Did Dr. Spock’s Parenting Advice Kill 60,000 Babies?

Authored by Ross Pomeroy via RealClearScience,

Dr. Benjamin Spock is remembered as one of the foremost authorities on raising children. His influential and prolific books, first published in the mid-1940s, advised parents to be more affectionate and flexible with their young kids, countering what was then the entrenched norm of being rigid and aloof.

Though most parents today are probably more familiar with a different, pointy-eared Spock, in his heyday during the 1950s and 60s, Dr. Spock was one of the most recognizable and respected public figures in the world. When he spoke or wrote, people – and particularly parents – listened intently.

Unfortunately, much of Spock’s guidance wasn’t grounded in scientific research, but rather his extensive clinical experience. While this generally produced helpful, or at least harmless, advice, in one major instance, it resulted in grave harm. 

Starting with the 1958 edition of his bestselling tome, The Common Sense Book of Baby and Child Care, Spock recommended to parents that they put their babies to sleep on their front, rather than on their backs. “If he vomits, he’s more likely to choke on the vomitus,” Spock reasoned. “Also, he tends to keep his head turned to the same side—usually toward the centre of the room. This may flatten the side of his head.”

At the time, there was an active debate about whether front-sleeping or back-sleeping was healthier for infants, so Spock’s recommendation – which we now know to be dead wrong – could be excused. However, in the dozen years since Spock urged prone-sleeping, scientific studies made clear that the practice markedly raised the risk of sudden infant death syndrome (SIDS) compared to back sleeping. A 2005 historical analysis conducted by researchers with the Centre for Evidence-based Child Health in London showed that by 1970, the scientific literature indicated that front-sleeping tripled the risk of SIDS compared to back-sleeping.

Spock, however, neglected to consult this gathered scientific evidence and didn’t update his book Baby and Child Care to reflect the new reality for some time. As Marit L. Bovbjerg, an Associate Professor at Oregon State University focusing on maternity care in the U.S., wrote in 2011:

“Dr. Spock’s book was not the only popular book to advocate prone sleeping at the time, but further revisions continued to make the recommendation nine years after solid epidemiological evidence had accumulated regarding the increased risk of SIDS for babies being placed on their stomachs for sleep.”

Spock’s book was by far and away the most read parenting guide to advocate prone sleeping. According to the New York Times, for a half-century since its publication, Baby and Child Care was the second-best-selling book, behind only the Bible.

The researchers behind the aforementioned 2005 scientific review estimated that the collective failure, led by Dr. Spock, to alter the advice on safe-sleep for infants in a timely fashion, resulted in an extra 10,000 infant deaths in the UK and at least 50,000 in Europe, the USA, and Australasia after 1970.

With great influence comes great responsibility. In failing to change his mind on infant safe-sleep in the face of overwhelming scientific evidence, Dr. Spock showed that he was not worthy of the standing he garnered and the trust he earned from the world’s parents.