Retorts

Cot Death

Cathryn Crane's article [Cot Death Conundrum, May 1991] was unscientifically presented and misleading. The statement about lack of funding for analysis was false, as $75,000 has been granted especially for this, in addition to over $300,000. It is surprising that the statisticians working on this project have failed to produce more than the analysis of 1987 data. In my own work, I have analysed data on 75 variables on 1,272 NZ children and 195 British children, working alone and unfunded.

The article is out of date in that recent reports indicate a dramatic fall in cot deaths. There are claims that this is due to advice on sleeping position and overwrapping. Babies are supposedly at risk when put to bed on their tummies. However, at the same time, dietary advice has changed and is now similar to that in Sweden. Interestingly, although in Sweden babies are put to bed on their fronts, the Swedish cot death rate is the lowest in the world.

The determined avoidance of investigation of dietary issues makes one wonder whether the cot death authorities fear the implications in the dietary theories. With each year that passes, the negligence in not evaluating them becomes more serious.

Patricia Holborow, Wellington

Reply

The bulk of the $375,000 from the Medical Research Council was for data collection, collating, handling and entry. A small supplementary grant was awarded towards analysis. A great deal of literature review and discussion is required, and time has to be made from busy schedules. Analysis is well under way.

I disagree that this article is out of date. Part of its point was to give some historical perspective. The very bad cot death rates in the 1980s were the driving force for our research. It is very encouraging that there has been a dramatic fall in cot deaths. Babies are supposedly at risk when put to bed on their tummies. Putting it like this suggests that really the babies are not at risk. The one most effective prevention strategy for cot death seems to be to avoid the tummy sleeping position.

The NZ cot death study collected data on many child rearing patterns and behaviours. This included some dietary information. We would have liked to have pursued dietary factors in more detail, but time and money constraints did not allow this.

We are working hard on the analysis of the three years' data and believe that further insights into the information will assist further successful promotional campaigns on child health practices.This would include dietary advice and sleeping position. Scientific thinkers require both time and data before valid conclusions can be drawn.

Dr Rodney Ford, Christchurch Hospital