The role of breastfeeding in sudden infant death syndrome

J Hum Lact. 2000 Feb;16(1):13-20. doi: 10.1177/089033440001600104.


The objective of this article is to review the literature regarding the risk of sudden infant death syndrome (SIDS) in bottle-fed infants compared to those that are breastfed. A meta-analysis and qualitative literature review were performed. Cohort and case-control studies were included if they met a minimum SIDS definition and presented data allowing calculation of an odds ratio (OR). Twenty-three studies were included in the meta-analysis. The studies were heterogeneous, and a majority (14) were of "fair" or "poor" quality. Crude ORs from 19 individual studies favored breastfeeding as protective against SIDS. The combined analysis indicated that bottle-fed infants were twice as likely to die from SIDS (pooled OR = 2.11; 95% CI 1.66-2.68). The results of the analysis show that there is an association between bottle-feeding and SIDS, but this may be related to confounding variables.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bottle Feeding / adverse effects*
  • Bottle Feeding / statistics & numerical data
  • Breast Feeding* / statistics & numerical data
  • Case-Control Studies
  • Child, Preschool
  • Cohort Studies
  • Confounding Factors, Epidemiologic
  • Humans
  • Infant
  • Infant, Newborn
  • Odds Ratio
  • Research Design
  • Risk Factors
  • Sudden Infant Death / epidemiology
  • Sudden Infant Death / etiology*
  • Sudden Infant Death / prevention & control*