April 2001
"The media do have a role in driving public opinion and reaction, but, especially in science reporting, they must be responsible and reasonable in their interpretations. [ . . . ]Sadly the fault seems to lie with those journalists who let their enthusiasm for a sensational story overshadow cautious and careful reporting." (The Lancet Editorial: SIDS theory: from hype to reality. The Lancet; 1995 Dec; 346: 1503)
The media is a powerful weapon, but can also be a scapegoat. It is all too easy to blame journalists for sensationalising research results and creating health scares. In the years since the start of the "Back to Sleep" campaign in 1991, there have been numerous studies into the causes, risk factors and epidemiology of Sudden Infant Death Syndrome (SIDS). While the national press have "spun" stories, they have also played an important part in raising public awareness of the campaign to reduce mortality rates from SIDS.
A recent example of sensation journalism is the article "Cot death link to mothers’ kisses"1 in The Daily Telegraph. A study at Manchester University showed that there is a higher incidence of Helicobacter pylori in infants who died from SIDS.2 The authors of the paper said that parents and carers should be careful not to transfer their saliva to the infant, for example by sucking a pacifier before giving it to the baby. The Daily Telegraph warned parents that they might pass the infection on by kissing, or by licking a dummy or bottle before putting it in the baby’s mouth.1 This article was based on the same research paper as the article in the Times, yet the Times’ article makes no mention of kissing and leads with the headline "Stomach bug may be clue to cot deaths".3
When an Italian study showed that babies with an increased QT interval three to four days after birth, had a much higher risk of SIDS,4 the media was cautious in reporting the news. There were no headlines in the broadsheets calling for ECG testing of all neonates and beta-blockers for those with increased QT intervals. Unusually the "second leg" of the Daily Telegraph story5 - the dissenting opinion, which is normally added to the end of the article for balance - featured in the third paragraph. Journalists are taught to place all the important information in the first three "paras", and then fill out the article with details and explanations. A good journalist writes articles so that they can be chopped from the bottom upwards. Subeditors rely on this when a last minute news story arrives and they need to clear room in the paper.
However when a study by Douglas, Gupta, Helms and Jolliffe6 in 1997 showed a link between the month of birth and a higher incidence of SIDS, few papers picked up on it. In fact the only article to be found relating to this study was published in the Daily Mail just before Christmas 2000.7
Recently The Daily Telegraph featured an article relating to babies playing on their fronts.8 The article referred to research by Mildred, Beard, Dallwitz and Unwin was published in 1995,9 but it was only when the Foundation for the Study of Infant Deaths (FSID) launched its "Sleep on the back, play on the front, sit up and watch the world" campaign with the Toys 'R' Us chain that the media picked up on the research.10 The articles about SIDS tend to come from the science or medical correspondents, who all seem to rely on the same sources of information. FSID - "the leading cot death charity" according to their website10 - seems to be the expert source for information and comments relating to SIDS.
It is perhaps noteworthy that while newspapers have recently quoted numerous surveys by FSID, these could not be found in academic journals. One such survey claimed that special monitors should only be used under supervision of health professionals. While this may be true, the information was based on a survey of the opinion of 134 paediatricians.11 The Royal College of Paediatrics and Child Health has more than 4500 members, so this survey represents the opinion of less than 3% of their members.12 One important point that the Independent highlighted in October 2000 was the range of variable quality information. As they point out, new parents are faced with a wealth of "dos and don’ts", and suspect items. Plastic mattresses, cot monitors, smoking, warm beds and bedsharing have all been listed as possible causes of SIDS.13 While more research has shown that the claim that plastic mattresses give off toxic fumes is untrue,14,15 the news media has not headlined these corrected findings.
Bedsharing remains a contentious issue. The CESDIa/SUDIb research group found that sleeping on the sofa with an infant was associated with a particularly high risk of SIDS.16 Previous studies have shown that sharing a bed with a baby when the parents have been smoking also increased the risk of cot death.17 Duvets18 and tired parents are also contributory factors.16 But the CESDI 1 SUDI research group found that there was no increased risk due to bedsharing if the infant was more than 14 weeks old, nor if neither of the parents smoked. The advice now given by FSID is that when sharing a bed with an infant, the parents should have separate duvets and the baby should also have its own covers.10
Williams, Lang and Mage examined the aetiology of sudden unexplained infant deaths in Dundee between 1882-1891. They found that the Dundee cohort died from overlying, rather than SIDS, and they feel that the current advice on bedsharing should be given cautiously.19 (See page of this issue) To further complicate matters for confused parents, researchers on an earlier study in Scotland claimed that sleeping on an old mattress may increase the risk too. But the main finding of this particular study was that parental smoking is a most important modifiable risk factor for SIDS.18 As a result of research, the Department of Health and FSID issued new guidelines for the "Reduce the risk" campaign in February 2000. These updated guidelines now include:
". . . do not fall asleep with your baby on a sofa"
and
". . . do keep your baby’s cot in your room for
the first six months".10
The director of FSID, Joyce Epstein, said:
I wish a little more care and attention was devoted to what is published and what is not."
Very applicable to newspapers of course. Then she added:
Of course, research has to go on, but it’s a pity that researchers sometimes publish at the hypothetical stage, which then gets wider publicity in the media. What they say may sound scary to the parents, but they do not know what it means."13
Correspondence to: marianne@pceurope.com
Note: The newspaper articles used were taken from the relevant Internet websites. Websites for the Times, the Independent, the Guardian, The Telegraph, the Sun, the Daily Express, the Daily Mail, the Scotsman, the Courier and the Dundee Evening Telegraph were searched for all articles published since Jan 1995.