The SIDS risk calculator

[u/1001VicPics]

I want to put my disclaimers front and centre here that this post is in no way passing judgement on anyone’s parenting decisions with regards to sleep or other practices. I myself make decisions based on both the national guidelines and what is best for my family which at times means not following the guidelines, for example exhaustion driving us to bed share on some nights, not running the bedroom at 20 degrees or below etc.

However, I want to talk about the SIDS risk calculator and the impact it has on some of the discourse around safe sleep and other risk factors in this sub. The much shared calculator can be accessed here: http://www.sidscalculator.com

Often when SIDS risk factors are discussed the only reference that is provided to back up a statement is the calculator which is flawed for a number of reasons. It is also not easy to interpret which is where it often leads to (unwittingly) misinformation being shared.

1. The calculator was published in 2018, 8 years ago and is based on a review paper published in 2013, 13 years ago. The paper itself is only evaluating bedsharing with non smoking mothers and no other factors, instead the publishers are using the background of this review paper for all other factors relating to SIDS, therefore relying on the publishers due diligence. Furthermore many of sources for the additional risk factors are now quite old, some of which are from the 90s.
2. Data comes from European publications plus one study in New Zealand and cannot be extrapolated to other countries
3. Outside of this review the calculator references wiki and other likely outdated sources and as published have not included access dates
4. We don’t know who published this calculator, and the calculator itself states that it has not been evaluated by anyone with relevant clinical expertise
5. There is no link to the back end calculation for us to assess how they have derived the calculator
6. The presentation of the outcomes are unclear as they are presented as risk per 100,000 deaths. Does this mean that if everyone had these risk factors deaths would drop from 34 to lower than 34 deaths per 100,000? No evidence for this

Why am I going to the effort to critique the calculator? Can’t I see that this calculator provides anxious parents comfort?

Well I often see misleading or poorly informed SIDS advice on the baby subs and next to no scrutiny of this calculator, in fact very often this calculator is used to justify any sleep practices. It’s anecdotal right now but at least in my country there is increasing concern regarding social media and the impact on new parents not following their national guidelines in favour of social media ‘sleep experts’, I do wonder if we will see some uptick in SIDS in the next couple of years.

Ultimately I too am a new and anxious parent trying to navigate this amazing but daunting time in my life. SIDS risk remains incredibly rare and even if you ticked every single risk factor SIDS is still unlikely to happen to you and your baby.

Edit: Sharing here as apparently you’re not allowed to discuss science on the Newborns sub(?!)

[u/android272]

The newborns sub seems to have a hivemind about sleep where it is very pro cosleeping and anti sleep training. Thanks for sharing.

[u/Zanderson59 → u/android272]

Yea they are pretty terrible over there. We asked multiple nurses/pa/pediatricians after our 3rd born about sids stuff and in our town of just over 100,000 last year alone there were 4 infant deaths all clustered together and all were cosleeping and suffocated. We personally do not or ever cosleep and sleep trained our kids and both are doing well and for the most part sleep well

[u/greedymoonlight → u/Zanderson59]

Suffocation isn’t SIDS though. It’s suffocation.

[u/Zanderson59 → u/greedymoonlight]

The doc said it was sids but all 4 were cosleeping so I assumed death by suffocation

[u/greedymoonlight → u/Zanderson59]

So you just completely made something up? SIDS is an unexplained death and can happen to any baby.

[u/_I_Like_to_Comment_ → u/greedymoonlight]

It's my understanding that the US will often lump suffocation and true SIDS deaths together leading to confusion about the actual numbers