Cot deaths advice 'not targeted'

Official advice is to put babies on their backs to sleep in a cot or crib, not on a sofa 'Cot death risk' to small babiesPlea to reduce stillbirth numbers A campaign to change babies' sleeping positions and reduce cot death rates in the 1990s failed to get the message across to deprived communities, a study has suggested.

It took up to 15 years for the death rate to reach "a low and stable rate" in those areas, researchers found.

The University of Cambridge study looked at sudden infant deaths in Scotland from 1985 to 2008.

Future campaigns should target people in areas of high deprivation, it said.

The 'Back To Sleep' campaign, which was launched in November 1991, aimed to get parents to put their babies to sleep on their backs.

This was known to lower the risk of sudden infant death syndrome (SIDS) or cot death, which affected about 1 in 500 live-born babies in the 1980s.

At present, fewer than one in 2,000 babies in the UK dies from SIDS.

The Cambridge study found a sharp decline in the rate of sudden infant death syndrome among women living in areas of low socioeconomic deprivation in Scotland between 1990 and 1993.

Continue reading the main storyADVICE ON SIDS Place your baby on their back to sleep (and not on the front or side). Cut smoking in pregnancy, including dads. Don't let anyone smoke in the same room as your baby. The safest place for your baby to sleep is in a crib or cot in a room with you for the first six months. Never sleep with your baby on a sofa or armchair. Do not let your baby get too hot, and keep your baby's head uncovered.

Source: Foundation for the Study of Infant Death Syndrome

Yet among women living in areas of high socioeconomic deprivation, the study found a much slower decline in the rate of sudden infant death syndrome between 1992 and 2004.

'Abrupt decline'

Prof Gordon Smith, author of the study from the department of obstetrics and gynaecology at the University of Cambridge, said the campaign had a global reach but needed to be more targeted.

"Ultimately, Back To Sleep was a huge success and helped to stimulate an abrupt decline in the rate of sudden infant death syndrome all over the world.

"Clearly, however, it was much slower where deprivation was high."

The study found that in the UK in areas of low deprivation, the maximum beneficial effect was achieved in just two to three years.

Continue reading the main story“Start QuoteWe may need to make special efforts in future public health campaigns to reach the most deprived sections of society.”

End QuoteProf Gordon SmithUniversity of Cambridge "In contrast, it took 10 to 15 years for the campaign to reach the same low levels in deprived communities," Prof Smith said.

He said that any future campaigns seeking to reduce risk factors for stillbirth and infant death should bear this in mind.

"One lesson we can learn from this is that we may need to make special efforts in future public health campaigns to reach the most deprived sections of society, the people who often need to hear the message most."

'Good access'

Ian Currie, from the Royal College of Obstetricians and Gynaecologists, said it was worrying that rates reduced more slowly in deprived areas.

"More certainly needs to be done to raise awareness amongst all women as to the possible causes of infant mortality and stillbirth. Women living in deprived communities especially need extra support and good access to information.

"Other factors associated with infant death and stillbirth include smoking in pregnancy, alcohol consumption and obesity. It is vital that pregnant women receive appropriate levels of support before birth and post birth."

Prof George Haycock, scientific adviser for the Foundation for the Study of Infant Deaths, said the study was well-constructed.

He said: "We agree with Prof Smith and his colleagues that the 1991 campaign did reduce the SIDS rate - 70% in the UK - but that there is no doubt that other pieces of advice and factors may well have contributed to the decline."

Diets fail 'because advice is wrong'

Weighing and measuring yourself regularly helps track your weight-loss progress Calories busted by cafe culture Eat less and you will lose weight.

This simple piece of advice is true, but it's one that many of us struggle to follow.

It is easy to blame a lack of willpower or a penchant for sugary, fat-laden snacks. And often weight does pile back on because people revert to their old way of eating too much of the wrong foods.

But researchers say the reason so many of us relapse and fail on diets is because we have unrealistic expectations.

And this is not our fault but that of experts, because the advice they give us is flawed.

Long slog

Most people start dieting with the notion that they will start to see results fast.

Experts tell us that if we cut around 500 calories from our daily diet, or burn them off exercising, then we can expect to lose 1lb (0.5kg) in weight every week.

Continue reading the main story“Start QuoteStudies show that somewhere between 50% and 80% of dieters will put weight back on”

End QuoteDr Kevin Hall of the US National Institutes for Health The British Dietetics Association, the NHS and the American Dietetic Association all say losing weight at this rate is "about right" and that if you stick at it for 12 months, for example, you will shed about 52 lb (26kg).

But US researchers from the National Institutes for Health say this is a gross overestimation because the calculation used is flawed.

They say it takes much longer to lose the weight - around three years to be precise, according to their work published in The Lancet.

For example, a year of dieting will result in only half of the amount of weight loss that experts currently predict.

Dr Kevin Hall and colleagues say this explains why many of us give up within months, because we expect unrealistic results that cannot be achieved.

Studies of outpatient weight loss programmes show most dieters peak at six months with the pounds starting to creep back on after this.

MPs reject abortion advice change

Nadine Dorries MP said : "I don't want to see a return to backstreet abortionists"

Tory MP Nadine Dorries wanted to stop abortion providers giving NHS-funded counselling to women.

She said it was about offering women more choice but was accused of trying to "import American sensationalism" to the abortion debate.

MPs rejected her call to offer women the "option" of independent counselling by 368 votes to 118, but there will be a consultation on improving services.

MPs did not have to follow party lines as abortion is considered an issue of conscience.

Labour MP Frank Field - who had backed Ms Dorries' original amendment - withdrew his support at the end of the debate after the government said it would consult on improving abortion counselling for women.

'Would not work'

Ms Dorries had proposed changing the statutory duties the NHS must provide to include "independent information, advice and counselling services for women requesting termination of pregnancy" - and had said private abortion providers should not be considered "independent".

But that was not put to the vote - instead it was on another of her amendments, proposing instead to offer women "the option of receiving independent" counselling and advice, that MPs voted.

Health Minister Anne Milton had urged Ms Dorries to withdraw her amendments.

Continue reading the main storyANALYSISNick TriggleHealth correspondent, BBC News

Abortion is one of those areas of health care where the NHS relies heavily on the independent sector.

More than half of all terminations are done by the main two providers - BPAS and Marie Stopes International.

Their services are regulated and they have to keep to official guidelines.

Counselling is provided by trained professionals independently of the clinics' doctors, but women do not have to take this up.

This reflects the fact that for some women their mind is already made up by the time they arrive at the doors of an abortion provider.

They may have discussed the decision at length with their GP and/or partner and so health professionals accept that they have reached a clear personal decision.

She said the government was "supportive of the spirit of these amendments" but that putting it in primary legislation was unnecessary and would "deprive Parliament of the opportunity to consider the detail of how this service would develop and evolve."

The Health and Social Care Bill, which MPs are debating, gives local government new public health functions, she said, including on abortion services and the government intended to ensure that "a part of what they commission is a choice of independent counselling".

She said defining "independent" was not simple and the government wanted to think through all the financial and legal implications first.

"We want counselling to be provided by appropriately qualified people who offer non judgmental therapeutic support and who act according to their professional judgement, without undue interference or regard to outside interests," she said.

Ms Dorries told the BBC later that she had "got what we wanted" as the government had now agreed to consult about abortion advice.

She said she had only pushed the issue to the vote because many MPs backing her had wanted to publicly declare their stance on the issue and the "spirit" of her amendment would be taken forward by the government.