Research has shown that the risk of cot death can be reduced. Let us know on Facebook or Twitter. Was it worth it?
Pinterest Prof Peter Fleming, whose research in the s was crucial to the reduction of Sids death rates. When he found that Bristol offered no counselling or support for families whose baby had died unexpectedly, he began to offer it himself.
He saw the families in the emergency department and later in their homes and told them what was known — and how much was unknown — about what was then still widely called cot death. They were made to feel very guilty. I wanted to get support, and information, to these families. When it was called cot death it was considered primarily a social problem, a parental failure that still carried a hint of the most unnatural of crimes, infanticide.
The Guardian view on a public health triumph: Meanwhile, bereaved parents were organising too. It recently rebranded itself as The Lullaby Trust , because it believed its previous name was too austere and off-putting.
A decade later there was an international federation of similar organisations. In , Fleming, working closely with the trust, set up the Avon infant mortality programme. But in , with two colleagues, I started a temperature and infection study, and we did include the sleeping position, because scientists in the Netherlands and Australia had no data but they did have a lot of careful observation that made them think it was important.
There were no immediately definitive results. Very few things are ever black and white. It is rarely clear-cut. This is why the maths matters.
You have to see whether a small change can make a difference. He grew up in Medway in Kent, where his father worked in the naval dockyard and his mother in the office of a local factory. For his study, Fleming and his team talked to the bereaved families as soon as possible after the death, to gather information about the baby and the family, what they normally did, what might have been different — all the variables that might have influenced the outcome.
He promised the families that they would know the results of his research before it was published: It is a collaborative effort. I want to work with people, not instruct them. If a GP got a call about a dead or an unresponsive baby, their next call would be to Fleming.
The control group were identified by asking the health visitor for the details of the two babies next on their list. Yet I still miss him Giles Fraser Read more The team was confident that their population-based study, with a control group drawn from the same population, at the same time, was as close as possible to achieving the holy grail of true comparability. Yet despite their confidence in the robustness of their data, presenting the preliminary results at the first ever meeting of the International Society for the Prevention and Investigation of Perinatal and Infant Deaths in March was a nerve-racking moment.
It was like being asked to believe two impossible things before breakfast. Here was a non-medical intervention that could, for no clear reason, stop babies dying of a syndrome that was also unexplained. But Fleming believed it himself. And when he went back to do a bigger study in Bristol, he found that health professionals who already knew of his findings were advising all new mothers to put their babies on their back to sleep. They want things done properly — randomised control trials and all that sort of thing.
Fleming published his paper in the British Medical Journal and went back to do more research.
Soon, a New Zealand study [ pdf download ] produced similar findings. The quest now was for evidence with which to argue for a new public health campaign. Unable to conduct a study with a bigger sample in Bristol because newborns were no longer being put to sleep on their fronts as a result of his first findings, instead Fleming found himself conducting a self-initiated, population-wide observational study of newborn babies sleeping on their backs.
As his first study predicted, the number of Sids deaths fell from around one a week to less than one a month, and then to just three a year.
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