Can Bed Sharing Cause Infant Death from SIDS?

It seems like a perfectly natural thing to do - bring your baby into bed with you so you both can get some sleep. It's particularly tempting if your baby wakes up frequently during the night. It keeps from having to get up from your own bed to comfort the child or to nurse, if you're breastfeeding. Parents all over the world practice co-sleeping, either part-time (out of perceived necessity) or all the time. But is it a good idea? Could this practice be putting your child at risk?

In 2011, the American Academy of Pediatrics issued a position statement against co-sleeping.

"Infants may be brought into the bed for feeding or comforting but should be returned to their own crib or bassinet when the parent is ready to return to sleep. Because of the extremely high risk of SIDS and suffocation on couches and armchairs, infants should not be fed on a couch or armchair when there is a high risk that the parent might fall asleep."

While SIDS (sudden infant death) remains unexplained, the risk of suffocation is considered to be high enough that the Academy advises against the practice.


Of course, thousands, if not millions of children have co-slept with their parents without anything bad happening to them. But one could argue that it's not unlike the seatbelt debate of many years ago. While seat-belts save lives, millions of people have ridden safely in cars without them. It's only when there's an accident that the seatbelt comes into play.

A new study was just published in the British journal BMJ Open, with findings that seem to back up the concerns of co-sleeping. The researchers looked at the cases of 1,472 babies who died of SIDS and 4,679 controls (healthy babies). None of the parents were smokers (often considered a risk for SIDS). All babies were younger than three months old.

The researchers found that a little over 22 percent of the babies who died co-slept with a parent or both parents, while not quite 10 percent of healthy babies did. The researchers also found that as the babies got older, the risk dropped somewhat. According to a press release put out by the London School of Hygiene and Tropical Medicine:

The researchers estimate that 81% of cot deaths among babies under 3 months with no other risk factors could be prevented if they did not sleep in the same bed as their parents. The study also showed that the risk associated with bed sharing decreases as a baby gets older, and that the peak period for instances of cot death was between 7 and 10 weeks. months old, were breastfed, and had no other known risk factors for SIDS.

So, what do you think? I wasn't comfortable sleeping with my babies, although there were times when I did fall asleep while nursing them in bed. I didn't even like having them in my room because I'm a very light sleeper and their noises, which are so cute during the day, weren't so cute when they kept waking me up.

Hereditary Cancer and Complicated Choices

Angela Jolie cut her breasts off.

The real story, of course, is a bit more complicated than that. Jolie, a famous actress and humanitarian who lost her mother to ovarian cancer, revealed this week in the New York Times that she had a preventive double mastectomy to decrease her breast cancer risk. In other words, Jolie had both of her breasts surgically removed to minimize her chances of developing cancer.

As Jolie reveals in the article, her risk of developing breast cancer was high. Her mother battled breast cancer before developing and succumbing to ovarian cancer. According to the Susan G. Komen Foundation, a woman who has an immediate female family member with breast cancer has twice the risk of developing breast cancer as the theoretical “average woman.” Please remember, though: that’s an average risk. Any particular woman’s risk of breast cancer depends on a multitude of factors, and a woman’s risk of developing breast cancer, even given a family history of breast cancer, varies.

Jolie’s risk was particularly high because she has a BRCA1 mutation. You may have heard of BRCA1 and BRCA2, the two most famous so-called “breast cancer genes.” That term, “breast cancer genes,” is actually a misnomer because the truth is that everyone has a BRCA1 and BRCA 2 gene. (And because both BRCA1 and BRCA2 mutations are also linked to ovarian cancer.)

Normally, BRCA1 and BRCA2 are tumor suppressor genes – they help prevent cancer by repairing cell damage. But some people don’t carry the normal version the BRCA1 or BRCA2. Instead, they have a mutated version of the gene, and that mutation makes them particularly prone to cancer because the gene doesn’t do its usual job – keeping cancer at bay – very well.

Jolie has a BRCA1 mutation, which dramatically increases her odds of developing breast cancer. In her New York Times article, she says that doctors estimated her breast cancer risk at 87%. Having her breasts removed decreases her risk to less than 5%.

The child and mother in me understands her decision. Like Jolie, I grew up in a family with a strong family history of breast cancer. I have watched my mother struggle with breast cancer (and ovarian cancer). I have a known BRCA mutation; in 2006 or 2007, I tested positive for a BRCA2 mutation. And like Jolie, I am scared to death of developing cancer. I have small children too. I want to be around for a long, long time.

But the nurse in me wants people to understand that dealing with hereditary cancer risk is much more complex than Jolie’s NYT article made it seem. Consider:

• A BRCA mutation does not guarantee cancer. Not everyone with a BRCA (or other cancer-related) mutation develops cancer. No one knows why some develop cancer, and some don’t.

• Every medical procedure entails risk. All medications, all surgeries, and all medical tests and treatments come with both risks and benefits. Breastcancer.org has a great run-down of mastectomy risks, and the risks aren’t insignificant.

• Other prevention options exist. Jolie’s article doesn’t even mention the other risk-reducing options available to women who have a high-risk of developing breast cancer. Tamoxifen and raloxifene are two medications that are FDA-approved to reduce breast cancer risk in high-risk women; other meds and non-surgical risk reduction techniques are currently being studied. Surgically removing the ovaries, especially before menopause, has also been shown to decrease breast (and ovarian) cancer risk.

• Increased surveillance is an alternative. Preventive action isn’t necessary. Some people with an increased risk of cancer choose to carefully watch and monitor the situation instead. In the case of breast cancer, increased surveillance may mean starting mammograms earlier than the normally recommended age, or having them more frequently, and/or combining mammography with other breast cancer screening techniques, such as MRI and ultrasound.

While I applaud Jolie’s decision to share her story, I’m concerned that some women will read her article and think that a double mastectomy is their best (or only) option to decrease breast cancer risk. It’s not (necessarily).

Jolie writes, “I…encourage every woman, especially if you have a family history of breast or ovarian cancer, to seek out the information and medical experts who can help you through this aspect of your life, and to make your own informed choices,” and I encourage women to take those words seriously. If you’re concerned about your cancer risk, talk to a medical doctor about your family history and personal cancer risk. Work with medical experts and ask questions – lots and lots of questions – about your risk and options.

by Jennifer L. W. Fink RN-BSN

The Real Secret to Weight Loss

by Elizabeth Hanes, RN-BSN

As a nurse writer, I receive many press releases every day. Many of these pitches tout products, books or experts on weight loss and related subjects. Since I don’t report on weight loss, I usually toss these into my e-mail program’s trash folder and move on.

Recently, I’ve seen an uptick in press releases about “cleanses” and “detox” programs. Some of these are marketed for weight loss, while others claim cleansing, detoxing and fasting help “rid your body of toxins.”

What rubbish.

Before I get to the real secret to losing weight, the nurse in me wants to spend a moment debunking these often-dangerous practices.

The notion your digestive system requires “cleansing” to function well or that your digestive tract is teeming with toxins that periodically should be washed out is not supported by any scientific evidence. None. Zero. In fact, your digestive system is a finely tuned machine that usually will work just fine as long as you eat plenty of nutritious foods that contain fiber. Think whole grains, raw vegetables and whole fruits. Some fruits and vegetables contain more fiber than others. You’ll find plenty of sources online that list the fiber content of various fruits and vegetables. Adult men should aim for about 35 grams of fiber intake per day, while women should aim for about 25 grams.


If “cleansing” and “detox diets” aren’t the way to lose weight, then what is?

Here’s the secret to weight loss I promised you: You must consume fewer calories than you burn off. The “secret” amounts to nothing more than simple mathematics.

If your recommended daily calorie intake is 2,000 calories, but you routinely eat 2,500 calories each day and never exercise, then you are going to gain weight. Each extra pound of weight is the result of 3,000 extra calories eaten. So, if you’re eating an extra 500 calories a day, you will gain one pound every six days (3,000 calories [one pound] divided by 500 calories per day equals six days).

It’s not hard to see how easy it can be to pack on the pounds!

Luckily the reverse equation works, as well. Let’s say you consume 500 calories less per day. That means you would lose one pound every six days. Pretty sweet, huh?

Of course if you add exercise to the mix (which burns calories), you might lose weight even faster. Experts generally consider a weight loss of two pounds a week to be safe for most people. No one should go on a diet or exercise regimen without consulting their doctor or nurse practitioner first.

You can find many free online resources to help you keep track of how many calories you eat and how many you burn through exercise. A couple of programs I like are Spark People and My Fitness Pal. If you want to make the process super easy, try something like the BodyBugg or the FitBit, both high-tech toys for tracking calories consumed and burned.

If you’re ready to get fit and lose those extra pounds (and isn’t spring a wonderful, renewing time to consider it?), don’t fall for any fad programs like detoxing and cleansing. Just use the simple math method of calories in versus calories out to help you reach your goal. It’s the true secret to weight loss.