Although the reasons for the association between breast-feeding and the reduced risk of SIDS is unclear, there are several theories.
"Breast-fed infants more arousable during sleep," Hauck said. This may be due to the infants' need to be nursed, which may interrupt sleep. (SIDS appears to be linked to a defect in arousability from sleep, according to some experts.)
In addition, breast-fed infants have fewer bouts of diarrhea and upper and lower respiratory infections, which are associated with vulnerability to SIDS, she said.
Moreover, there are benefits of breast milk to immune system at a time when infant's own immunity is still developing and the immunity the infant received from the mother is waning, which may also play a role in reducing the risk of SIDS, Hauck explained.
Based on these findings, "the recommendation to breast-feed infants should be included with other SIDS risk-reduction messages, to both reduce the risk of SIDS and promote breast-feeding for its many other infant and maternal health benefits," the investigators concluded.
Dr. Lourdes Q. Forster, an assistant professor of pediatrics at the University of Miami Miller School of Medicine, said that "we had been thinking that breast-feeding had a protective effect, but this solidifies the evidence."
The advice from the American Academy of Pediatrics is clear, Forster said. "Mothers should exclusively breast-feed their babies in the first six months of life and continue to nurse through the first year of life with the addition of supplemental foods," she said.
In addition to all the other benefits of breast-feeding, the reduction in the risk of SIDS is another important one, Forster said.
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