Biomedical subjects

R E Wigfield

Publications and source records attributed to R E Wigfield.

3 recordsLinked to original sources

PubMed1995

Bottle feeding and the sudden infant death syndrome.

OBJECTIVE: To determine whether the risk of the sudden infant death syndrome is increased in bottle fed babies. DESIGN: Population based case-control study matching for age and time. SUBJECTS: All babies aged 1 week to 1 year dying of sudden infant death syndrome during November 1987 to April 1989 or February 1990 to June 1991 and two live controls. SETTING: Avon and north Somerset. MAIN OUTCOME MEASURES: Breast or bottle feeding, sleeping position, maternal smoking, parental employment, and length of gestation. RESULTS: Compared with being fully breast fed, the 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 ratios 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 position partly masked the effect of being bottle fed on sudden infant death as breast fed babies were more likely to have slept prone than bottle fed babies. CONCLUSIONS: Bottle feeding is not a significant independent risk factor for the sudden infant death syndrome. Patterns of maternal smoking, preterm gestation, and parental employment status account for most of the apparent association with bottle feeding.

Bottle Feeding↗

PubMed1993

How much wrapping do babies need at night?

In a longitudinal, population based study, overnight temperature recordings were made in the bedrooms of 152 babies aged 3-18 weeks and the insulation provided by their bedclothing was assessed. Outdoor temperatures for the study nights were also available. Parents applied more insulation on colder nights with lower bedroom temperatures than on warmer nights (mean 8.5 tog at 15 degrees C minimum bedroom temperature falling to 4.0 tog at 25 degrees C). For a particular temperature they also applied 2 tog more insulation in winter than in summer. The amounts of bedclothing used in the home were compared with insulation levels predicted to achieve thermo-neutrality over a similar range of environmental temperature from heat balance studies in young infants. They corresponded closely. The average amount of bedclothing chosen for babies in Avon allows them to remain in thermoneutral conditions throughout the night. These values are proposed as broad guidelines for the thermal care of young babies at night.

Bedding and Linens↗

PubMed1992

Can the fall in Avon's sudden infant death rate be explained by changes in sleeping position?

OBJECTIVE: To examine the impact of changing practice with regard to infant sleeping position on mortality from the sudden infant death syndrome. DESIGN: A population based study of all infants dying suddenly and unexpectedly during February 1990 to July 1991, and two groups of controls; one comprising every 125th baby born to Avon residents and the other comprising pairs of infants matched to each index case for age, neighbourhood, and date of study. Information about sleeping position was collected at home visits soon after the index baby's death or, for the population based controls, on several occasions in the first six months of life. The design was comparable to that of an earlier study of the same population. SETTING: County of Avon. SUBJECTS: 35 infants who died suddenly and unexpectedly (32 of the sudden infant death syndrome), 70 matched controls, and 152 population based controls. RESULTS: The prevalence of prone sleeping in the matched controls was much lower than that found in an earlier study in Avon (28% (18/64) 1990-1 v 58% (76/131) 1987-9; p less than 0.001) and was comparable with the prevalence in population based controls (29%). This would be expected to lead to a reduction in the incidence of the sudden infant death syndrome to 2.0/1000 live births (95% confidence interval 1.8/1000 to 2.5/1000). The actual mortality fell from 3.5/1000 in 1987-9 to 1.7/1000. CONCLUSION: The fall in mortality can be almost entirely accounted for by the reduction in prone sleeping, suggesting a causal relation exists between them. Side and supine positions confer protection but the side position is unstable and the infant may roll prone. We therefore recommend supine as the safest sleeping position for babies.

Case-Control Studies↗