Setting priorities

Life is risky. A riskless life is impossible, but we can try to decrease risks as far as possible. Especially when the lives and health of children are at stake. That’s why international organizations like WHO and Unicef and governments perform broad and sometimes harsh campaigns to persuade parents to make healthy and safe choices for their children. Worldwide campaigns for all kinds of vaccinations are widespread. National governments in many countries have quite fervent campaigns against child obesity and SIDS. In The Netherlands gynecologists and midwifes have a more or less civilized, but hard war on the question whose fault it is that in the Netherlands the numbers for perinatal child mortality are relatively high. The anti SIDS campaigns targeting supposedly SIDS inducing behavior is at the verge of being unethical in the pressure on parents to take unpractical measures. These campaigns all but say that co-bedding parents are child murderers. It is strange that other risks and risky behavior gets way less attention. Stacey et al reported in BMJ their study that showed that women who sleep on their backs or right side during the last pregnancy trimester have a strongly heightened chance of delivering a lifeless child. Commentaries point out that where more children die in utero in the last trimester than die of SIDS, hardly any efforts are made to decrease those numbers. Durmuş et al published recently as part of the generation R studies about the risks of smoking during pregnancy: not only risky behavior for mom’s own health, but also increasing baby’s chances of being born underweight, but increasing the chance of ending up obese later on in childhood. Parents who smoke during and after pregnancy increase the SIDS risks for their offspring, as does not breastfeeding as shown clearly in Hauck et al’s meta-analysis earlier this week. Risk management is a great good, but should be done well and efficiently. To scare parents out of co-bedding (which is safe to do as can be read in previous Newsflashes) and not paying attention to the risks of smoking and not breastfeeding is far from effective in decreasing perinatal infant mortality.
Stacey T, Thompson JMD, Mitchell EA, Ekeroma AJ, Zuccollo JM, McCowan LME: Association between maternal sleep practices and risk of late stillbirth: a case-control study. BMJ
Sudden Infant Death Syndrome: A Meta-analysis. Pediatrics 2011; peds.2010-3000; published ahead of print June 13, 2011, doi:10.1542/peds.2010-3000
Durmuş B, Kruithof CJ, Gillman MH, Willemsen SP, Hofman A, Raat H, Eilers PHC, Steegers EAP, Jaddoe VWV: Parental smoking during pregnancy, early growth, and risk of obesity in preschool children: the Generation R Study. Am J Clin Nutr 2011 ajcn.009225; First published online May 18, 2011. doi:10.3945/ajcn.110.009225