Are breastfed infants less likely to die from SIDS than formula-fed infants?

Last updated: February 20, 2022
There is no consensus in the literature on this question. We encourage you to read the study summaries below or the studies themselves if you have access. While the studies in this list that examine the question came to different conclusions, the most recent study here is a literature review, which is a type of study that reviews and often evaluates the findings of many studies on a question. This gives us more confidence that the answer is yes.
This short answer was generated by aggregating the answers that each of the studies below gave to the question (as indicated by State of K members) and adjusting for source quality and other factors. If key studies are missing or the answers attributed to individual studies are incorrect, the above answer could be wrong. For medical questions, don't rely on the information here. Consult a medical professional.
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YES ANSWERS
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NO ANSWERS
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NO DATA ON ANSWER


Chart summary of 4 studies examining this question

All answers are assigned by State of K users. The label Couldn't Identify means that State of K was not able to determine whether a study answers the question "yes" or "no". This could be due to several factors. One possibility is that a study found some evidence to indicate that the answer to the question is "yes" and some evidence to indicate that the answer is "no". This often happens when a study uses two or more proxies to study the same phenomenon (i.e. firearm sales figures and self-reported firearm ownership rates as proxies for the prevalence of firearms) and the proxies yield different results when looking for correlations with another phenomenon (i.e. firearm-related deaths). Alternatively, the label may be applied if the phenomenon under study (i.e. whether breast milk improves cognitive function) is true for one group, but not another (i.e. true for girls, but not for boys). Yet another possibility is that a study found there was insufficient evidence to reach a conclusion regarding the question. Finally, the full text or abstract of a study may not have been written clearly or was inaccessible. This would make it difficult to determine how a study answered a question.

All labels of Literature Reviews and source quality are assigned by State of K. All labels of High Quality Source are assigned based on whether the publication in which the article appeared was ranked as Q1 by Scimago Institutions Rankings. Certain well-regarded think tanks are also given this label.

Literature Reviews
Although we recommend you consider all of the studies below, we believe the following studies are literature reviews, which survey and evaluate many studies on this question:

SUMMARIES OF STUDIES
Total studies in list: 4
Sorted by publication year
1
Duration of Breastfeeding and Risk of SIDS: An Individual Participant Data Meta-analysis
"CONTEXT:Sudden infant death syndrome (SIDS) is a leading cause of postneonatal infant mortality. Our previous meta-analyses showed that any breastfeeding is protective against SIDS with exclusive breastfeeding conferring a stronger effect.The duration of breastfeeding required to confer a protective effect is unknown.OBJECTIVE:To assess the associations between breastfeeding duration and SIDS.DATA SOURCES:Individual-level data from 8 case-control studies.STUDY SELECTION:Case-control SIDS studies with breastfeeding data.DATA EXTRACTION:Breastfeeding variables, demographic factors, and other potential confounders were identified. Individual-study and pooled analyses were performed.RESULTS:A total of 2267 SIDS cases and 6837 control infants were included. In multivariable pooled analysis, breastfeeding for <2 months was not protective (adjusted odds ratio [aOR]: 0.91, 95% confidence interval [CI]: 0.68–1.22). Any breastfeeding ≥2 months was protective, with greater protection seen with increased duration (2–4 months: aOR: 0.60, 95% CI: 0.44–0.82; 4–6 months: aOR: 0.40, 95% CI: 0.26–0.63; and >6 months: aOR: 0.36, 95% CI: 0.22–0.61). Although exclusive breastfeeding for <2 months was not protective (aOR: 0.82, 95% CI: 0.59–1.14), longer periods were protective (2–4 months: aOR: 0.61, 95% CI: 0.42–0.87; 4–6 months: aOR: 0.46, 95% CI: 0.29–0.74).LIMITATIONS:The variables collected in each study varied slightly, limiting our ability to include all studies in the analysis and control for all confounders.CONCLUSIONS:Breastfeeding duration of at least 2 months was associated with half the risk of SIDS. Breastfeeding does not need to be exclusive to confer this protection."
AUTHOR
John M.D. Thompson
PUBLISHED
2017 Pediatrics
Literature Review
High Quality Source
Yes
Yes
2
Breastfeeding and dummy use have a protective effect on sudden infant death syndrome
"We conducted a literature review on the effect of breastfeeding and dummy (pacifier) use on sudden infant death syndrome (SIDS). From 4343 abstracts, we identified 35 relevant studies on breastfeeding and SIDS, 27 on dummy use and SIDS and 59 on dummy use versus breastfeeding.ConclusionWe found ample evidence that both breastfeeding and dummy use reduce the risk of SIDS. There has been a general reluctance to endorse dummy use in case it has a detrimental effect of breastfeeding. However, recent evidence suggests that dummy use might not be as harmful to breastfeeding as previously believed."
AUTHOR
Bernt Alm
PUBLISHED
2015 Acta Paediatrica
Literature Review
Yes
Yes
3
Breastfeeding and Reduced Risk of Sudden Infant Death Syndrome: A Meta-analysis
"CONTEXT:Benefits of breastfeeding include lower risk of postneonatal mortality. However, it is unclear whether breastfeeding specifically lowers sudden infant death syndrome (SIDS) risk, because study results have been conflicting.OBJECTIVE:To perform a meta-analysis to measure the association between breastfeeding and SIDS.METHODS:We identified 288 studies with data on breastfeeding and SIDS through a Medline search (1966–2009), review articles, and meta-analyses. Twenty-four original case-control studies were identified that provided data on the relationship between breastfeeding and SIDS risk. Two teams of 2 reviewers evaluated study quality according to preset criteria; 6 studies were excluded, which resulted in 18 studies for analysis. Univariable and multivariable odds ratios were extracted. A summary odds ratio (SOR) was calculated for the odds ratios by using the fixed-effect and random-effect inverse-variance methods of meta-analysis. The Breslow-Day test for heterogeneity was performed.RESULTS:For infants who received any amount of breast milk for any duration, the univariable SOR was 0.40 (95% confidence interval [CI]: 0.35–0.44), and the multivariable SOR was 0.55 (95% CI: 0.44–0.69). For any breastfeeding at 2 months of age or older, the univariable SOR was 0.38 (95% CI: 0.27–0.54). The univariable SOR for exclusive breastfeeding of any duration was 0.27 (95% CI: 0.24–0.31).CONCLUSIONS:Breastfeeding is protective against SIDS, and this effect is stronger when breastfeeding is exclusive. The recommendation to breastfeed infants should be included with other SIDS risk-reduction messages to both reduce the risk of SIDS and promote breastfeeding for its many other infant and maternal health benefits."
AUTHOR
Fern R. Hauck
PUBLISHED
2011 Pediatrics
Literature Review
High Quality Source
Yes
Yes
4
Review Article Reducing the Risk of Sudden Infant Death Syndrome: A Review of the Scientific Literature
"In March 1997 a multidisciplinary forum was convened by the National SIDS Council of Australia to review recent evidence concerning risk factors of sudden infant death syndrome (SIDS) and to revise and refine the current guidelines for reducing the risk of SIDS. The forum provided an assessment of the evidence for recommendations to reduce the risk of SIDS using an evidence-based process. Strong evidence has now accumulated that the intervention campaigns to reduce prone sleeping during infancy have been followed by SIDS rate declines. Recent data indicate that the supine position is not associated with an increase in significant morbidity outcomes and provides greater protection for SIDS than the side position, which may be unstable. Covering of the baby's head by bedding is strongly related to SIDS. The infant's sleeping environment should be carefully set up to ensure that the baby's head, including the face, cannot be obstructed during sleep. Parental smoking is strongly associated with SIDS. Structural supportive interventions for parental smoking cessation are required. Bedsharing increases the risk of SIDS amongst smokers and the data are currently not sufficient to provide complete reassurance to nonsmoking parents that bedsharing is safe. Infants should be maintained in a comfortable temperature zone. The evidence for a protective effect of breast-feeding is conflicting, so breast-feeding cannot be promoted strongly as reducing the risk of SIDS. Immunisation has not been associated with SIDS. Parents and carers should be aware of the current guidelines. Health professionals should also be aware of the evidence on which the current recommendations are based. Effective health education programmes should lead to a further decline in SIDS mortality in Australia."
AUTHOR
David J Henderson‐Smart
PUBLISHED
2003 Journal of Paediatrics and Child Health
Literature Review
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