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Tizzie Hall & FSID, a formal request for information please (PART 1)

I am being contacted by an increasing number of mothers, concerned and confused by blanket guidelines provided by "Tizzie Hall, International Baby Whisperer and author of Save Our Sleep (SOS)".  These guidelines are so different to the information provided by other sources of SIDS guidance, and some mothers are concerned babies could be at risk of overheating - a factor we often hear linked with SIDS.  Tizzie Hall appears to claim the opposite however, that being cold is a bigger risk factor for SIDS.

Some mums claim they have asked Tizzie for evidence to support the blanket recommendations via her Facebook page, but have not received a satisfactory response.

Therefore I thought I would create a blog post to openly and clearly ask both Tizzie Hall, and the Foundation for the Study of Infant Deaths (FSID) for further information, evidence & guidance.

It is unfair that mothers receive such conflicting information and clarification is needed as to what evidence shows is safest for the prevention of SIDS.

A Facebook group named "The Dangers of Baby Training" sums up the problem neatly:
As an example, in a room heated to 20* C in the winter or cooled to 22*C in the summer, Tizzie hall suggests for those of us in the UK & ireland to use a vest, a sleepsuit/babygro, a 'double wrap' swaddle, a cotton sheet folded into 2, and 4 layers of blankets, preferably bamboo. Our UK/Ireland SIDS & government guidelines suggest a room temp of between 18-20*C, with your child wearing a vest, sleepsuit/babygro, a light swaddle or light sleeping bag (never both, as shown in TH's video guide on youtube), 1 cotton sheet and 1 lightweight blanket....and never advocates the use of more than 4 layers, even in the coldest of conditions. Why is there such a big difference?
Earlier this week, Tizzie's forum was available to non subscribed members, where apart from clarifying  the maximum blanket layers that should be used 
"on a newborn to 3 month old baby sleeping in a bassinet is 10 layers, a newborn to 3mth old baby sleeping in cot is 12 layers and a baby 4 months and over is 16 layers". (no reference to room temperature was made) 
also stated:
"Tizzie’s safe bedding guide is written on the amount of layers NOT how many tog those layers add up to. When we talk about references to the tog of a quilt in relation to the amount of bedding needed to keep your baby sleeping warm and safely this is an example to demonstrate that babies do require bedding to sleep safely. Cotton or Bamboo cellular blankets will trap warm air in to keep your baby warm enough to sleep safely with more efficiency than a adult quilt does. We do not need to achieve the same tog rating as a 14 tog quilt but we need to achieve the same warmth which is quite different when using cotton/bamboo blankets.
It was available here - but the page has since changed to read:

Access Denied



Error Error
Only members with sufficient permission can access this page.

with an option to login, so it appears one needs to register and pay now to obtain this post.

This confused one mum Fleur who posted on Facebook saying:
If you use her special bamboo blankets that she recommends, at the max 16 layers, at approx 0.6 tog each, that would put your child under a massive, surely dangerous 13.6 tog.... to put that in perspective, the average adult duvet here in the UK is 11-13 tog, which is considered 'winter weight.'
It does seem very confusing, if a mum creates 13.6 tog from layering, and if the above comments are correct that "cotton or bamboo cellular blankets will trap warm air in with more efficiency than a quilt would of the same tog", doesn't that mean the 13.6 tog of blankets will make baby even hotter than an equivalent quilt would?  It then gets more confusing as it states the aim is not to achieve the same tog rating as a duvet, because achieving the same warmth is different with blankets - but the layers can easily add up to the same tog rating as a duvet, no?

EDIT - I THOUGHT THESE CALCULATIONS WERE INCORRECT AS 0.6 TOG X 16 DOES NOT ADD UP TO 13.6 TOG.  I CHECKED FLEUR'S CALCULATIONS AND THE TOTAL TOG OF 16 BLANKETS BASED ON THE TOG FLEUR QUOTED OF 0.6 IS 9.6.


So I checked with Fleur:
"On my calculation of the tog rating - Tizzie's fans have repeatedly told me that the tog rating of her bamboo blankets is 0.64 tog x 16= 10.24 tog (apparently she has had them tested.) and a cotton sheet folded in 2, at approx 0.2 tog (x2= 0.4 tog). I also included in my calculations the toggage (made up word, lol) of the 'safe sleeping bags' that she sells, which will be either 1 tog or 2 tog, depending which one you choose, and the tog of the 'double wrap' which again, equates to 4 layers in itself (2 inside wrap pieces and 2 outside fold over bits) which again, could be anywhere from 1 tog to 4 tog, depending on the material used). I didnt include the tog of a vest, a sleepsuit or a nappy. That was how i worked out the approx 13+ tog.
Vest0.2
Babygro1
Jumper2
Trouser2
Nappy (disposable)2 (less when wet)
Sleep suit4
Sheet0.2

I'm optimistic however that Tizzie Hall will have evidence to share with us, because of the next half of her comment:
We have observed that many of you have been trying to achieve the total tog of the Save Our Sleep® recommended blankets with other brand blankets but we do not advise that you do this. This is because you need to use too many layers of other blankets to achieve the same warmth as the Save Our Sleep® blankets for your baby to sleep safely. Using anymore than the recommended amounts listed above is not safe.
This confused the founder of Dispelling Breastfeeding Myths:
"What I'd REALLY like to know is whether her products conform to BS8510 (describes tog testing for baby products, the concern here being to ensure that babies do not overheat)? Otherwise how is a parent to have any clue about the level of thermal insulation their child is going to experience when layering up her products? That's the whole reason for the tog system in the first place... She says her blankets work in a different way - but BS 8510: 2009 'specifies requirements for the safety of sleep bags for the use of children with a minimum weight of 4 kg designed to provide sufficient warmth SO AS TO REMOVE THE NEED FOR ADDITIONAL BEDDING when sleeping in a cot or similar product in which a child is contained.'
Tizzie doesn't advise anyone uses blankets other than her own brand?  Why - if a mum needs to use more than the 10-16 layers recommended to achieve the same warmth as the branded blankets - there surely must be a unique factor?  Ultimately the tog rating of blankets is comparable, regardless of brand.  (In case anyone wonders, blankets range from £18.50 - £46.30 each depending upon which you choose. This makes the cost of 16 blankets £296-£740.80, not including spares for washing ie if they vomit to manipulate as Tizzie confirms they may, or sheets.)

Secondly In order to state using different brands or more blankets is unsafe - one must have identified and proven ie tested what is safe? Otherwise how could you know that more or different brands would be unsafe?  Plus I'm sure nobody would give parents so directly contradicting official SIDS advice without having hard evidence, because that would be madness right?

And it does directly contradict FSID as they state:
Babies who get too hot are at an increased risk of cot death. They can get too hot because the room is too hot or because they have too much bedding or clothing. The ideal room temperature is 16-20ÂșC.
In 2008 researcher at the University of Calgary showed that thermal stress, can lead to an increased risk of Sudden Infant Death Syndrome (SIDS). Increased ambient temperature such as over-wrapping a baby at night time or increasing the room temperature can affect the baby's pattern of breathing.
Australia's Practical Parenting magazine published the following, and is based on baby wearing nappy/vest/babygro plus a cotton sheet:

Room temp
No of blankets
12 ⁰
4 layers
14 ⁰
3-4 layers
16 ⁰
3 layers
18 ⁰
2 layers
20 ⁰
1-2 layers
22 ⁰
1 layer
24 ⁰
Sheet only


Here is the information from Gro-bag (a company that makes baby sleeping bags)
Choose a Tog

and details of what should go with the recommended tog sleeping bag:

What to Wear

I decided to try and ask Tizzie Hall direct on her Facebook page:



and a close up of my message:

The response wasn't under my post, but as a new message:

So I went to visit the page I was told to and you too can read it here 
"As all of you know before giving any advice I do countless hours of research so I stand by all of my advice. These ladies don’t seem to be aware of the current SIDS guidelines stating as long as your babies head and face are uncovered and you are using cotton or bamboo bedding then it is perfectly safe to layer up the amount of these blankets to keep your baby warm. My opinion and research shows this in return keeps our babies in the safe back sleeping position. Also it is now clear overheating is only cited a risk factor and not as big a factor as was first thought but we do live in a generation with parents so scared of over heating their babies they are doing the opposite and under heating them which in my opinion a greater factor because a cold baby will roll to his or her tummy and sleep face down in the mattress.

These concerned parents may not be aware of my research that shows that if a baby is cold and not warm enough in bed they will, as soon as they are able, roll to their tummy, tuck their knees and arms in under their body, stick their bottom in the air with their face pressed down in the mattress to try and warm up, which of course we know is a very dangerous sleeping position for a baby and toddler. New research shows this causes less oxygen to get to the brain and could be connected to SIDS.

Link to research http://pediatrics.aappublications.org/cgi/content/abstract/127/3/e558
Having had a personal experience of loosing a sibling to SIDS I am passionate about baby safety and ensuring everything I recommend down to the bodysuit your baby wears and the toys your baby plays with are the safest on the market."
So of course I checked out the quoted research.

Cerebral Oxygenation Is Depressed During Sleep in Healthy Term Infants When They Sleep Prone
SUBJECTS AND METHODS: Seventeen healthy term infants (8 girls and 9 boys) were recruited as study participants. Infants were studied at ages 2 to 4 weeks, 2 to 3 months, and 5 to 6 months by use of daytime polysomnography, with additional measurements of blood pressure
RESULTS: In infants who slept in the prone position, tissue oxygenation index was lower in both quiet sleep and active sleep at age 2 to 4 weeks and in quiet sleep at age 2 to 3 months. Tissue oxygenation index was lower in active sleep compared with quiet sleep in infants aged 2 to 4 weeks (P < .05). When the infants reached 5 to 6 months of age, tissue oxygenation index was greater in active sleep, as there was a profound decrease in tissue oxygenation index during quiet sleep over this period. 
All this tells us is that oxygenation index for a young infant is reduced in the prone position.  Isn't that the whole point of the "Back To Sleep" campaign?  Again Tizzie stated: my research that shows that if a baby is cold and not warm enough in bed they will, as soon as they are able, roll to their tummy, tuck their knees and arms in under their body, stick their bottom in the air with their face pressed down in the mattress to try and warm up.


THIS is the research we would like to see Tizzie please?

Otherwise it's just confusing for parents:
"Once a baby is strong enough to roll onto his stomach by himself, you don't need to worry about him staying on his back all night. This is especially true if he's been enjoying playtime on his tummy during the day, can hold his head up well, and can roll from his tummy onto his back again by himself." 
Fern R. Hauck, M.D., M.S professor of family medicine and public health sciences at the University of Virginia

"Losing sleep because your former back snoozer is now flipping onto his tummy? You probably don't need to risk waking him by trying to roll him back. If your baby can get himself onto his tummy, he can usually get himself off it, because rolling from back to tummy is the tougher milestone (try it yourself and you'll see what we mean).
By the time your baby has mastered rolling around, the SIDS risk has dropped dramatically"
Learning to Roll Over, By Anita Sethi, Ph.d

Has Tizzie measured the vital statistics of infants under 16 blankets? Unless the blankets are weighless, what is the impact of the weight of this on top of baby to their oyxgen sats?

I hope we can obtain some evidence and further clarification for mothers and will update should either party respond!

PS Sears also conducted a small experiment with fascinating results:
"In 1992 we set up equipment in our bedroom to study eight-week-old Lauren's breathing while she slept in two different arrangements. One night Lauren and Martha slept together in the same bed, as they were used to doing. The next night, Lauren slept alone in our bed and Martha slept in an adjacent room. Lauren was wired to a computer that recorded her electrocardiogram, her breathing movements, the airflow from her nose, and her blood oxygen level. The instrumentation was painless and didn't appear to disturb her sleep.
A technician and I observed and recorded the information. The data was analyzed by computer and interpreted by a pediatric pulmonologist who was "blind" to the situation—that is, he didn't know whether the data he was analyzing came from the shared-sleeping or the solo-sleeping arrangement.
Our study revealed that Lauren breathed better when sleeping next to Martha than when sleeping alone. Her breathing and her heart rate were more regular during shared sleep, and there were fewer "dips," low points in respiration and blood oxygen from stop-breathing episodes. On the night Lauren slept with Martha, there were no dips in her blood oxygen. On the night Lauren slept alone, there were 132 dips. The results were similar in a second infant, whose parents generously allowed us into their bedroom."

UPDATE ONE
I posted a link to my blog in the hope of a response, but I then checked back and it has been deleted.
I am unsure why Tizzie Hall would simply delete a polite post asking for clarification on her methods?  I have emailed her a link to this blog, just in case her admin team is deleting these message, unaware how this appears.


UPDATE TWO:
I have received a reply to my email giving a reason why Tizzie hasn't yet answered - however they have marked the email CONFIDENTIAL, so I guess I can't share any more than that!  Should I receive an answer from Tizzie answering any points raised in the blog, I will advise that unless the confidential disclaimer is removed from her email, thus allowing me to share the contents with readers - I will not be able to post in on the blog as an official response.


UPDATE THREE:
I have received a (very speedy) response from FSID, excerpt below:
"We have read your article and are more than willing to respond, my colleague who would normally do this is out of the office today, so we will let you have something shortly."
UPDATE FOUR:
FSID Excerpt: Dear Analytical Armadillo.
Thank you very much for your email. So sorry for the delay, but our Scientific Adviser, Prof Haycock, is preparing a detailed response with all the research references for you.  I’m hoping he will send me the document by Friday.

65 comments:

  1. Fantastic post. This woman needs to be stopped, and your well informed (as always) post shows exactly why.

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  2. Well done. Good post. Here's hoping you get a full response from Tizzie INCLUDING all relevant research.

    Mars xx

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  3. Excellent post. I can't imagine the evidence will be forthcoming from Ms Hall though, seeing as her 'evidence' appears to be based on nothing but opinion and profit margin.

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  4. Sue Kinross, Independent Midwife24 July 2011 at 14:16

    Thank you for seeking clarification .. I have spoken to many upset and confused parents.. confused because at a time when new parents are on a steep learning curve and want to follow the best a safest practice for their babies, it is disheartening to conclude that this 'expert' may in fact be ignoring or being selective about research findings for personal or economic gain.

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  5. Thank you for your post. I have a couple of issues with it though. The quotes you have given, in particular the one from Anita Sethi. You have not given any backup to this or the context in which it was written. I doubt her advice here. My eldest child was able to fully roll at under 4 months of age. Hardly an age at which SIDS is no longer a risk. Don't have much confidence in her 'probably' and 'usually' either, and a baby knowing to roll on to her back while asleep because that is the safest position for her (they dont know), is a whole different matter to rolling whilst fully awake and supervised. Also it is not always true that a baby can roll from front to back before back to front. I know a baby baby who is just able now at 6 months to roll from back to front, but is unable to roll the other way, so that quote is complete rubbish. If that baby were to roll on to her front in the night, she would not be able to roll back, and without her parents awake and there to supervise, that would be a very dangerous situation.

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  6. Hi Anon
    here is the context of Antia Sethi's quote: http://www.parenting.com/article/learning-to-roll-over-21335048

    QUOTE My eldest child was able to fully roll at under 4 months of age. Hardly an age at which SIDS is no longer a risk.

    Is the SIDS risk the same between a baby who has the physical strength to roll over and one who hasn't?

    SIDS most commonly affects babies between the ages of 2 and 4 months.

    Interesting other sources also state: By the time the baby is learning to roll over, often around 4–5 months, parents and caregivers should transition baby from swaddling to a LESS RESTRICTIVE covering for sleep. If baby is able to roll over, then it is important for baby to have use of its hands and arms to adjust his or her head position after rolling over. http://en.wikipedia.org/wiki/Swaddling

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  7. Thank you for this well-researched and timeconsuming post. I am thankful this woman did not have a book out when my first son was born. I feel guilty enough as it is to have 'baby whispered' him. I do not think I am especially dumb, but I am sufficiently distant from my mother and she is sufficiently distant (in time) from baby rearing that I turned to books for help. I think I have figured out by baby 3 that demand feeding, co-sleeping, cuddling and generally tuning in is the best way.
    Will enjoy the response.

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  8. Another thought:
    QUOTE Also it is not always true that a baby can roll from front to back before back to front. I know a baby baby who is just able now at 6 months to roll from back to front, but is unable to roll the other way, so that quote is complete rubbish. If that baby were to roll on to her front in the night, she would not be able to roll back, and without her parents awake and there to supervise, that would be a very dangerous situation.

    Random idea but if the baby rolled over and got stuck, wouldn't she cry? I can see why this would be a problem if you are ignoring cries for whatever reason, but if not you could just roll them right back over?

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  9. Agree with the above post - my little girl learnt to roll from back to front 2 months before she learnt how to go back to her back but every time she did it, asleep or awake she would call / cry for help to get her back on her back, she would never sleep on her tummy. Now however, when she can roll both ways she's happy to sleep on her tummy. And no way I will put 16 blankets on her to stop her from doing it...

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  10. Michele Kavanagh24 July 2011 at 15:25

    Great post. I'll be very interested in a FSID reply?

    Babies should be nurtured and loved and cared for with respect and empathy...they are not pets to be "trained"

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  11. Just dug out my little red book - it's around 2.5 years old now but the advice given within (under the heading 'Cot Deaths - reducing the chances') says:

    "...
    - 2 or 3 layers or blanket are enough
    - babies after the age of one month do not need more clothes than their parents

    ...

    In a room temperature of 16-20*C a baby should be clothed and wrapped in no more than 10-12 tog units with the head uncovered."

    It then goes on to list an estimation of tog value for baby's clothes and bedding - and just a vest, sleepsuit and nappy add up to 3.2tog. Adding swaddling or a sleeping bag onto that before a heap of blankets is bunged on top is going to send Tizzie's tog total skyhigh. Plus, new blankets have a higher tog rating than old blankets. I fail to see how Tizzie's recommendations can do anything other than to cause the baby to overheat.

    Have you tried contacting the FSID directly? I agree that this is so important - especially when new mothers are being bombarded with information, it's important that that information is accurate and not misrepresented.

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  12. Brilliant article that I'll be sharing. Hope Ms Hall steps up and explains her research a bit better.

    I am also staggered that we're now expected (by her) to put SIXTEEN blankets on one tiny newborn baby! That's ridiculous! How high does that come?

    Also very suspicious that they're sold only by her, and the way she's using the guilt factor to sell her products. Very unethical.

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  13. I wonder if 'Anon' above is a Tizzie flower.. or even Tizzie herself? If not, why withhold even a pretend name if you feel so strongly about such A matter.

    Fantastic post, I imagine it will be hard to ignore for all involved and hope some genuine answers come back to this which actually make sense, well done AA! C: x

    Jenni - a devoted AA Facebook follower!

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  14. QUOTE I am also staggered that we're now expected (by her) to put SIXTEEN blankets on one tiny newborn baby!

    No it's 10 for a newborn. I'm not sure why if 16 are required when older, 10 is ok when younger ie wont they be cold?

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  15. Brilliant post. I look forward to the (lack of) reply.

    Surprised this hasn't been swarmed with Tizzie followers already. Maybe they've read the info and figured out that she's wrong? *fingers crossed*

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  16. Thank you for posting this. It's increasingly frustrating that questions regarding safety especially and comments are deleted from her page without response.

    I hope that this isn't the end of it and if Tizzie doesn't respond that FSID will at least take some action.

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  17. Jenni - no I am not a 'Tizzie follower', I am just a mum wanting to look at all the information and advice. Although if I was a follower, would I not be allowed to question any advice? I did not put my name, simply because none of the other profile options applied to me. I have now had to create a Google account just so that I can respond to you, as the Anonymous option has been removed.

    In response to AA, SIDS may be more common in babies 2-4 months, but it DOES happen in older babies.

    Yes a baby who rolls to its tummy and can't roll back may well cry, but what if it doesn't? Or what if for some reason, I don't hear it. I would always go to by my baby when she cries, but I must admit sometimes I don't hear her right away as I am so tired and in such a deep sleep. I would feel happier and more confident if I could ensure my baby would not roll on to her tummy in the first place.

    Also, what about a baby that can roll both ways, but chooses not to? The baby may like the tummy position, and if it is in that position because, as Tizzie Hall claims, it is cold, it won't roll back as that is the warmest position for it. But does that make it safe? Babies don't know what is best for them. This is made even more of a concern if, as advised the baby is less easily aroused and has decreased oxygen supply to the brain in the tummy position, so presumably therefore less likely to be able to complain, even if it wanted to.

    SIDS Guidance clearly states that the biggest risk factor for SIDS is tummy sleeping, above anything else. So should we not be looking at what we can do to prevent tummy sleeping? As advised by the ISPID, "thermal factors are less important if the baby sleeps on it's back", so isn't it then more important that we do all we can to keep the baby asleep on it's back? If that is indeed achieved by warmth, perhaps a few more layers are needed? I know that I sleep on my front when I am cold, and looking back at photos of my eldest child, who was dressed for bed as per Beths comment above, in a vest, sleepsuit sometimes a bag and 2-3 layers of blanket, did indeed sleep on her tummy. Aside from a safety point of view in ensuring the safest sleeping position, I question whether I was right to leave my baby feeling cold?? I certainly would not want to overheat my baby, but is there a medium ground to achieve of being warm? Not hot, or cold, just warm?

    I would like to see statistics surrounding cases of SIDS. How many have occurred from tummy sleeping? How many have occurred from having 10, 16 or however many blankets? Are you able to and provide us with this AA?

    As I have said,I am not a follower of anyone, I am just a mum, wanting to sift through all the conflicting advice and come up with the safest solution.

    AA and TH aside, it will be interesting to see what FSID have to say about this matter.

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  18. AA I wrote a post in response but you have deleted it? Why is that? Is this not an open forum for discussion on the matter?

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  19. Hi, AA,
    Have you had a look at Tizzie's breastfeeding advice? Now there is something I have rarely heard anywhere else. But, if you were to make a recipe for formula feeding that would be it

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  20. 'Excellent post. I sincerely hope it will elicit detailled responses from both FSIDS and 'Tizzie Hall' (not her real name). Much of the advice given in her book 'Save our Sleep' is of real concern to me - in particular her advocation of the use of 'graduated extinction' (even for very small babies), her extremely damaging & inaccurate breastfeeding 'advice', and especially her assertion that young children and babies vomit 'for attention' whilst being sleep-trained. Those who do employ her methods frequently accuse those opposed to them of misunderstanding or simply of having not read the book properly. Speaking personally, that is not a valid argument. If someone has to pay to join a forum in order to discuss a book they have already paid to read - or for help to interpret a bedding guide they have already paid to download - there is something wrong in my opinion. Why the secrecy if there is nothing to hide? If she is proud of her methods, has faith in her research, and is confident that her system is safe (both physically and emotionally) for young children, THEN AN OPEN DISCUSSION IS NOT THREATENING. If anything, it's an opportunity to broaden her readership and convince the sceptics that she knows what she's talking about. If however, her main goal is to generate as much income as possible, then obviously creating a private (paid for) forum, and refusing to engage with critics is ideal. Many other similar authors maintain public forums - which are well moderated - for free. When perfectly polite requests for clarification and information are repeatedly ignored/ removed, of course people become suspicious.
    'You can fool all of the people some of the time, and some of the people all of the time. But you can't fool ALL of the people ALL of the time.' '

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  21. I never used to think that anyone could vomit on purpose, for attention or otherwise. TH has taught me otherwise. ALL I need to do is read her BF advice in her SOS book and I wanto to vomit.... Seriously., the "advice" is totally, totally AWFUL. And that is being kind.

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  22. Fantastic. Will share this. This is the second person who tries to con (yes, I think it is a con) fearful parents into buying their stuff by citing questionable or even dangerous articles.

    And yes, I believe a baby who rolls onto his tummy but can't roll back would cry or at least whinge unless he is in a deep sleep. I'm unsure about her claim that they would bury their faces in the mattress. I've never slept face down so why would a baby?

    Thank you.

    Nev

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  23. But why should they have to cry?????????? It's better that they are warm enough to sleep comfortably without rolling over to desperately try to keep warm. That's like saying, yes a baby would cry if she rolled off the bed and smacked her face on the floor - but prevention is better than them having to cry!! When my baby has supervised tummy time and gets tired, she does bury her face in what she is laying on. So I'm darn sure I do not want her in that position in the middle of the night. But hey, that's just me. Oh and I'm not sure if my post on Facebook was seen, but just be aware that 19/20 degrees in an Australian winter feels A LOT colder than 19/20 degrees in a UK summer. It's bitter, numb toes, need a hot water bottle kind of weather. nd we have no central heating, n double glazing and terrible housing insulation.

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  24. I'm not willing to let my baby roll to sleep on her tummy, because Nev 'believes she will cry'. Sorry Nev, that's not enough assurance for me.

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  25. And others aren't prepared to pile 16 blankets on because TH believes "they will roll over and be at increased risk of SIDS", that's not enough assurance for them (especially when it contradicts SIDS guidance unlike Nev's comment) There is nothing to suggest TH's opinion is any more qualified or evidence based than Nev's.

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  26. The recommendation is that you place your baby to sleep on their back - not that you KEEP them there by pinning them down under dozens of blankets! It is only TH that recommends this as far as I know. There might be other "experts" who have the same level of qualifications and have done similar "research" but I don't think any official organisation takes this stance....?

    It seems utterly illogical to me. I don't sleep all night in the same position; why would I demand that of a baby? Plus, now people are actually having to designate TUMMY TIME to prevent/treat "flat heads" in their babies. This is surely a sign that babies are spending TOO MUCH time on their backs and that it's probably not good for them... OK, PUT them to sleep on their back, but if they move from that position, is that really MORE dangerous than being completely layered up and having their movement totally restricted for hours on end...?

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  27. I am not defending TH and I am not saying anything about using 16 blankets. I am saying that because we clearly know from all SIDS guidance that the best prevention, is back sleeping, I want to do all I can to ensure my baby stays asleep in this position. As the parent, the one who knows best, that is MY job. It is not something that I leave to my baby, and hope that she gets it right, or at least tells me about it. A baby in a deep sleep, as Nev said, will not cry out, and in a deep sleep is when the tummy sleeping would be at it's most dangerous. A baby who rolls and either can or cannot roll back, may not want to anyway. They might like it. But it is not safe.
    I do believe that a baby will sleep on it's tummy if it is not warm enough, as I have seen it happen with my first baby, and I sleep on my front when I am cold, it keeps the warmth in better. So yes I am making my second baby warmer in bed (not hot). Not 16 layers by the way, she doesn't need that many to be warm.
    Now to be on the fence and un-bias, I have read the article that was put out by Tizzie, and she wasn't actually telling people to use 16 blankets. She was telling them to use no more than that because of the weight. Because winter in Australia can really feel very cold, a lot of people here using cheap blankets are compensating by piling them on, but TH told them to limit it, because it will be too heavy. SIDS guidance tells us to keep babies warm and on their back. So that is what people have been trying to achieve in adding the layers.
    With respect to Ned, I did not mean to cause any offence, I just felt that my point had been misunderstood.

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  28. I'm in South Africa in Durban which is in the middle of a massive cold spell. Last night my house was 13 degrees inside (like aus we dont have central heating, double glazing etc), yet I was toastie warm under my 9 tog duvet with fleece pajamas and some socks on. My little boy slept in a vest, his fleec pjs and some socks in his sleep sack with just 1 extra crochet blanket (admittedly folded) in his cot until his first wakening (when I bring him into bed with me). His hands and feet were both warm to touch when he woke up and he showed no signs of being cold so I disagree with the assumption that you need more blankets in a warmer climate because we dont have central heating. 20 degrees is 20 degrees, it just feels colder because we're so used to 30 degrees

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  29. @Madasaspon - a flat head is a lot better than a dead baby. Flat head's go away once the baby is older. It's not about pinning them down under blankets, it's just about being warm. We as adults may move about, but we have mature airways, ones that will not be affected by sleeping on our tummy. We KNOW that this is dangerous for babies. It was only the 1990's or something when all the official advice told us to actually sleep babies on their tummy, but that wasn't right was it. Advice changes and evolves. Since that advice was changed, which Anne Diamond sought hard for, SIDS rates have dropped dramatically.

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  30. With respect to your rolling comment Jenna a baby in a deep sleep would not roll as movement happens in light sleep state? They also wake if they're cold then too.

    Again there is nothing to support that once babies have the strength to roll they are at increased risk on their front (please share if you know otherwise) on the contrary guidance online as quoted in my blog suggests otherwise.

    Secondly you are making your baby warmer by instinct - TH produces a bedding guideline, she as you quite rightly state gives details of temperatures and blanket amounts.

    ALL I am asking for is the evidence she bases these maximum guidelines on. Who decided 16 not 15 or 17 was ok? Who decided what "weight" was and wasn't ok on top of baby? Seemingly TH and I am purely asking ON WHAT BASIS!

    I refuse to believe that without her book, mothers would be going above 16 and piling 20-25 blankets on - certainly everyone I ever speak is stunned at 16! and nothing anywhere else online discusses anywhere near this sort of level as I discussed in my post.

    Do we not have the right to ask Tizzie to demonstrate what she is saying IS based on something solid?

    AA

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  31. QUOTE Flat head's go away once the baby is older

    Flat heads v v v v rarely "go away when older" without intervention. I'm NOT supporting prone sleeping in a young infant, but just wanted to correct this point.

    You cannot compare adult to infant sleep - this is why they don't recommend duvets (an adult can use one!) this is why we have to tuck blankets in (we don't do that for adults)

    The research Tizzie linked to showed oxygen levels where higher on the tummy (prone) once the infant was 5-6 months.

    If infants only turn over and do that because cold, why do babies in hot countries tummy sleep?

    AA

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  32. Fleece makes babies feel hot, when they actually may not be. Perhaps he woke because he was cold. Perhaps he thought that getting in bed with you was a much cosier option. Which is fine, that's wonderful that you have that and u love it. But maybe there is some truth to the cold factor.

    Yes AA, a cold baby may wake up, and roll over, then go into a deep sleep. You hit the nail on the head there. Sorry does SIDS not say that tummy sleeping is the biggest cause? Perhaps I have misread. My baby rolled at 3 months old, slap bang in the middle of the highest risk age group that you quoted.

    If you want to ask TH then yes, of course you have that right. I have no idea where those numbers came from. That has nothing to do with me.

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  33. Stand corrected about the flat head, I am only speaking from my own experience where it must have been only mild cases that I have seen.

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  34. Sorry AA, you have obviously read far more statistics than me, perhaps you should present this in a dossier to Tizzie Hall so that we can all take an objective look.

    I just want my baby to be cosy.

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  35. I agree with AA's comment above. Jenna I'm not quite sure what point you are trying to argue? We seem to be on the same page? No one is suggesting that you don't know what is best for your baby, or indeed that some babies may be cold at night. What is being questioned, as AA says above is Tizzie's apparently unqualified and un-evidenced advice. If she is having to post updated 'safety advice' with regard to her methods on her website then surely there is something amiss here?
    Nobody wants a dead baby (do I really have to say that?) which is why so many are concerned that Tizzie doesn't appear willing or able to substantiate her claims with hard evidence.

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  36. Jenna, we all want our babies to be warm and comfortable, but surely it's better for a baby to wake up between sleep cycles because it is cold, and have a layer added, than risk over heating the baby and them NEVER wake up?

    Back sleeping is great, but tell that to my son, who has slept on his side since he was able to roll at 3 months. He doesn't sleep on his tummy. He cries. It didn't take long to find that out.

    As a side note, my nephew who slept through from 6 weeks, has a lovely case of plagiocephaly (flat head) which at the age of four, is still very much apparent.

    I agree with Scarlett. I don't really get what point you're arguing.

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  37. Scarlett, I completely agree that someone who puts recommendations on baby safety into the public arena should be prepared and able to substantiate them. I think we have perhaps gone off on a tangent. The real point I was making, was that I do believe that some babies are cold at night, that the fear of overheating has perhaps sent us all the other way and some babies do not have enough bedding. SIDS aside, tummy sleeping aside, I think babies should at least be warm enough.

    AA it was not me who decided to compare adult sleep in infant sleep. I was responding to the comment from madasaspoon.

    I hope you are able to get some more information on the issue so that, as I said we can all look at it fairly and objectively.

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  38. Helena yes of course it is better for them to wake and then to add a layer, or if some prefer, take the baby into bed with them. With the layers, noone in their right mind would jump from 1 up to 16 layers. It would be exactly as u say, a process of figuring out what your baby likes and monitoring them to make sure they are not hot.

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  39. Her evidence is her study into cot deaths following her own loss and the subsequent years of working with infants and young children.

    I wonder if a study has ever been carried out on the figures for cot death in infants whose parents followed Tizzie's advice and those who bed share with their child? What do you think the results would be?

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  40. It's a shame really that we even have to be discussing this issue. Babies are born expecting to be kept close to their mother, especially during the very vulnerable state of sleeping. Deviating from the biological norm in yet another area of parenting is causing problems that we now have to solve, with people like TH cashing in.

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  41. Jenna is making some very valid points there. What we all want is safe, warm babies. TH's advice isn't only about babies being too cold, it also covers protecting your babies from overheating! I guess this must have been missed when you all read her books?

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  42. It's interesting, we believe babies will wake because they're cold, but we don't believe they will if they roll over and are stuck, unable to roll back.

    Jenna you say 3 months is the peak age for SIDS, once again I will repeat what I said before - is there evidence an infant who can roll themselves and thus has the strength to do so is at increased risk of SIDS. The babies in the study were placed prone - and the experts quoted suggest once a baby is strong enough to roll (be that 3 months or 5) risks of SIDS from being prone reduce.

    Jenna you say nobody in their right mind would jump from 1 to 16, yet parents who are overtired and desperate DO take things literally from books and the fact remains she produces a bedding guideline!

    QUOTE Suzi Her evidence is her study into cot deaths following her own loss and the subsequent years of working with infants and young children.

    Fantastic Suzi then let us see this study, provide the evidence to support the claim is more than theory. During her "years of working with infants and young children" (which seems to "trump" any qualification/scientific evidence when it comes to all the great baby tamers) that is called anecdotal evidence - it's unreliable for proving anything.

    AA

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  43. I am very close to my children without being in the same bed as them. That is another discussion though.

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  44. Her study into Cot Deaths? Has she got the qualifications to conduct such a study? And if her advice is so sound, why has she admitted in the past that she didn't not use the techniques with her own children? My personal view is that she is profiteering, she is given dangerous advice because its "unique" in the parenting market. Therefore her book has a USP, marking it different to other parenting books. All AA is asking, is for TH to validate her advice. TH has thusfar refused. Why would you say that is? If she has replied, and has marked it confidential, why would she do that? Surely if she is 100% confident in her methods, she would want to shut the naysayers up for once and for all?

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  45. QUOTE I wonder if a study has ever been carried out on the figures for cot death in infants whose parents followed Tizzie's advice and those who bed share with their child? What do you think the results would be?

    As the research shows safe bed sharing (ie with all the identified risk factors removed)causes parents to respond to their infants even whilst asleep, I think that's a no brainer :)

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  46. Quote from Facebook wall:
    Carrie Wilson Just read the bit where she says babies sleep on their tummies with their knees and arms tucked under and their bums in the air because they are cold. Really? Because my daughter has slept like that since she was able to roll - whether she is in the UK in her bedroom which is anything from 19-25 degrees, or when we visit family in Spain (regularly) where her room hits anything up to 28/29 degrees.

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  47. "I wonder if a study has ever been carried out on the figures for cot death in infants whose parents followed Tizzie's advice and those who bed share with their child? What do you think the results would be?"

    Well first split them in to two groups: breastfed babies, and formula fed babies. I would imagine that the results would be, from most to least deaths:
    Formula fed infants sleeping alone
    Formula fed co-sleeping infants
    Breastfed infants sleeping alone
    Breastfed co-sleeping infants.

    Of course, that's based on creating a safe co-sleeping environment for the baby.

    I agree, I would be very interested in the results of that study, but can't imagine they'd have that many people willing to partake.

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  48. When has she admitted that PH? Can u point us to the source?

    That's very true Susi, but narrow minded people see the world in one-dimensional ways. Just because I don't sleep my baby in bed with me does not mean we are not close, and for someone to suggest that it does is the real shame here. We all have our own choices and styles of parenting, and if following the guidance of a woman with years of experience, makes for happy babies, happy mums and happy families, than that's a winner. Mums need all the support they can get, not criticism. Whatever style we choose and choices we make, we should support and respect each other.
    If TH was really that bad, would so many people be supportive of her advice? They are not sheep, they ALL put their children above anything else so would therefore consider any advice very carefully.

    Safe bed sharing is fine, and so is putting a safe amount of safe blankets blankets on your baby. I certainly would never put polyester the sweat machine on my baby.

    Now over and out. I've got better things to do, like spend time with my family! Goodnight xx

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  49. QUOTE: As the research shows safe bed sharing (ie with all the identified risk factors removed)causes parents to respond to their infants even whilst asleep, I think that's a no brainer :)

    Yet I personally know someone who didn't drink, smoke, take drugs,was ill, or any of the other identified risk factors who sadly lost their infant to SIDS while bed sharing. That was enough for me.
    Breathable natural fabrics keeping baby warm, but not hot, along with many other safety factors in a sleeping environment, including sleeping alone (bed I mean, not alone in a room when they are very young) are what I feel comfortable with. I did not read TH's books and think wow this is new and different to anything I have read, I'll try it, I thought yes this makes sense. We all have our own parenting views and styles and perhaps sometimes need to respect that a little more.

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  50. QUOTE Yet I personally know someone who didn't drink, smoke, take drugs,was ill, or any of the other identified risk factors who sadly lost their infant to SIDS while bed sharing. That was enough for me.

    Do you...And how many die in cots?!? It was called COT death for long enough. All over the world the vast majority of infants share a sleep space with their mother because of the need to feed frequently at night. Check out some of the research about co-sleeping and the stats. It is only certain cultures that have started trying to train infants to sleep in spells of abnormal length, because this suits our society which is very much focussed on the needs of the parents and not the long term impact to the infant (none of the baby tamers consider or provide evidence for long term impact of any technique)

    There is also evidence that children who breastfeed or co-sleep continue to "signal" at night (ie cry and wake up) therefore the reverse of this is those who are sole sleeping are at more risk of not signalling (ie crying and waking up) which whilst being what some parents are aiming for may in itself be a risk factor for SIDS!

    It's also not about feeling whether baby is hot or cold and adding more - that much I have taken from what I've read and the forum. Posts of "my baby is waking at 6am" are met with add another blanket or two, no question of did your baby feel cold?!

    Breathable natural fabrics may keep a baby warm, but we also have extensive evidence that a mother's body regulates her infant's body temperature - no need to calculate and constantly add or remove layers.

    The point Susi (and Jenna) ultimately is that nobody has knocked your parenting views or style, or criticised YOU. I have been that vulnerable new mother and read enough books to last a lifetime. What I do question is the evidence behind TH's guidelines. You choose to follow her, that's entirely up to you!

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  51. Exactly AA! No one has questioned closeness (I'm assuming you were referring to my comment Jenna, which you seem to have mis-read, I was referring to physical closeness, ie proximity not emotional attachment).

    TH does not have any qualifications and anecdotes are not a safe nor sensible basis on which to make potentially life/death decisions. I also seriously question the credibility of any interpretation of anecdotes by someone who uses their experience of loss as a starting point. All situations are not equal and true interpretation can only be made through scientific controlled study. Where are Tizzie's controlled scientific studies? Why does she steadfastly refuse to substantiate her claims?

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  52. If it was SIDS it was going to happen as someone who has held a baby whilst they died I can tell you I'd rather my baby died in my arms than alone - if they're going to die.

    Safe bedsharing will lower the risk of accidents and SIDS but accidents and SIDS can happen in a baby's own bed. I know of three stories of babies dying from SIDS in the parents arms whilst the parents were awake - one whilst changing the nappy. You're never going to eliminate all risk but you do your best and carry on with life knowing there could be a bus around the corner.

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  53. Yes I do. Like I said it was enough for ME.

    I don't feel critised, it's fine we disagree, like we both say, each to their own. I have raised my children in the way I wanted to, after like you a lot of reading and now a lot of experience added to that. I just wanted to try and add another point of view from someone who understands and has used Tizzie's methods.

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  54. Question to Susi? How do you feel about the fact Tizzie is reluctant to verify her methods, her reluctance to produce studies? Studies she has conducted herself are not undertaken in controlled environments, nor are they peer reviewed. If she is so confident in what she is saying, why not publish these results in a medical journal? She wrote the book before she had children, so that didn't make her experienced, although she has updated it since. What about her lack of qualifications? Do you really not find any of this suspicious? Genuine questions btw, not having a pop.

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  55. So sad that ppl don't realise that getting babies to sleep longer is in itself a risk factor for SIDS.Be careful what you wish for you may get to sleep all night every night :-(((

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  56. In case of moderation elsewhere on the blogged reply by Tizzie...

    Formal research is validated by the peer review process:
    http://www.senseaboutscience.org/pages/peer-review.html

    This helpful leaflet explains how scientists present and judge research and how you can ask questions of the scientific information presented to you: http://www.senseaboutscience.org/data/files/resources/16/IDontKnowWhatToBelievereprint2008.pdf

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  57. I posted this on her blog - it's awaiting moderation so I will post it here too, in case it doesn't get past the Tizziebots:

    - -

    You keep referring to “your research”, but what research?! When and where was it conducted? How many subjects did you use? What were the controls and variables? What was the abstract, what was the conclusion? Has the research been peer reviewed? I was hoping that this information would be included in your response to the Armadillo. I am disappointed. Will it EVER be published? When?

    For all I know, this research could be on one baby behind closed doors in your bedroom in the dead of winter when your heating broke. In which case I would not be likely to take it very seriously and would be even less inclined to follow advice from it in the summertime.

    Or it could be 800 babies, carefully controlled, carried out in conjunction with a large university or sleep lab…. In which case I’d be more likely to think: OK, maybe Tizzie knows her stuff.

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  58. "I wonder if a study has ever been carried out on the figures for cot death in infants whose parents followed Tizzie's advice and those who bed share with their child? What do you think the results would be? "

    The Tizzified babies would be at increased risk for SIDS anyway, as formula feeding is a risk factor for SIDS.

    But I think this whole discussion is probably going to be passe as soon as Tizzie finds a thicker, more expensive blanket that she can be sole distributor for. She'll crank up a few usernames on parenting forums to tell everyone how great they are, revise downward her official correct number of blankets (TM), write a new article on the superiority of said blankets (download only $6), hawk the blankets and continue making her money off paranoid control freak new parents.

    Juanita

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  59. Um, just made the mistake of commenting on breastfeeding to a Tizzie Hall follower on a Facebook group. Apparently my 35 years as a lay breastfeeding counselor and 20 years of being a fully credentialled IBCLC don't mean anything--how could I possibly know that most mums would not do well at breastfeeding when leaving the baby to sleep 11 hours at night and starting solids at 4 months (weaning, in the UK). Obviously, all the mothers who talk to ME have problems, and all the schedule feeding, happily sleeping at night mums don't. So there. And yet the Tizzie ladies are doing eveything by the book without a qualm based on what? Why do I even care about this? I guess because I hate to see parents bamboozled by yet another "expert" who promises the moon, based on nothing, and makes big bucks doing it. After scrolling down this discussion of Tizzie Hall's idea of proper covers for a baby at night, I am reminding myself never to read her book. My blood pressure couldn't take it. I have tried over the years to base what I tell mothers on evidence that is reliable, and if there is no good research on the topic to fall back on "Many mothers find that..." or "Some babies do better when...".But really, NO evidence? I think Tizzie Hall is just one more flash back to baby advice form the 1930s and 1940's, for heaven sake. Shades of the Plunkett nurses.

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  60. V well said Nellie! I'm blogging about her bfing advice at the moment (then that will be the last TH post for a while!) I don't find it BP raising reading the book tbh, in part because some of the ideas are so giggle worthy it at least has the amusement factor eg we drink cow's milk because it's close to human milk dontcha know? LOL
    AA

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  61. My ds sleeps in all sorts of positions in his cot at home (tummy, back, side) in the UK, but on our recent holiday to tenerife he started adopting the face down, bum in the air, arms tucked in position. It was quite hot compared to his usual sleeping climate, so is it really being too cold that makes babies try to sleep in this position?
    Gill x

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  62. I'd like to ask Tizzie if she takes into consideration a babies body temperature when doing this 'research' and giving out this 'advice'.
    Any human beings body temperature should be kept at or around 35 - 37 degrees celius. And in a 24 degree C room with many layers on including clothes, blankets, swaddles and sleeping bags, body temperature would be raised.

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  63. EEk. I'm not British but when my DD was a newbie we lived in Japan. During the winter she would be in a singlet, fleecey onesie and wrapt in a fairly light fleece blanket, then placed next to me in the double bed up between two pillows so she wouldnt risk getting the quilt over her head. She always seemed warm enough and she slept very well at night despite being a Hizzie worst nightmare during the day. She would wake to boob 2-3 times most night, have her boob and go back to sleep. I often fell back to sleep during the feed too. It was so much easier than getting up to feed my DS and having to sit an extra 10mins till was out cold before waiting to attempt the cot. About half the time he would wake and we'd be back to square one but I'd read in some silly magazine that if he didnt go in the cot he'd never learn to sleep. I remember fretting a bit about my Japanese nephews and friend's childrens sleeping under layers and layers of thick warm blankets. They were often sweating and it didnt seem to stop them waking if they were hungry.

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