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The Role of Breastfeeding in Sudden Infant Death Syndrome

Department of Family Medicine, 983075, Nebraska Medical Center, Omaha, NE 68198-3075.

Paul D. Turner, PhD

Center for Practice Improvement and Outcomes Research, Creighton University School of Medicine.

Dawnette K. Peppler, MD

Department of Obstetrics and Gynecology, University of Nebraska Medical Center, Omaha, Nebraska.

The objective of this article is to review the literature regarding the risk of sudden infant death syndrome (SIDS) in bottle-fed infants compared to those that are breastfed. A meta-analysis and qualitative literature review were performed. Cohort and case-control studies were included if they met a minimum SIDS definition and presented data allowing calculation of an odds ratio (OR). Twenty-three studies were included in the meta-analysis. The studies were heterogeneous, and a majority (14) were of "fair" or "poor" quality. Crude ORs from 19 individual studies favored breastfeeding as protective against SIDS. The combined analysis indicated that bottle-fed infants were twice as likely to die from SIDS (pooled OR = 2.11; 95% CI 1.66-2.68). The results of the analysis showthat there is an association between bottle-feeding and SIDS, but this may be related to confounding variables.

Key Words: sudden infant death syndrome • breastfeeding • infant nutrition • meta-analysis

Journal of Human Lactation, Vol. 16, No. 1, 13-20 (2000)
DOI: 10.1177/089033440001600104


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