A GENERATION of childcare writers — including the American guru Dr Benjamin Spock — contributed to the deaths of 10,000 babies in Britain, according to a major new study.

Researchers from the Institute of Child Health in London believe that misguided advice to lay babies on their fronts was to blame for 12 avoidable cot deaths a week for the better part of two decades.

The practice continued until 1991 despite the availability of evidence since the early 1970s that it was safer to place babies on their backs.

The research team, led by Dr Ruth Gilbert of University College London, traced the erroneous advice back to popular health books of the 1940s and 1950s.

One of the chief exponents of the “untested theory” was Dr Spock, the paediatrician, whose books became essential reading for mothers all over the world. Writing in the International Journal of Epidemiology, published by Oxford University Press, the researchers note that Spock initially wavered over his advice.

Their study says: “The sudden shift in favour of front-sleeping is best illustrated by Baby and Child Care by Dr Benjamin Spock who recommended the back position in his 1955 edition, and the front position in 1956.

“Many authors repeated these arguments. Others argued that front sleeping reduced wind, coughing due to mucus, and made respiration easier.”

Before Spock’s death in 1998, Baby and Child Care was translated into 39 languages and sold more than 50m copies, said to be second in sales only to the Bible.

His revised edition as late as 1978 recommended that babies should be placed face down in the cot. But researchers say this was contrary to evidence that linked the practice to sudden infant death syndrome (SIDS). The study says: “Systematic review of preventable risk factors for SIDS from 1970 would have led to earlier recognition of the risks of sleeping on the front and might have prevented over 10,000 infant deaths in the UK.”

It is estimated that a further 50,000 babies died unnecessarily in Europe, the USA and Australasia between 1974 and 1991. The 1970s research had shown a threefold increased risk of SIDS for front sleeping, chiefly through suffocation.

In a move to formalise the advice, the British government launched a campaign in the 1990s urging parents to make sure that their babies were facing upwards.

The campaign, called Back to Sleep followed a series of benchmark studies that established both front-sleeping and smoking as factors contributing to SIDS.

The new study states that the Back to Sleep campaign led to a “rapid and undeniable” decline in SIDS deaths, which, the researchers claim, provides “the strongest evidence to date for a harmful effect of the front position”. Following the campaign, the incidence of SIDS halved within a year.

The advice was too late for Anne Diamond, the former TV-am presenter, who had lost her four-month old son Sebastian to SIDS — then referred to as “cot death” — in 1991.

Following his death, she discovered that the New Zealand government had been warning mothers to put their children to sleep on their backs, and that SIDS deaths were dropping dramatically as a result.

Reflecting in 1993 on the Back to Sleep campaign, Diamond wrote: “When Sebastian was born, I did the same as all mothers in this country and laid him on his tummy . . . it’s what all babycare experts were telling us to do . . . the government was slow on cot death.”

She then urged the government to advise mothers to put their babies to sleep on their backs and spearheaded efforts to hammer the message home.

Gina Ford, the baby care expert and author of The Complete Sleep Guide for Contented Babies and Toddlers, said: “If it wasn’t for Anne Diamond, we would have lost a lot more babies to cot death. I talk to mothers who have lost their children through cot death and they never get over it. We still don’t know the real reasons why it happens, but the one thing that helped reduce the risk was putting them on their backs.”

The new study says that an investigation of why clinicians had previously recommended that infants sleep on their fronts was beyond its scope.

However, it concludes: “Had systematic reviews been common practice in the early 1970s, parents, professionals, and policy makers would have been aware of the cumulative effect of the front position on SIDS at least 15 years earlier than they were.”

Additional reporting: Holly Watt

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