Sunday, 30 October 2011

The Scientific Manual for Mums

It's a long running joke; "babies! They don't come with a manual you know!". Oh if only that were true. A few seconds on google and you can find literally millions of books, articles, websites etc etc all proffering instructions from child rearing "experts" most claiming that their methods are backed up by "scientific evidence".

But here's the thing - the presentation of this "scientific evidence" by both the "experts" and the media can be deeply, deeply flawed.

There are countless examples of this, but  here is a recent one from the Telegraph.  If you can't be bothered to read it yourself here's a summary:

 A paediatrician says that babies should sleep in the same bed and in close contact with their mothers (co-sleeping) until they are three years old. Not doing so will cause stress to the child's heart, the child will sleep poorly, have more difficulty bonding with it's mother, and their brain development may be damaged, leading to behavioural problems later in life. The article also acknowledges that this goes against the prevailing medical view that co-sleeping should be discouraged because it may increase the risk of cot death, but this is countered by the paediatrician who says that these deaths are due to "toxic chemicals, cigarettes, alcohol..."etc. 

So, a balanced article on a vital new scientific discovery right?

I just want to say at this point that this post isn't about my opinions on co-sleeping, or people who choose to practice it or not. This is me with my scientist hat ( or should that be coat?) on getting annoyed at some dodgy journalism.

With that in mind the first thing that worries me about this article is - where are the references? You'd expect a article on a scientific discovery to tell you where the information was published, that's how science is supposed to work.* Here the only other publication mentioned is the Daily Mail.

So I did a quick search on PubMed, (a website that allows you to search for scientific/medical publications). I'll be honest I was a bit surprised when a recent paper by the paediatrician concerned did actually turn up. But I was even more surprised when I read the abstract. To summarise the summary: 

16 two day old infants (still in hospital) were studied for one hour while they slept on their mothers and for one hour while they slept in a crib. The babies behaviour and the variation in their heart rates was observed as they slept. Most of the babies slept better when on their mothers.

This is the only paper this doctor seems to have published in the last seven years** so we have to assume that this is the only validated evidence for the article.

EEECK!

So how do we get from 16 two day old neonates having steadier heart rates for a hour when with their mothers than for an hour in a crib, to behavioural problems in teenagers who didn't sleep with their Mums as toddlers?

I have no idea.

There are a huge number of flaws that could be picked on at this point, but for the sake of brevity I'll limit myself to one of them: Anyone who has cared for a new born baby will know that they are only calm and happy when being held, I'm actually amazed he got 16 of them to sleep in a crib at all! 48 hours ago they were curled in a tight warm ball inside Mum, now they are in a little plastic tank in a fluorescently lit hospital ward. Of course they are happier cuddling Mummy. But to assume from this that all toddlers would behave the same is far fetched to say the least, so why then stop at 3? Perhaps we could have prevented all the recent riots if only teenagers snuggled up to Mum at night? 

Of course the actual published paper makes none of the claims in the Telegraph article, or indeed in the Daily Mail article it was taken from , if it did it would never have been accepted for publication, it merely concludes that sleeping away from the mother increased variation in heart rates, that the babies didn't sleep for so long and that this may be a cause of stress. 

It is the newspaper articles that make the real consequence-heavy, evidence-light claims, while attempting to seem balanced. A similar thing happened with the now notorious MMR scare. In an attempt to seem fair, journalists gave equal space to the tiny minority who thought the vaccine was damaging and to the vast vast majority of medical professionals who thought it was safe. As a result the public, understandably, got the impression that no one really knew the truth and many opted not to vaccinate their kids as they thought the risk of side effects was greater than the risk of disease. Children died.

So, not a balanced article, or a major scientific breakthrough, but a small study of a handful of newborns and a few wildly speculative column inches. But how the heck are readers supposed to know that? We're told by a broad sheet newspaper that this is a Paediatrician, at a university, a scientific study with numbers and results. This is just one article of the many that appear in the media every week, surely the writers don't assume every reader is checking up on the references on PubMed? Why should they anyway?

As with so many parenting issues there is no clear scientific evidence to say all parents should or shouldn't co-sleep. The official advice, backed up by another study in the news just last week, is that babies should be in a cot in their parents room until they are 6 months old, but that actual co-sleeping carried an increased risk of cot death. However many parents, aware of that advice, believe that given the risks are minimal, it is more natural and beneficial to have their baby in bed with them or simply resort to it as the only way of anyone getting any sleep. Many of these parents will look to the media, websites etc, for evidence to help them make an informed decision, so it is vital that the information they find is accurate, not personal opinions masquerading as facts

Additionally, parents who choose to follow the conventional advice shouldn't be made to feel guilty about it, or worry that they are physically and emotionally damaging their children unless there is really, really REALLY good evidence.

Kxxx

*For the non-scientists reading this, the norm is for scientists/doctors to to conduct their experiments, then write up what they have done and send it to a scientific journal. The journal will pass it on to a number of unconnected people working in the same field who will check it over and if they think it is good enough, give it the ok for publication. Basically, anything a doctor, scientist or some bloke off the telly says they have scientific proof for, if it's not made it through this peer review process, it doesn't count. That's not to say it is definitely false, just that there is insufficient evidence to believe it at the moment. That's the great thing about science, we get to change our minds.

**One paper in seven years isn't all that impressive by the way, I'm just a techy and I published two papers while I was on maternity leave (and yeah I just put this bit in to show off).


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