Friday, March 17, 2006

Cot death and scientific arrogance

Those of you with children will know just how frightening the concept of cot death (Sudden Infant Death Syndrome in the US) is. When your new baby wakes you up first thing in the morning with her cries, your reaction is not "Blast, I have to get out of bed" but "Thank God, she survived the night."

Between 1990 and 2000 cot deaths fell by about half in the western world. That is very good news, but the story of why it happened is less well known (old BBC story here). It should be one of the greatest scientific scandals of our age, but somehow science escaped the blame. From 1940 dodgy science was used to advise all mothers to put their babies to sleep on their front. This advice continued until about 1990 and may have killed about 50,000 babies (source UCL Institute of Child Health). In the mid-1990s, the advice changed to putting babies on their backs (the Back to Sleep campaign). The effect was a dramatic and immediate fall in cot deaths.

Now you could say this was a victory for science. But I don't see it like that. For centuries, children had been put to bed on their backs and it was science that caused them to be turned over. Bad science was overturned by good science, but it is almost unbelievable that it took so long. As a matter of fact, my mother put me on my back because she could see the scientific advice flew in the face of common sense. This strikes me as a good example of why we can and should stand up to the arrogance of the scientific professionals. Next time you hear someone lauding the mythical scientific method as the only good and pure way to knowledge, think about 50,000 heart broken couples who lost their babies because they followed the best scientific advice.

And while I'm about it, I wonder why no one has given the Nobel Prize for medicine to the paediatricians who realised what a disaster the advice for babies to sleep on their fronts was. It is undoubtedly the greatest clinical advance in child medicine for fifty years.

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