it works. That research shows only correlation does not mean research shows ~causality. Correlation does not imply causation, but it definitely suggests it absent other explanations. It would be hard to study causality in this instance because of medical ethics. You cannot assign a treatment that you believe to be more likely to cause an infant to die, so RCTs are impossible in this domain. http://www.medpagetoday.com/Pediatrics/GeneralPediatrics/16428 http://www.medpagetoday.com/Pediatrics/GeneralPediatrics/164... -- co-sleeping babies are 21.7 times more likely to die from SIDS than non-co-sleeping babies, according to this study. That definitely doesn't prove causality. But the correlation is certainly waggling its eyebrows suggestively in causality's direction.
  - antirez 14y ago
    From the study you cite: "Much of the elevated risk appeared to be attributable to drug and alcohol use among the parents". There are parents that co-sleep because they are disorganized, drunk, and so forth, not even able to put the children in their bed. That's the reason why probably there is no causality.
    - jamesaguilar 14y ago
      Wait, so a large portion of the risk comes from drugs and alcohol, therefore you are going to ignore whatever risks come directly from co-sleeping? Am I misunderstanding your argument?
      - secabeen 14y ago
        I think what he's saying is that co-sleeping provides benefits to his family. While there are risks, it's difficult to discern what the increased risk is in the absence of drugs and alcohol. He feels that there may not be a causal link between SIDS and co-sleeping for families who take co-sleeping seriously and take steps to minimize the known factors in SIDS. It's not a great argument necessarily, but people accept additional risk of injury to their kids all the time if the benefits outweigh the risks.
ambler0 14y ago
I appreciate the sentiment, but I don't think you're reading the parent's post very charitably. They aren't saying, "things used to be a certain way, therefore it's OK." The way I read it, they're suggesting that, if the behavior really killed that many infants, it would be weeded out by the biocultural evolutionary process. If you actually look into the research instead of offloading your opinions to the experts, you'll see that the SIDS research is not well done. As I recall, the work on which this AAP decision was based included sleeping in a couch and sleeping while intoxicated - not exactly best practices. SIDS is basically just a catch-all term for "we don't know what killed the baby".
- jamesaguilar 14y ago
  > if the behavior really killed that many infants, it would be weeded out by the biocultural evolutionary process. That would also be a terrible argument. To name just one example, shaken baby syndrome still exists. > If you actually look into the research instead of offloading your opinions to the experts I've briefly looked into the research, and it seems to mesh pretty well with what the experts are saying. Now you are saying that it "isn't well done". That may be true. But I'm not seeing anything that shows co-sleeping to be equally safe with a crib in the same room. So I have a few possibilities: all the experts are wrong and all the studies that are being done on the issue are defective. Or, SIDS is probably somewhat related to co-sleeping. Unless there is some more evidence that I'm not seeing, I'm going to have to assign the latter a higher probability of being true. Also, let's face it, part of the reason people offload opinions to experts is that experts are trained in analyzing and processing data in their domain to a greater degree than non-experts. There needs to be some pretty compelling evidence to override their views.
  - secabeen 14y ago
    Here's the details from the previously mentioned study on co-sleeping that shows it can be safe or safer than non-co-sleeping: "The proportion of SIDS infants found cosleeping in a bed with parents who had drunk two units or less of alcohol and taken no drugs was no different from that of the random control infants (18% v 16%). If parents who regularly smoked were further excluded, then five of the SIDS infants (6%) were found in this less risky cosleeping environment compared with nine of the random control infants (10%)." http://www.bmj.com/content/339/bmj.b3666 http://www.bmj.com/content/339/bmj.b3666 TLDR: In this study, SIDS was more likely if the co-sleeper had ingested drugs/alcohol, if the sleeping occurred on a couch, or both. Sober co-sleeping on a bed was as safe or safer than not co-sleeping.
wmboy 14y ago
Doctors are usually learned people who have a lot of helpful (and often lifesaving) advice. But the fact is, being a doctor doesn't make you an expert in nutrition or diet, and it certainly doesn't make you an expert in things like co-sleeping. I'm pretty sure the only deaths you'll have these days as a result of co-sleeping is when one of the parents smoked, took drugs or was obese (and usually a combination).
- antirez 14y ago
  I agree with what you say, but in my experience here in Sicily, I'm sure there is also a good percentage of bad faith. In the hospital where Greta (my daughter) was born, and later in doctors waiting rooms, I saw a lot of mothers actively discouraged to breastfeed their children in a way or the other. Because co-sleeping is a very important factor in the success rate of breastfeeding I wonder if there is also some connection with many doctors discouraging it. I know this looks odd but I know first-hand people working inside the hospital and I got internal acknowledges about the fact that hospitals received pressurs in the context of breastfeeding once they started to encourage it too broadly. Artificial milk is a 50$/week tax they are able to get from most newborns for months.
  - jbp 14y ago
    Thats surprising, here in US, atleast at Kaiser hopital highly recommend breast feeding, and they offer lots of free support/classes. And surprisingly they don't recommend cosleeping.
  - wmboy 14y ago
    Hmm perhaps I'm just a cynic, but if health care providers are coming out with such garbage as discouraging breast feeding, it's got to make you wonder whether they want people to be sicker!

Domenic_S 14y ago

A scientifically-minded person realizes that doctors people too, with their own biases, agendas, and misinformation. A scientifically-minded person would seek out research to determine the best course of action.

jamesaguilar 14y ago
Of course, I would never deny that people should do their own research. Based on my googling, they would probably find that there's a lot of research to back up the doctors' advice, and plenty of anecdotes to back up co-sleeping advocates. Certainly the default position should be that medical professionals know what they are talking about for folks who are not inclined to do the actual research.
- DanBC 14y ago
  > Certainly the default position should be that medical professionals know what they are talking about In general I agree with you. When you're faced with a large amount of literature from many doctors and specialists in the field you should be able to assume that someone has done the research, and that most of the medical profession agree. It'd be great if more people could read and understand research. But we're stuck with sub-optimal reporting, and people struggling to understand what is really meant by "50% reduction in risk" or "20 times less likely to die". Having said all that: Here's an off topic rant. There are very many examples of doctors not using scientific method but relying on their "expertise".[1] This has caused significant harm to many people. Doctors tend not to talk about stuff that is obvious nonsense, and a lot of their interventions sound plausible. But that's the sneaky danger! We know woo is woo, and if people want to fund research into it good luck to them. But for things that sound plausible? That's exactly when we need good research, because common sense and expertise is fallible. This isn't from doctors trying to deceive people. It's from good clinicians who are not aware of their limits. [1] A great example is "Arthroscopic Knee Surgery No Better Than Placebo Surgery", from about 2000.
readme 14y ago
A person with common sense would look at the mass of a baby, and the mass of an adult human. They'd consider their tendencies to sleep heavily, and perhaps conclude that the adult could easily roll over on the baby, and kill it. Or knock it off the edge of the bed, and kill it. Hell, if you do the research there are plenty instances of people punching their sleeping partner in the face during sleep, because they were having a dream (I almost did it once, with my fist landing right next to my girlfriend's head in her pillow. I thought I was having a fist fight, but I was dreaming) So, could a human kill a baby by sleeping with it? I don't know. Could a swallow carry a coconut?
- Volpe 14y ago
  > A person with common sense would look at the mass of a baby, and the mass of an adult human. Weight/mass has very little to do with it. The baby is never 'crushed' it is 'smothered'. Also when you smother a baby (accidentally or intentional) it squirms. So common sense would indicate the key factor is how heavily you sleep, and how easily could you role onto the baby. If the babies head is the same level as your head, the chances of rolling on top, would require some pretty intense dreaming. Knocking a baby off the bed is very unlikely to kill a baby (they are in a relaxed state, and have flexible bone structure/skull). Research indicates co-sleeping is dangerous when the adult has consumed alcohol or drugs (i.e is sleeping very heavily).
  - readme 14y ago
    I personally would be a horrible co-sleeper. I can set 5 alarms and hear none. I only wake up at the end of a sleep cycle, no matter what's happening around me.
- Tichy 14y ago
  Incidentally I just read the child rearing chapter of Jared Diamond's latest book about traditional societies. Turns out they all tend to co-sleep, but usually they sleep on the ground or on hard mattresses. As JD points out, it is easier to notice that you have rolled onto your child with a hard mattress.

antirez 14y ago

Probably not because of co-sleeping, many researches think that co-sleeping shows a correlation without actual causality.

jamesaguilar 14y ago
That's not how it works. That research shows only correlation does not mean research shows ~causality. Correlation does not imply causation, but it definitely suggests it absent other explanations. It would be hard to study causality in this instance because of medical ethics. You cannot assign a treatment that you believe to be more likely to cause an infant to die, so RCTs are impossible in this domain. http://www.medpagetoday.com/Pediatrics/GeneralPediatrics/16428 http://www.medpagetoday.com/Pediatrics/GeneralPediatrics/164... -- co-sleeping babies are 21.7 times more likely to die from SIDS than non-co-sleeping babies, according to this study. That definitely doesn't prove causality. But the correlation is certainly waggling its eyebrows suggestively in causality's direction.
- antirez 14y ago
  From the study you cite: "Much of the elevated risk appeared to be attributable to drug and alcohol use among the parents". There are parents that co-sleep because they are disorganized, drunk, and so forth, not even able to put the children in their bed. That's the reason why probably there is no causality.
  - jamesaguilar 14y ago
    Wait, so a large portion of the risk comes from drugs and alcohol, therefore you are going to ignore whatever risks come directly from co-sleeping? Am I misunderstanding your argument?
    - secabeen 14y ago
      I think what he's saying is that co-sleeping provides benefits to his family. While there are risks, it's difficult to discern what the increased risk is in the absence of drugs and alcohol. He feels that there may not be a causal link between SIDS and co-sleeping for families who take co-sleeping seriously and take steps to minimize the known factors in SIDS. It's not a great argument necessarily, but people accept additional risk of injury to their kids all the time if the benefits outweigh the risks.

ambler0 14y ago

I appreciate the sentiment, but I don't think you're reading the parent's post very charitably. They aren't saying, "things used to be a certain way, therefore it's OK." The way I read it, they're suggesting that, if the behavior really killed that many infants, it would be weeded out by the biocultural evolutionary process. If you actually look into the research instead of offloading your opinions to the experts, you'll see that the SIDS research is not well done. As I recall, the work on which this AAP decision was based included sleeping in a couch and sleeping while intoxicated - not exactly best practices. SIDS is basically just a catch-all term for "we don't know what killed the baby".

jamesaguilar 14y ago
> if the behavior really killed that many infants, it would be weeded out by the biocultural evolutionary process. That would also be a terrible argument. To name just one example, shaken baby syndrome still exists. > If you actually look into the research instead of offloading your opinions to the experts I've briefly looked into the research, and it seems to mesh pretty well with what the experts are saying. Now you are saying that it "isn't well done". That may be true. But I'm not seeing anything that shows co-sleeping to be equally safe with a crib in the same room. So I have a few possibilities: all the experts are wrong and all the studies that are being done on the issue are defective. Or, SIDS is probably somewhat related to co-sleeping. Unless there is some more evidence that I'm not seeing, I'm going to have to assign the latter a higher probability of being true. Also, let's face it, part of the reason people offload opinions to experts is that experts are trained in analyzing and processing data in their domain to a greater degree than non-experts. There needs to be some pretty compelling evidence to override their views.
- secabeen 14y ago
  Here's the details from the previously mentioned study on co-sleeping that shows it can be safe or safer than non-co-sleeping: "The proportion of SIDS infants found cosleeping in a bed with parents who had drunk two units or less of alcohol and taken no drugs was no different from that of the random control infants (18% v 16%). If parents who regularly smoked were further excluded, then five of the SIDS infants (6%) were found in this less risky cosleeping environment compared with nine of the random control infants (10%)." http://www.bmj.com/content/339/bmj.b3666 http://www.bmj.com/content/339/bmj.b3666 TLDR: In this study, SIDS was more likely if the co-sleeper had ingested drugs/alcohol, if the sleeping occurred on a couch, or both. Sober co-sleeping on a bed was as safe or safer than not co-sleeping.

wmboy 14y ago

Doctors are usually learned people who have a lot of helpful (and often lifesaving) advice. But the fact is, being a doctor doesn't make you an expert in nutrition or diet, and it certainly doesn't make you an expert in things like co-sleeping. I'm pretty sure the only deaths you'll have these days as a result of co-sleeping is when one of the parents smoked, took drugs or was obese (and usually a combination).

antirez 14y ago
I agree with what you say, but in my experience here in Sicily, I'm sure there is also a good percentage of bad faith. In the hospital where Greta (my daughter) was born, and later in doctors waiting rooms, I saw a lot of mothers actively discouraged to breastfeed their children in a way or the other. Because co-sleeping is a very important factor in the success rate of breastfeeding I wonder if there is also some connection with many doctors discouraging it. I know this looks odd but I know first-hand people working inside the hospital and I got internal acknowledges about the fact that hospitals received pressurs in the context of breastfeeding once they started to encourage it too broadly. Artificial milk is a 50$/week tax they are able to get from most newborns for months.
- jbp 14y ago
  Thats surprising, here in US, atleast at Kaiser hopital highly recommend breast feeding, and they offer lots of free support/classes. And surprisingly they don't recommend cosleeping.
- wmboy 14y ago
  Hmm perhaps I'm just a cynic, but if health care providers are coming out with such garbage as discouraging breast feeding, it's got to make you wonder whether they want people to be sicker!