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Physician Resource

Two Months of Breastfeeding Cuts SIDS Risk In Half

At a Glance

  • Breastfeeding rates are on the rise in the U.S., but have not yet reached the goal of 80 percent.
  • Studies have shown breastfeeding helps lower the risk of SIDS.
  • UVA researchers co-authored a more recent study that determined, for the first time, the duration of breastfeeding necessary to significantly reduce SIDS risk.

As part of the Healthy People 2020 initiative released by the Department of Health and Human Services in 2010, the United States has set a course to improve breastfeeding rates across the nation. With rates currently at 74 percent, the goal is to increase the proportion of infants who are breastfed even further to 80 percent by 2020.

“The rates have steadily been going up due to programs like the World Health Organization’s Baby Friendly Hospital initiative, which we’ve adopted at UVA. But we’re still not where we want to be,” says UVA family medicine physician Fern R. Hauck, MD, MS. “Ideally, of course, we would reach 100 percent.”

Getting us ever closer to that goal, the findings from an international study published this past year in the journal Pediatrics give physicians even more convincing evidence to share with patients regarding the importance of breastfeeding, specifically as it relates to Sudden Infant Death Syndrome. Hauck, a pioneer in the field who has been researching SIDS for more than 25 years, was the study’s senior author; she was joined on the project by UVA pediatrician Rachel Moon, MD, and other collaborators.

Previous studies have suggested that breastfeeding was associated with a decreased risk of SIDS, the leading cause of death of babies between 1 month and one year of age. According to Hauck, this most recent study is unique in that it is the first to determine the duration necessary to provide that protection.

“We found that breastfeeding for at least two months reduces the risk of SIDS by almost half, and the longer babies are breastfed, the greater the protection,” says Hauck. “The other important finding from our study is that any amount of breastfeeding reduces the risk of SIDS — in other words, both partial and exclusive breastfeeding appear to provide the same benefit.”

To determine these findings, researchers used raw data from eight of the largest SIDS studies done in recent decades, examining 2,259 cases of SIDS and 6,894 control infants where death did not occur. “In each study, parents of both babies who had died and those who lived were interviewed to compare their similarities and differences and to determine what factors may have increased the risk of SIDS in the babies who died,” says Hauck.

Mechanisms at Work
While not entirely certain why breastfeeding has protective properties against SIDS, researchers do have some strong hypotheses based on a variety of physiologic, neuropathologic and genetic studies, which point to:

  • Arousal response. Babies who are breastfed arouse more easily from a deep sleep so they are more likely to cry or try to get themselves out of a vulnerable position such as face down on their sleep surface.
  • Fewer infections. Antibodies transferred from mom to baby during breastfeeding protect babies from infections such as gastrointestinal or febrile illnesses that put them at increased risk for SIDS.
  • Brain development. Breast milk provides nutrients that promote brain health and make babies less vulnerable to SIDS.

Making the Case
The next step for providers: sharing these findings with patients. Breastfeeding is a personal choice and healthcare providers must respect the wishes of the mother, says Hauck. But with this mounting evidence, physicians have an opportunity to inform and support patients in their decision-making. “These study results will be useful in helping providers encourage moms to at least try breastfeeding,” she adds. “Because we now know that any breastfeeding is better than none.”





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