In the Netherlands a case control study into cot death was undertaken as part of the European Concerted Action on sudden
infant death syndrome. Children between 1 week and 2 years of age who died suddenly and unexpectedly were reported. Non cot
death cases were excluded after a consensus by three pathologists. The study comprised 73 cot death cases and two controls
per case, matched for date of birth. Compared to national data, the coverage was 91%. We investigated whether in the Netherlands
new risk or preventive factors might have emerged. The present report focuses on the relative risks of dummy use, thumb sucking,
breast versus bottle feeding, and sleeping with the mouth open.
Conclusion Dummy use seems to be an important preventive factor for cot death in the Netherlands, independent of other risk factors
such as prone sleeping and bedding. We recommend dummy use at least for bottle-fed infants. We found no indication that dummies
influence the frequency or duration of breast feeding but more data are needed. Mouth breathing appears to be associated with
an increased risk for cot death, but again further research is needed.
Key words Cot death - Sudden infant death syndrome - Dummy use - Mouth breathing - Breast feeding
Received: 8 December 1998 / Accepted: 4 May 1999