BOTTLE-FEEDING AND THE SUDDEN-INFANT-DEATH-SYNDROME

Objective-To determine whether the risk of the sudden infant death syn drome is increased in bottle fed babies. Design-Population based case- control study matching for age and time. Subjects-All babies aged 1 we ek to 1 year dying of sudden infant death syndrome during November 198 7 to April 1989 or February 1990 to June 1991 and two live controls. S etting-Avon and north Somerset. Main outcome measures-Breast or bottle feeding, sleeping position, maternal smoking, parental employment, an d length of gestation. Results-Compared with being fully breast fed, t he crude odds ratio for sudden infant death in fully bottle fed babies was 3.1 and for mixed breast and bottle fed babies 1.5. These odds ra tios fell to 1.8 (95% confidence interval 0.7 to 4.8) and 1.2 (0.5 to 2.7) respectively after maternal smoking, parental employment, preterm gestation, and sleeping position had been adjusted for. Sleeping posi tion partly masked the effect of being bottle fed on sudden infant dea th as breast fed babies were more likely to have slept prone than bott le fed babies. Conclusions-Bottle feeding is not a significant indepen dent risk factor for the sudden infant death syndrome. Patterns of mat ernal smoking, preterm gestation, and parental employment status accou nt for most of the apparent association with bottle feeding.