BMJ  2006;332:178 (21 January), doi:10.1136/bmj.332.7534.178-a

Letter

Dummies and SIDS

Causality has not been established

The first 150 words of the full text of this article appear below.

Editor—The relative risk for associated factors should not be confused with the attributable risk for causative factors. Li et al express the risk associated with sudden infant death syndrome (SIDS) and use of a dummy (pacifier) during sleep as a 90% reduction in risk, which could be potentially misunderstood and brings unwarranted media attention to what otherwise is a very interesting paper.1


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Any calculation of attributable risk would be limited to the prevalence of exposure, which for dummy users in the Californian infant population would be 23% (based on the control data). However, projecting risk reduction or quantifying attributable risk in this study is inappropriate. As the authors point out in the discussion, a causal effect between dummy use and SIDS has not been established. The discrepancy in dummy use has already been reported in previous larger studies,2-4 with better ascertainment levels providing a more cautious interpretation of the data.

. . . [Full text of this article]

Peter S Blair, research fellow

Institute of Child Life and Health, University of Bristol, Bristol BS2 8AE p.s.blair@bris.ac.uk

Peter J Fleming, professor of infant health and developmental physiology

Institute of Child Life and Health, University of Bristol, Bristol BS2 8AE


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Relevant Article

Use of a dummy (pacifier) during sleep and risk of sudden infant death syndrome (SIDS): population based case-control study
De-Kun Li, Marian Willinger, Diana B Petitti, Roxana Odouli, Liyan Liu, and Howard J Hoffman
BMJ 2006 332: 18-22. [Abstract] [Full Text] [PDF]

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