Sleep study no basis for clinical advice

The following is a copy of the letter to be printed in Pediatrics responding to the article by Henderson et al. Clearly such a problematic study cannot be used as a basis for parental guidance!! See also the letter in Pediatrics from Jim Mckenna

To the Editor:
I am dismayed by the publication of the study of Henderson et al which ostensibly documents the normal patterns of sleep in infants in the first year of life. The population studied was non-random, self selected and not representative of the varied ethnic, cultural, socioeconomic diversity of a normal population. Thus, just on these grounds this inevitable selection bias precludes any conclusions.

Even more importantly, no information was provided as to the feeding patterns of the infants: what percentage if any were breastfed? In the breastfed infants to what degree was supplementary commercial formula added, at what age were complementary foods introduced and how (bottle, spoon), and what sleeping arrangements were followed (separate rooms, close proximity or co-sleeping)? The absence of information regarding these variables which impact on the sleeping pattern of infants similarly invalidates the presentation of the authors results as a description of the natural history of sleep and surely the results cannot serve as a basis for the guidance of parents as to what are normal infant care practices.

Furthermore, while the fact that the authors have no medical background may explain their lack of including such basic clinical data in the their study design, it does not explain the absence of even mentioning these serious limitations in the discussion section. This in of itself raises serious question as to the review process that the study underwent.

Dr. Arthur I Eidelman is a Professor of Pediatrics at Shaare Zedek Medical Center, Jerusalem, Israel. He is a Fellow of the Academy of Breastfeeding Medicine and Vice-President of ABM.

Posts on this blog reflect the opinions of individual ABM members, not the organization as a whole.