Tina Kimmel: “Apples and oranges”

I noticed there were a lot of hits last night on this post from LACTNET, a listserv for lactation consultants whose general tone caters to the earthy-birthy LLL crowd (along with all their supposedly “unmixed” issues). I traced the link back to the following discussion about SIDS, started by a poster who brought up Tina Kimmel’s trumped-up claim that babies who sleep in cribs have a X2+ chance of death as compared to crib-sleeping ones.

“Dr.” Linda Folden Palmer – a retired chiropractor who triumphantly claims on her website that “The Evidence Supports Natural, Instinctual Parenting Above All Else! “, doesn’t seem quite so sure. She correctly identifies James McKenna’s physiological factoids as exactly that (I might add that McKenna himself has agreed the relationship between cosleeping and SIDS is rather complex), and invokes my analysis, stating “I applaud her efforts but imagine the truth may be somewhere in between.” (No reason given why, other than that I’m apparently “rude” and she doesn’t like what I wrote). Tina Kimmel herself answers thusly, with my comments:

a few points:

— i don’t believe that babies who co-sleep are statistically more
likely to die of SIDS. could we see that citation, please? James
McKenna has published population-level statistics to the contrary.

The statistics have shown that babies under 2-3 months are increased risk of dying when bedsharing. Whether this is from SIDS or suffocation is often not 100% determinable, other than via examination of the death scene. You can read all about it here and here.

Now I can’t seem to find where in McKenna’s publication list he has “published population-level statistics to the contrary”. Anyone want to help? Pieces at Mothering or other non-peer-reviewed journals don’t count, sorry. In fact, when McKenna is actually talking to fellow scientists, his statements are a good deal more circumspect as he knows he’ll be called on unsupported opinion:

“The growing consensus is that bedsharing behavior is diverse, and can be practiced safely or unsafely. One way to conceptualize this issue is to think in terms of a
‘risks-benefits continuum’ wherein, depending on the presence or absence in the bedsharing environment of known risk factors, bedsharing can be protective in some situations and risky in others.”

I don’t necessarily agree that bedsharing can be protective in some situations, but I agree that its riskiness certainly changes according to external circumstances.

— btw i don’t know how anyone could say “(McKenna’s) information is
physiology insight and intelligent conjecture… but not statistics” unless they hadn’t actually read his 25+ published scientific
articles.

So where in that jumble of physiological studies and opinion pieces are McKenna’s “statistics” proving cosleeping reduces SIDS/SUDI? Pray tell. ‘Cause I’ve read quite a few of them and found a lot of wishful thinking and some contradictory findings, but nothing conclusive.

— be aware that if an infant dies of whatever disease SIDS turns out
to be, and he or she happens to be in their parents’ bed, many coroners will enter “overlaying” as the cause of death.

I tend to doubt most coroners do so without some evidence someone actually was lying on the baby, but let’s play along and throw out all the overlain babies in a bed, pretending they’re actually SIDS and not suffocation cases (102 cases out of 2178 total, leaving 607 deaths in beds vs. at least 326 deaths deaths in cribs, plus an unknown percent out of 102 “Wedging:Other within crib/bed” deaths). Does that suddenly prove Tina Kimmel’s case (that cosleepers are 2.37 times less likely to die of suffocation)? Nope.

— the Mothering Magazine article where i found that “crib sleeping is 2.37 times more risky than bed sharing” was about suffocation, not SIDS. the CPSC (US Consumer Product Safety Commission), in
conjunction with the JPMA (crib manufacturer’s lobby) had come out with a statement regarding co-sleeping and suffocation that disregarded the known risks of crib-sleeping. Mothering (with Dr.
McKenna as guest editor) asked me to contribute an article about the relative risks of both sleep situations with regard to suffocation.

Ahhh… here we go. The usual baseless whiff of a conspiracy between the CPSC and the crib manufacturers, alleging mysterious “known risks of crib-sleeping” (which are what, exactly?). We also get a glimpse of the quality of the editorial review at Mothering: lousy.

— btw in that strange critical article in “Mainstream Parenting”, the author compared apples and oranges, and i’m not sure what her agenda was.

Tina Kimmel, PhD, MSW, MPH

My “agenda” is to get at the truth, something Tina, in typical AP/NPer fashion, is desperately trying to hide when the facts don’t go her way.

However, I’m willing to listen if Tina can convincingly (she may have talked her friend Linda out of her “heresy” even without providing facts, but I need a leetle more than that) explain what apples and oranges I’m comparing, and what possible good-faith explanation can be had for her:

1) arbitrarily throwing out the majority of bed-related suffocation fatalities by claiming some of them may have been single beds (like that matters), kiddie beds or misused cribs, without even attempting to clarify this with the authors*, and

2) deliberately assigning all the 102 deaths in the “Wedging:Other within crib/bed” category to the crib-related deaths group, thus inflating their numbers.

I’ll even delete my Jan 26th post and issue a public apology if you do, Tina. OK?

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3 Responses

  1. Apples and Oranges? I’m interested as I didn’t read it that way.

    I really hope she responds.

  2. co-sleeping is one of my favorite issues to discuss, because i was SO sure i wanted to co-sleep before my first DD was born. when i read the article in mothering, i was totally convinced it was safer (this is embarrassing to admit, because i really, really should not have fallen for that. but i admit it because it showed me what level of BS a person can fall for, or choose to believe, when it fits their agenda).

    thankfully, when my daughter was born, i was shocked my how small she was (7.5 lbs, 21 inches, so average size. that’s just really, really small). i realized there was no way i could safely sleep with her, so she slept next to me in a bassinet. when she was 6 mos old, we started co-sleeping, with a million safety regulations that i invented.

    so, when she was about 1, i went back to that mothering article and crunched the numbers myself. i don’t remember what i got, but like you estharer, i got that crib sleeping was safer.

    just an anecdote, but it really opened my eyes to how much a person can blind themselves to in order to preserve their beliefs.

    and another anecdote, but have you ever noticed that the co-sleeper crowd will often say it’s safer IF you do it really safely (don’t smoke, drink, use drugs, sleep on a water bed, &c &c). i always point out that really conscientious co-sleepers would be equally conscientious about safe crib sleeping. eliminating the bumpers-using, put to sleep on the belly, throw in a fluffy quilt set from the crib group, and i’ll bet their SIDS/suffocation deaths would drop a bunch too.

    finally, i think when crunching the sleep safety numbers, we should include both SIDS and suffocation. if it can be hard to tell what the baby died of, then we shouldn’t try to separate the two. or is my logic faulty here?

  3. KEC, there are no apples and oranges here. I checked the figures and the process a dozen times before I posted that January 26th post, and again yesterday. Linda Palmer was satisfied with Tina’s non-explanation as she very much sees this as a struggle between ‘us’ (the NPers) and ‘them’ (the mainstream parents and preofessional organizations), but I can’t think of any way to legitimately analyze figures where you’ve arbitrarily thrown out most of one group, and mis-assign another. Of course, if Tina has an alternate explanation that makes sense, I’m all ears.

    Desiree, the whole “mindful cosleeping” issue – barring providing a separate sleeping surface like a sidecar – is a crock. I have yet to hear or see anyone who actually abides by all the rules all the time. assuming your good intentions alone will automatically make a practice safer is nothing but wishful thinking.

    And you’re right about the SIDS/suffocation issue. Which is why the term is slowly but surely shifting from SIDS to SUDI – Sudden Unexpected Death in Infancy. See here.

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