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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]"Hats

The final change I wanted to discuss is a new prohibition on infant hats.

In prior iterations of its guidelines, the AAP has noted concerns with overheating as a risk of SIDS. I talked about that evidence in this post a month ago. The evidence on heat overall is a bit sparse, but in this iteration, the organization has taken it one step further to express concern about the heat generated by infant hats.

The data cited is from a single paper. This is a case-control study in Australia that looked at a large number of possible relationships between clothing and bedding and SIDS. The paper finds that in 8.3% of SIDS cases, a hat (“bonnet”) was worn, versus only 5.2% of control infants. This difference is statistically significant.

However: the paper runs a lot of tests, and this raises concerns about overinterpreting any one result. The authors find, for example, a much stronger statistical link between SIDS and wearing socks than between SIDS and wearing hats. They also find that wearing a nightgown is protective, but wearing “stretch and grow” leggings is associated with an elevated SIDS risk. It’s not clear what any of this means.

In fact, the authors do not make much of any of these results. They note: “Significant differences in the type of products used by case and control infants occurred, and may be related to the difference in season of interview between cases and controls.” Basically, they may have observed more SIDS infants in the winter, when hats (and socks) are more common.

Without belaboring the point, to take from this paper the conclusion that infants shouldn’t wear hats seems … a stretch. The data would more strongly support a “no socks” conclusion. Put differently: if the AAP is convinced by this one study that hats are dangerous, it should also be convinced that socks are dangerous, and nightgowns are protective. "

https://emilyoster.substack.com/p/new-aap-guidelines-on-breastfeeding[/quote]

The AAP addresses this : " should be noted that because there are no randomized controlled trials related to SIDS and other sleep-related deaths, case-control studies are the best evidence available."...."Physicians and nonphysician clinicians are encouraged to have open and nonjudgmental conversations with families about their sleep practices. Individual medical conditions may warrant that a clinician recommend otherwise after weighing the relative risks and benefits."....

AND YET AGAIN SHE ONLY LINKS THE ONE PAPER NOT BOTH CITED IN THE REPORT. She picked the 2008 Bristol paper  and not the NICU paper that found that hypothermia was not a risk for infants who didnt have hats.  The paper further goes on to say "It is unclear whether the relationship to overheating is an independent factor or merely a reflection of the increased risk of SIDS and suffocation with blankets and other potentially asphyxiating objects in the sleeping environment. Head covering during sleep is of particular concern. In 1 systematic review, the pooled mean prevalence of head covering among SIDS victims was 24.6%, compared with 3.2% among control infants.274  Although head covering usually refers to bedding or bed clothes, 1 study found significantly more SIDS cases in infants wearing hats compared with controls.321  It is not known whether the risk related to head covering is attributable to overheating, hypoxia, or rebreathing. A study on the aerodynamics of rebreathing exhaled gases demonstrated that with higher temperature and humidity, the exhaled gas is denser and does not escape the vicinity of the nostrils.429  In this in vitro model, the result was increased rebreathing of CO2-rich gas, suggesting that both overheating and rebreathing are important components in the association between head covering and SIDS." Going back to the NICU study on hats, suffocation was a concern ".

Hats have multiple risks and have no discernable benefit. Thats the equation. [/quote]

What about socks?  [/quote]

I cant access the full article. But as I stated above- socks were in the article she choose but she didnt talk about the NICU paper or other papers r/t hats and suffocation risk AND she emphasized in her article that the AAP recommendation was based on one article- not true.

Further, if there are papers on socks and suffocation risk then yes the AAP should be consistent. The hat is 3-fold risk- overheating, suffocation, and rebreathing risk. Socks may only be an overheating risk, which makes them less risk. That would also imply that footed pajamas should be avoided. [/quote]

As your excerpt said, the studies looked at head covering, not hats. The concerns over overheating, rebreathing, and suffocation don't apply to hats in the same way as blankets/sheets that end up over heads.

The AAP should really be more concerned about their reputation. People aren't going to take their recommendations seriously if they explicitly recommend things without evidence indicating a risk.[/quote]

"1 study found significantly more SIDS cases in infants wearing hats compared with controls.321 It is not known whether the risk related to head covering is attributable to overheating, hypoxia, or rebreathing." If you cant ascertain that a hat can cause the same issues as a blanket I dont think we are going to be able to find common ground. [/quote]

that’s the same study that states it can’t be sure the cause is hats or the winter (since more babies wear hats in the cold). [/quote]

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