Tuesday, May 23, 2017


Satanic Jews must be permanently removed from our realm. They are a sexually depraved, psychotic bunch and a menace to all life forms.

EXCERPT: Are people in the West aware of the Jewish role in producing the filthiest child porn imaginable?

With the full connivance of the American government, Jews pursue this foul trade in the San Fernando valley, California, otherwise known as “Porn Valley”. (See here). No, the public largely remains unaware of these iniquitous facts, for the simple reason that the media covers up the facts.

The situation in Russia is even more extreme, with the majority of Russians totally unaware of the historical crimes committed against them by Jews in the Communist era. Here is Dr Pierce’s incendiary comment, and we must make allowances for his white-hot anger:

"The Jews are lucky they still control most of the television and other mass media in Russia—because if the Russian people ever are fully awakened to what the Jews are still doing to them, they will rise up and kill every Jew in Russia—every Jew—every Jew!—and they will be fully justified in doing so."

Whatever you do, don’t miss this electrifying video before it is banned.

Dr. William Pierce - White Children Are In Danger

Source Article by Lasha Darkmoon:
Snuff Porn Pedophilia: Killing Children for Sexual Pleasure

Before providing the gruesome details of the sadistic cruelties inflicted on sexually exploited children, many of them toddlers kidnapped from orphanages in Russia and tortured to death, it is necessary to set out the basic statistics: the principal facts and figures of the worldwide porn industry.


“This is a sick world we are living in.”
— Dr William Pierce (in video below)

These notes come from an unpublished article of mine written a few years ago which I have just found among my papers after misplacing them. I have updated the figures wherever possible, but I wouldn’t be surprised to learn they are in some cases an underestimate. This is because porn addiction sucks millions of new victims into its net every year. There were only 670 million internet users worldwide in 2002, for example, but by 2013 this figure had soared to 2.7 billion. (See here). In other words, the pool of potential victims of porn addiction has grown much larger with each passing year.

Most of the figures cited below, except those with separately numbered references within the text, are sourced from Family Safe Media’s Pornography Statistics. Otherwise, they will be found in Top Ten Reviews’ Internet Pornography Statistics.

Total world revenues per annum from pornography amount to $100 billion, with $3,100 spent on porn internationally every second. These revenues are larger than the revenues of the top technology companies combined: Microsoft, Google, Amazon, eBay, Yahoo, Apple, Netflix and EarthLink.

There are 7 billion people in the world spread over 200 countries. It would be of interest to know which countries are most given to porn consumption on a per capita basis. Given the inseparable link between pornography and masturbation, the citizens of those countries could then be justly regarded as the “most lustful in the world” — or, at any rate, as the world’s most prolific masturbators.

These are the top 10 countries most given to masturbatory lust, based on per capita expenditure on pornography: (1) South Korea ($527 per capita). (2) Japan ($157 pc). (3) Finland ($115 pc). (4) Australia ($99 pc). (5) Brazil ($53 pc), (6) Czech Republic ($44.9). (7) United States ($44.6 pc), (8) Taiwan ($43.4 pc), (9), U.K. ($32 pc). (10) Canada ($30 pc).

Why the South Koreans and Japanese spend such enormous amounts of money on porn, compared to other nations, is subject matter for a sensational PhD thesis which I hope some eager doctoral student will write one day. For 11 years in a row, South Korea has ranked at No. 1 in the suicide rate among OECD nations. Whether there is any correlation between high porn consumption and high suicide rates is a fascinating conundrum which academic researchers might wish to solve.

Though China spends more on porn than any other nation in the world (a whopping 28 percent of total pornography revenues compared to America’s 14 percent), this is only because of China’s enormous population of 1.3 billion people. In spite of the fact that porn is officially “illegal” in China, a country sometimes described as “a land where porn doesn’t exist”, the Chinese appear to have easy access to pornography imported from Japan.

The annual expenditure on pornography in two countries alone, China and Japan, would be enough to feed the world’s hungry for an entire year.

There are over 4 million porn websites in the world, growing by the thousands every day. There are 68 million pornographic search engine requests a day, 25 percent of the total. Four out of 10 internet users view porn sites regularly. There are 100,000 websites offering illegal child pornography. The largest consumers of internet porn, surprisingly, are children aged 11-17. There are 40 million regular users of porn in the US, and 20 percent of these are accustomed to peek at porn sites at work when they think no one is looking.

A new porn site is being created in the US every 40 minutes. The most expensive domain name ever purchased (site link deleted) cost $14 million: an indication of the enormous profits accruing to porn.

Roughly one in three visitors to porn sites are women, with almost one in six women (17 percent) admitting to a serious porn addiction. In the pre-internet age, women were relatively safe from the devastating effects of pornography. No longer. In the last three years alone, online porn viewership for women has quadrupled. It is a myth that women have different preferences to men and show less appetite for hardcore pornography.

A 2008 study found that women showed signs of arousal watching pretty much anything: masturbation, straight sex, girl-on-girl, guy-on-guy, bonobo chimps, everything — everything except pictures of naked men, which did not float a woman’s boat.

Average age of the first internet exposure to pornography is 11 years old. 90 percent of 8-16-year-olds have viewed porn online, mostly while doing homework.

Over half of global child porn (55%) is produced in the US, mostly in the Los Angeles area. There are 100,000 websites offering illegal child porn. Annual child porn revenues range from a low of $3 billion to an unrealistically high $20 billion. Daily Gnutella “child pornography” requests are 116,000 and keep growing. Even more disturbingly, there is strong evidence that an addiction to “normal” adult pornography can lead in time to an appetite for child porn.

Between 2005 and 2009, there was a huge and unexplained 432 percent increase in child pornography use, taking this new sex plague to pandemic levels. [Link lost]

The top video porn producers are found in the US, with Brazil and the Netherlands coming in second and third. The top six US erotica cities are Los Angeles, Las Vegas, New York, Chicago, San Francisco and Miami.

The fully employed female porn star can earn $100k-300k a year, three times more than the average male porn star. The more unnatural the sex is, the higher the rates. An actress who gets $500 for a session of straight vaginal sex can demand $1000 for a session of anal sex and $2000 for “double anal sex”. Celebrity porn stars naturally get paid much more. (Link lost). A criminal pedophile willing to molest a child in front of a live webcam can earn $1000 a night.

The top ten countries most opposed to porn are the Islamic countries, viz., Saudi Arabia, Iran, Syria, Bahrain, Egypt, UAE, Kuwait, Malaysia, Indonesia, and Singapore.

Almost 90 percent of the world’s internet porn pages are produced in the US for distribution to other countries, so the US can be seen as the world’s premier sex emporium.

The big players in the porn distribution market are now the major corporations, and, ultimately, the fabulously rich and faceless executives who control them. These are Fortune 500 companies such as AOL Time-Warner, AT&T, and General Motors. Through their cable and satellite subsidiaries they have distributed, and continue to distribute, vast quantities of pornographic material worldwide.

The number of pornographic websites owned by American Jews is of course a closely guarded secret—this is one politically incorrect statistic Wikipedia is unlikely to supply—but it is common knowledge that Jews dominate the porn industry (See also here and here). Indeed, it is also common knowledge that six Jewish-owned companies own 96 percent of the world’s media and that Big Media and Big Porn are interlocking and overlapping concerns.

The Jewish Role in Child Murder and Snuff Pornography

If 55 percent of the world’s child pornography is produced in the US—according to the British charity National Children’s Homes—23 percent of the world’s child porn is produced in Russia. (Link suppressed)

Whether or not Russian child porn is dominated by Russian Jews remains a nebulous issue. There is a high probability that it is, given that there is substantial evidence of Russian Jewish involvement in sex trafficking, kidnapping, pedophilia, and even child murder in the production of snuff porn movies.

Let me now quote from a news report first published in October 2000. I will intersperse snippets of this report — “JEWISH GANGSTERS RAPED, KILLED CHILDREN AS YOUNG AS TWO ON FILM” — with comments on the same case by Dr William Pierce which you can listen to yourself in the video at the end of this article:

ROME, ITALY — Italian and Russian police, working together, broke up a ring of Jewish gangsters who had been involved in the manufacture of child rape and snuff pornography.

Three Russian Jews and eight Italian Jews were arrested after police discovered they had been kidnapping non-Jewish children between the ages of two and five years old from Russian orphanages, raping the children, and then murdering them on film.

Mostly non-Jewish customers, including 1700 nationwide, 600 in Italy, and an unknown number in the United States, paid as much as $20,000 per film to watch little children being raped and murdered.

Here is what Dr William Pierce has to say:

“I suggest that if you asked your favorite Jewish media boss why his report of the police raids in Italy and the arrest of the child pornographers in Moscow didn’t get more news coverage in the United States, he’ll tell you that such news would only generate hatred against the Jews. And you know, he’d be right.

“My view is that such people should SIMPLY BE KILLED ON THE SPOT whenever and wherever they are found. More than that, the people who promote and encourage the extreme individualist mindset through their control of the media SHOULD BE EXTERMINATED ROOT AND BRANCH AS A CLASS.”

(Video transcript, emphasis added)

The news report concludes:

Jewish officials in a major Italian news agency tried to cover the story up, but were circumvented by Italian news reporters, who broadcast scenes from the films live at prime time on Italian television to more than 11 million Italian viewers. Jewish officials then fired the executives responsible, claiming they were spreading “blood libel.”

Though AP and Reuters both ran stories on the episode, US media conglomerates refused to carry the story on television news, saying that it would prejudice Americans against Jews.

Dr Pierce is naturally outraged at these dirty tricks to conceal from the public the heavy Jewish role in snuff porn pedophilia: the systematic torture and murder of little children by Jewish pornographers in order to sate the jaded appetites of sexual perverts in the West:

“If there’s any group of people on this planet who have valid reasons for hating the Jews, it’s the Russians…. The Jews bled Russia dry with 70 years of Marxist rule and and murdered tens of millions of Russians—the best Russians—in the Communist slave labor camps or in the basements of the secret police headquarters or beside the shooting pits in forests all over Russia and Ukraine.

They have forced thousands of the prettiest young Russian women into prostitution and slavery after the fall of Communism; and now they kidnap Russian children and rape and sexually torture them in front of a camera in order to make child porn for rich perverts in the West.”

(Video transcript)

Are people in the West aware of the Jewish role in producing the filthiest child porn imaginable?

With the full connivance of the American government, Jews pursue this foul trade in the San Fernando valley, California, otherwise known as “Porn Valley”. (See here). No, the public largely remains unaware of these iniquitous facts, for the simple reason that the media covers up the facts.

The situation in Russia is even more extreme, with the majority of Russians totally unaware of the historical crimes committed against them by Jews in the Communist era. Here is Dr Pierce’s incendiary comment, and we must make allowances for his white-hot anger:

The Jews are lucky they still control most of the television and other mass media in Russia—because if the Russian people ever are fully awakened to what the Jews are still doing to them, they will rise up and kill every Jew in Russia—every Jew—every Jew!—and they will be fully justified in doing so.

(Video transcript)

Whatever you do, don’t miss this electrifying video before it is banned.

VIDEO : 8.48 mins

Dr. William Pierce - White Children Are In Danger - Oct. 7, 2000 (with CC)

Tuesday, May 16, 2017


Animal sacrifice is alive and well on the streets of New York City thanks to SATANIC JEWS that feel they have a right to make the streets run red with blood for their sick, sadistic rituals. The Jewdicial system supports this madness as well as other forms of evil like blood sucking circumcision rituals by members of this same satanic cult.

When do we say enough folks? How long are we going to let these filthy Luciferian, devil-worshippers walk free in America?


Mirrored video originally posted at: https://www.facebook.com/theirturn/videos/1802576783326044/

Monday, May 15, 2017


They have attempted to hide this information. Let's do our part to keep it moving. Please copy, paste, post on your own blogs, and share.


The vaccinated were less likely than the unvaccinated to have been diagnosed with chickenpox and pertussis, but more likely to have been diagnosed with pneumonia, otitis media, allergies and NDD. After adjustment, vaccination, male gender, and preterm birth remained significantly associated with NDD. However, in a final adjusted model with interaction, vaccination but not preterm birth remained associated with NDD [neurodevelopmental disorders], while the interaction of preterm birth and vaccination was associated with a 6.6-fold increased odds of NDD (95% CI: 2.8, 15.5). In conclusion, vaccinated homeschool children were found to have a higher rate of allergies and NDD than unvaccinated homeschool children. While vaccination remained significantly associated with NDD after controlling for other factors, preterm birth coupled with vaccination was associated with an apparent synergistic increase in the odds of NDD.

Study on Health of vaccinated and unvaccinated 6 to 12 year olds

Study on Health of vaccinated and unvaccinated 6 to 12 year olds
Pilot comparative study on the health of vaccinated and unvaccinated 6- to 12- year old U.S. children
Anthony R Mawson
Professor, Department of Epidemiology and Biostatistics, School of Public Health, Jackson State University, Jackson, MS 39213, USA
Brian D Ray
President, National Home Education Research Institute, PO Box 13939, Salem, OR 97309, USA
Azad R Bhuiyan
Associate Professor, Department of Epidemiology and Biostatistics, School of Public Health, Jackson State University, Jackson, MS 39213, USA
Binu Jacob
Former graduate student, Department of Epidemiology and Biostatistics School of Public Health, Jackson State University, Jackson, MS 39213, USA
DOI: 10.15761/JTS.1000186


Vaccinations have prevented millions of infectious illnesses, hospitalizations and deaths among U.S. children, yet the long-term health outcomes of the vaccination schedule remain uncertain. Studies have been recommended by the U.S. Institute of Medicine to address this question. This study aimed 1) to compare vaccinated and unvaccinated children on a broad range of health outcomes, and 2) to determine whether an association found between vaccination and neurodevelopmental disorders (NDD), if any, remained significant after adjustment for other measured factors. A cross-sectional study of mothers of children educated at home was carried out in collaboration with homeschool organizations in four U.S. states: Florida, Louisiana, Mississippi and Oregon. Mothers were asked to complete an anonymous online questionnaire on their 6- to 12-year-old biological children with respect to pregnancy-related factors, birth history, vaccinations, physician-diagnosed illnesses, medications used, and health services. NDD, a derived diagnostic measure, was defined as having one or more of the following three closely-related diagnoses: a learning disability, Attention Deficient Hyperactivity Disorder, and Autism Spectrum Disorder. A convenience sample of 666 children was obtained, of which 261 (39%) were unvaccinated. The vaccinated were less likely than the unvaccinated to have been diagnosed with chickenpox and pertussis, but more likely to have been diagnosed with pneumonia, otitis media, allergies and NDD. After adjustment, vaccination, male gender, and preterm birth remained significantly associated with NDD. However, in a final adjusted model with interaction, vaccination but not preterm birth remained associated with NDD [neurodevelopmental disorders], while the interaction of preterm birth and vaccination was associated with a 6.6-fold increased odds of NDD (95% CI: 2.8, 15.5). In conclusion, vaccinated homeschool children were found to have a higher rate of allergies and NDD than unvaccinated homeschool children. While vaccination remained significantly associated with NDD after controlling for other factors, preterm birth coupled with vaccination was associated with an apparent synergistic increase in the odds of NDD. Further research involving larger, independent samples and stronger research designs is needed to verify and understand these unexpected findings in order to optimize the impact of vaccines on children’s health.

Key words

acute diseases, chronic diseases, epidemiology, evaluation, health policy, immunization, neurodevelopmental disorders, vaccination


ADHD: Attention Deficit Hyperactivity Disorder; ASD: Autism Spectrum Disorder; AOM: Acute Otitis Media; CDC: Centers for Disease Control and Prevention; CI: Confidence Interval; NDD: Neurodevelopmental Disorders; NHERI: National Home Education Research Institute; OR: Odds Ratio; PCV-7: Pneumococcal Conjugate Vaccine-7; VAERS: Vaccine Adverse Events Reporting System.


Vaccines are among the greatest achievements of biomedical science and one of the most effective public health interventions of the 20th century [1]. Among U.S. children born between 1995 and 2013, vaccination is estimated to have prevented 322 million illnesses, 21 million hospitalizations and 732,000 premature deaths, with overall cost savings of $1.38 trillion [2]. About 95% of U.S. children of kindergarten age receive all of the recommended vaccines as a requirement for school and daycare attendance [3,4], aimed at preventing the occurrence and spread of targeted infectious diseases [5]. Advances in biotechnology are contributing to the development of new vaccines for widespread use [6].

Under the currently recommended pediatric vaccination schedule [7], U.S. children receive up to 48 doses of vaccines for 14 diseases from birth to age six years, a figure that has steadily increased since the 1950s, most notably since the Vaccines for Children program was created in 1994. The Vaccines for Children program began with vaccines targeting nine diseases: diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b disease, hepatitis B, measles, mumps, and rubella. Between 1995 and 2013, new vaccines against five other diseases were added for children age 6 and under: varicella, hepatitis A, pneumococcal disease, influenza, and rotavirus vaccine.

Although short-term immunologic and safety testing is performed on vaccines prior to their approval by the U.S. Food and Drug Administration, the long-term effects of individual vaccines and of the vaccination program itself remain unknown [8]. Vaccines are acknowledged to carry risks of severe acute and chronic adverse effects, such as neurological complications and even death [9], but such risks are considered so rare that the vaccination program is believed to be safe and effective for virtually all children [10].

There are very few randomized trials on any existing vaccine recommended for children in terms of morbidity and mortality, in part because of ethical concerns involving withholding vaccines from children assigned to a control group. One exception, the high-titer measles vaccine, was withdrawn after several randomized trials in west Africa showed that it interacted with the diphtheria-tetanus-pertussis vaccine, resulting in a significant 33% increase in child mortality [11]. Evidence of safety from observational studies includes a limited number of vaccines, e.g., the measles, mumps and rubella vaccine, and hepatitis B vaccine, but none on the childhood vaccination program itself. Knowledge is limited even for vaccines with a long record of safety and protection against contagious diseases [12]. The safe levels and long-term effects of vaccine ingredients such as adjuvants and preservatives are also unknown [13]. Other concerns include the safety and cost-effectiveness of newer vaccines against diseases that are potentially lethal for individuals but have a lesser impact on population health, such as the group B meningococcus vaccine [14].

Knowledge of adverse events following vaccinations is largely based on voluntary reports to the Vaccine Adverse Events Reporting System (VAERS) by physicians and parents. However, the rate of reporting of serious vaccine injuries is estimated to be <1% [15]. These considerations led the former Institute of Medicine (now the National Academy of Medicine) in 2005 to recommend the development of a five-year plan for vaccine safety research by the Centers for Disease Control and Prevention (CDC) [16,17]. In its 2011 and 2013 reviews of the adverse effects of vaccines, the Institute of Medicine concluded that few health problems are caused by or associated with vaccines, and found no evidence that the vaccination schedule was unsafe [18,19]. Another systematic review, commissioned by the US Agency for Healthcare Research and Quality to identify gaps in evidence on the safety of the childhood vaccination program, concluded that severe adverse events following vaccinations are extremely rare [20]. The Institute of Medicine, however, noted that studies were needed: to compare the health outcomes of vaccinated and unvaccinated children; to examine the long-term cumulative effects of vaccines; the timing of vaccination in relation to the age and condition of the child; the total load or number of vaccines given at one time; the effect of other vaccine ingredients in relation to health outcomes; and the mechanisms of vaccine-associated injury [19]. A complicating factor in evaluating the vaccination program is that vaccines against infectious diseases have complex nonspecific effects on morbidity and mortality that extend beyond prevention of the targeted disease. The existence of such effects poses a challenge to the assumption that individual vaccines affect the immune system independently of each other and have no physiological effect other than protection against the targeted pathogen [21]. The nonspecific effects of some vaccines appear to be beneficial, while in others they appear to increase morbidity and mortality [22,23]. For instance, both the measles and Bacillus Calmette–Guérin vaccine reportedly reduce overall morbidity and mortality [24], whereas the diphtheria-tetanus-pertussis [25] and hepatitis B vaccines [26] have the opposite effect. The mechanisms responsible for these nonspecific effects are unknown but may involve inter alia: interactions between vaccines and their ingredients, e.g., whether the vaccines are live or inactivated; the most recently administered vaccine; micronutrient supplements such as vitamin A; the sequence in which vaccines are given; and their possible combined and cumulative effects [21]. A major current controversy is the question of whether vaccination plays a role in neurodevelopmental disorders (NDDs), which broadly include learning disabilities, Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD). The controversy has been fueled by the fact that the U.S. is experiencing what has been described as a “silent pandemic” of mostly subclinical developmental neurotoxicity, in which about 15% of children suffer from a learning disability, sensory deficits, and developmental delays [27,28]. In 1996 the estimated prevalence of ASD was 0.42%. By 2010 it had risen to 1.47% (1 in 68), with 1 in 42 boys and 1 in 189 girls affected [29]. More recently, based on a CDC survey of parents in 2011–2014, 2.24% of children (1 in 45) were estimated to have ASD. Rates of other developmental disabilities, however, such as intellectual disability, cerebral palsy, hearing loss, and vision impairments, have declined or remained unchanged [30]. Prevalence rates of Attention Deficit Hyperactivity Disorder (ADHD) have also risen markedly in recent decades [31]. Earlier increases in the prevalence of learning disability have been followed by declining rates in most states, possibly due to changes in diagnostic criteria [32]. It is believed that much of the increase in NDD diagnoses in recent decades has been due to growing awareness of autism and more sensitive screening tools, and hence to greater numbers of children with milder symptoms of autism. But these factors do not account for all of the increase [33]. The geographically widespread increase in ASD and ADHD suggests a role for an environmental factor to which virtually all children are exposed. Agricultural chemicals are a current focus of research [34-37]. A possible contributory role for vaccines in the rise in NDD diagnoses remains unknown because data on the health outcomes of vaccinated and unvaccinated children are lacking. The need for such studies is suggested by the fact that the Vaccine Injury Compensation Program has paid $3.2 billion in compensation for vaccine injury since its creation in 1986 [38]. A study of claims compensated by the Vaccine Injury Compensation Program for vaccine-induced encephalopathy and seizure disorder found 83 claims that were acknowledged as being due to brain damage. In all cases it was noted by the Court of Federal Claims, or indicated in settlement agreements, that the children had autism or ASD [39]. On the other hand, numerous epidemiological studies have found no association between receipt of selected vaccines (in particular the combined measles, mumps, and rubella vaccine) and autism [10,40-45], and there is no accepted mechanism by which vaccines could induce autism [46]. A major challenge in comparing vaccinated and unvaccinated children has been to identify an accessible pool of unvaccinated children, since the vast majority of children in the U.S. are vaccinated. Children educated at home (“homeschool children”) are suitable for such studies as a higher proportion are unvaccinated compared to public school children [47]. Homeschool families have an approximately equal median income to that of married-couple families nationwide, somewhat more years of formal education, and a higher average family size (just over three children) compared to the national average of just over two children [48-50]. Homeschooling families are slightly overrepresented in the south, about 23% are nonwhite, and the age distribution of homeschool children in grades K-12 is similar to that of children nationwide [51]. About 3% of the school-age population was homeschooled in the 2011-2012 school year [52]. The aims of this study were 1) to compare vaccinated and unvaccinated children on a broad range of health outcomes, including acute and chronic conditions, medication and health service utilization, and 2) to determine whether an association found between vaccination and NDDs, if any, remained significant after adjustment for other measured factors. Methods

Study planning

To implement the study, a partnership was formed with the National Home Education Research Institute (NHERI), an organization that has been involved in educational research on homeschooling for many years and has strong and extensive contacts with the homeschool community throughout the country (www.nheri.org). The study protocol was approved by the Institutional Review Board of Jackson State University.

Study design

The study was designed as a cross-sectional survey of homeschooling mothers on their vaccinated and unvaccinated biological children ages 6 to 12. As contact information on homeschool families was unavailable, there was no defined population or sampling frame from which a randomized study could be carried out, and from which response rates could be determined. However, the object of our pilot study was not to obtain a representative sample of homeschool children but a convenience sample of unvaccinated children of sufficient size to test for significant differences in outcomes between the groups.
We proceeded by selecting 4 states (Florida, Louisiana, Mississippi, and Oregon) for the survey (Stage 1). NHERI compiled a list of statewide and local homeschool organizations, totaling 84 in Florida, 18 in Louisiana, 12 in Mississippi and 17 in Oregon. Initial contacts were made in June 2012. NHERI contacted the leaders of each statewide organization by email to request their support. A second email was then sent, explaining the study purpose and background, which the leaders were asked to forward to their members (Stage 2). A link was provided to an online questionnaire in which no personally identifying information was requested. With funding limited to 12 months, we sought to obtain as many responses as possible, contacting families only indirectly through homeschool organizations. Biological mothers of children ages 6-12 years were asked to serve as respondents in order to standardize data collection and to include data on pregnancy-related factors and birth history that might relate to the children's current health. The age-range of 6 to 12 years was selected because most recommended vaccinations would have been received by then.

Recruitment and informed consent

Homeschool leaders were asked to sign Memoranda of Agreement on behalf of their organizations and to provide the number of member families. Non-responders were sent a second notice but few provided the requested information. However, follow-up calls to the leaders suggested that all had contacted their members about the study. Both the letter to families and the survey questions were stated in a neutral way with respect to vaccines. Our letter to parents began:

“Dear Parent, This study concerns a major current health question: namely, whether vaccination is linked in any way to children's long-term health. Vaccination is one of the greatest discoveries in medicine, yet little is known about its long-term impact. The objective of this study is to evaluate the effects of vaccination by comparing vaccinated and unvaccinated children in terms of a number of major health outcomes …”

Respondents were asked to indicate their consent to participate, to provide their home state and zip code of residence, and to confirm that they had biological children 6 to 12 years of age. The communications company Qualtrics (http://qualtrics.com) hosted the survey website. The questionnaire included only closed-ended questions requiring yes or no responses, with the aim of improving both response and completion rates.

A number of homeschool mothers volunteered to assist NHERI promote the study to their wide circles of homeschool contacts. A number of nationwide organizations also agreed to promote the study in the designated states. The online survey remained open for three months in the summer of 2012. Financial incentives to complete the survey were neither available nor offered.

Definitions and measures

Vaccination status was classified as unvaccinated (i.e., no previous vaccinations), partially vaccinated (received some but not all recommended vaccinations) and fully vaccinated (received all recommended age-appropriate vaccines), as reported by mothers. These categories were developed on the premise that any long-term effects of vaccines would be more evident in fully-vaccinated than in partially-vaccinated children, and rare or absent in the unvaccinated. Mothers were asked to use their child’s vaccination records to indicate the recommended vaccines and doses their child had received. Dates of vaccinations were not requested in order not to overburden respondents and to reduce the likelihood of inaccurate reporting; nor was information requested on adverse events related to vaccines, as this was not our purpose. We also did not ask about dates of diagnoses because chronic illnesses are often gradual in onset and made long after the appearance of symptoms. Since most vaccinations are given before age 6, vaccination would be expected to precede the recognition and diagnosis of most chronic conditions.

Mothers were asked to indicate on a list of more than 40 acute and chronic illnesses all those for which her child or children had received a diagnosis by a physician. Other questions included the use of health services and procedures, dental check-ups, “sick visits” to physicians, medications used, insertion of ventilation ear tubes, number of days in the hospital, the extent of physical activity (number of hours the child engaged in “vigorous” activities on a typical weekday), number of siblings, family structure (mother and father living in the home, divorced or separated), family income and/or highest level of education of mother or father, and social interaction with children outside the home (i.e., amount of time spent in play or other contact with children outside the household). Questions specifically for the mother included pregnancy-related conditions and birth history, use of medications during pregnancy, and exposure to an adverse environment (defined as living within 1-2 miles of a furniture manufacturing factory, hazardous waste site, or lumber processing factory). NDD, a derived diagnostic category, was defined as having one or more of the following three closely related and overlapping diagnoses: a learning disability, Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) [53].

Statistical methods

Unadjusted bivariate analyses using chi-square tests were performed initially to test the null hypothesis of no association between vaccination status and health outcomes, i.e., physician-diagnosed acute and chronic illnesses, medications, and the use of health services. In most analyses, partially and fully vaccinated children were grouped together as the “vaccinated” group, with unvaccinated children as the control group. The second aim of the study was to determine whether any association found between vaccination and neurodevelopmental disorders remained significant after controlling for other measured factors. Descriptive statistics on all variables were computed to determine frequencies and percentages for categorical variables and means (± SD) for continuous variables. The strength of associations between vaccination status and health outcomes were tested using odds ratios (OR) and 95% Confidence Intervals (CI). Odds ratios describe the strength of the association between two categorical variables measured simultaneously and are appropriate measures of that relationship in a cross-sectional study [54]. Unadjusted and adjusted logistic regression analyses were carried out using SAS (Version 9.3) to determine the factors associated with NDDs.


Socio-Demographic characteristics of respondents

The information contained in 415 questionnaires provided data on 666 homeschool children. Table 1 shows the characteristics of the survey respondents. Mothers averaged about 40 years of age, were typically white, college graduates, with household incomes between $50,000 to $100,000, Christian, and married. The reasons for homeschooling for the majority of respondents (80-86%) were for a moral environment, better family relationships, or for more contact with their child or children.

The children as a group were similarly mostly white (88%), with a slight preponderance of females (52%), and averaged 9 years of age. With regard to vaccination status, 261 (39%) were unvaccinated, 208 (31%) were partially vaccinated, and 197 (30%) had received all of the recommended vaccinations. All statistical analyses are based on these numbers.

Acute illness

Vaccinated children (N=405), combining the partially and fully vaccinated, were significantly less likely than the unvaccinated to have had chickenpox (7.9% vs. 25.3%, p <0.001; Odds Ratio = 0.26, 95% Confidence Interval: 0.2, 0.4) and whooping cough (pertussis) (2.5% vs. 8.4%, p <0.001; OR 0.3, 95% CI: 0.1, 0.6), and less likely, but not significantly so, to have had rubella (0.3% vs. 1.9%, p = 0.04; OR 0.1, 95% CI: 0.01, 1.1). However, the vaccinated were significantly more likely than the unvaccinated to have been diagnosed with otitis media (19.8% vs. 5.8%, p <0.001; OR 3.8, 95% CI: 2.1, 6.6) and pneumonia (6.4% vs. 1.2%, p = 0.001; OR 5.9, 95% CI: 1.8, 19.7). No significant differences were seen with regard to hepatitis A or B, high fever in the past 6 months, measles, mumps, meningitis (viral or bacterial), influenza, or rotavirus (Table 2).

Chronic illness

Vaccinated children were significantly more likely than the unvaccinated to have been diagnosed with the following: allergic rhinitis (10.4% vs. 0.4%, p <0.001; OR 30.1, 95% CI: 4.1, 219.3), other allergies (22.2% vs. 6.9%, p <0.001; OR 3.9, 95% CI: 2.3, 6.6), eczema/atopic dermatitis (9.5% vs. 3.6%, p = 0.035; OR 2.9, 95% CI: 1.4, 6.1), a learning disability (5.7% vs. 1.2%, p = 0.003; OR 5.2, 95% CI: 1.6, 17.4), ADHD (4.7% vs. 1.0%, p = 0.013; OR 4.2, 95% CI: 1.2, 14.5), ASD (4.7% vs. 1.0%, p = 0.013; OR 4.2, 95% CI: 1.2, 14.5), any neurodevelopmental disorder (i.e., learning disability, ADHD or ASD) (10.5% vs. 3.1%, p <0.001; OR 3.7, 95% CI: 1.7, 7.9) and any chronic illness (44.0% vs. 25.0%, p <0.001; OR 2.4, 95% CI: 1.7, 3.3). No significant differences were observed with regard to cancer, chronic fatigue, conduct disorder, Crohn’s disease, depression, Types 1 or 2 diabetes, encephalopathy, epilepsy, hearing loss, high blood pressure, inflammatory bowel disease, juvenile rheumatoid arthritis, obesity, seizures, Tourette’s syndrome, or services received under the Individuals with Disabilities Education Act (Table 3). Table 3. Vaccination status and health outcomes – Chronic Conditions

Partial versus full vaccination

Partially vaccinated children had an intermediate position between the fully vaccinated and unvaccinated in regard to several but not all health outcomes. For instance, as shown in Table 4, the partially vaccinated had an intermediate (apparently detrimental) position in terms of allergic rhinitis, ADHD, eczema, and learning disability.

Table 4. Partial versus full vaccination and chronic health conditions

Gender differences in chronic illness

Among the vaccinated (combining partially and fully vaccinated children), boys were more likely than girls to be diagnosed with a chronic condition – significantly so in the case of allergic rhinitis (13.9% vs. 7.2%, p = 0.03; OR 2.1, 95% CI: 1.1, 4.1), ASD (7.7% vs. 1.9%, p = 0.006; OR 4.3, 95% CI: 1.4, 13.2), and any neurodevelopmental disorder (14.4% vs. 6.7%, p = 0.01; OR 2.3, 95% CI: 1.2, 4.6) (Table 5).

Table 5. Chronic conditions and gender among vaccinated children

Use of medications and health services

The vaccinated (combining the partially and fully vaccinated) were significantly more likely than the unvaccinated to use medication for allergies (20.0% vs. 1.2%, p <0.001; OR 21.5, 95% CI: 6.7, 68.9), to have used antibiotics in the past 12 months (30.8% vs. 15.4%, p <0.001; OR 2.4, 95% CI: 1.6, 3.6), and to have used fever medications at least once (90.7% vs. 67.8%, p <0.001; OR 4.6, 95% CI: 3.0, 7.1). The vaccinated were also more likely to have seen a doctor for a routine checkup in the past 12 months (57.6% vs. 37.2%, p <0.001; OR 2.3, 95% CI: 1.7, 3.2), visited a dentist during the past year (89.4% vs. 80.5%, p <0.001; OR 2.0, 95% CI: 1.3, 3.2), visited a doctor or clinic due to illness in the past year (36.0% vs. 16.0%, p <0.001; OR 3.0, 95% CI: 2.0, 4.4), been fitted with ventilation ear tubes (3.0% vs. 0.4%, p = 0.018; OR 8.0, 95% CI: 1.0, 66.1), and spent one or more nights in a hospital (19.8% vs. 12.3%, p = 0.012; OR 1.8, 95% CI: 1.1, 2.7) (Table 6). Table 6. Vaccination status, medication use and health services utilization

Factors associated with neurodevelopmental disorders

The second aim of the study focused on a specific health outcome and was designed to determine whether vaccination was associated with neurodevelopmental disorders (NDD) and, if so, whether the association remained significant after adjustment for other measured factors. As noted, because of the relatively small numbers of children with specific diagnoses, NDD was a derived variable combining children with a diagnosis of one or more of ASD, ADHD and a learning disability. The close association and overlap of these diagnoses in the study is shown in the figure above (Figure 1). The figure shows that the single largest group of diagnoses was learning disability (n=15) followed by ASD (n=9), and ADHD (n=9), with smaller numbers comprising combinations of the three diagnoses.

Figure 1. The overlap and distribution of physician-diagnosed neurodevelopmental disorders, based on mothers’ reports.

Unadjusted analysis

Table 7 shows that the factors associated with NDD in unadjusted logistic regression analyses were: vaccination (OR 3.7, 95% CI: 1.7, 7.9); male gender (OR 2.1, 95% CI: 1.1, 3.8); adverse environment, defined as living within 1-2 miles of a furniture manufacturing factory, hazardous waste site, or lumber processing factory (OR 2.9, 95% CI: 1.1, 7.4); maternal use of antibiotics during pregnancy (OR 2.3, 95% CI: 1.1, 4.8); and preterm birth (OR 4.9, 95% CI: 2.4, 10.3). Two factors that almost reached statistical significance were vaccination during pregnancy (OR 2.5, 95% CI: 1.0, 6.3) and three or more fetal ultrasounds (OR 3.2, 95% CI: 0.92, 11.5). Factors that were not associated with NDD in this study included mother’s education, household income, and religious affiliation; use of acetaminophen, alcohol, and antacids during pregnancy; gestational diabetes; preeclampsia; Rhogham shot during pregnancy; and breastfeeding (data not shown).

Table 7. Unadjusted analysis of potential risk factors for neurodevelopmental disorders

*Numbers may not add to column totals due to missing or incomplete data.
**Note that Odds Ratios are the cross-product ratios of the entries in the 2-by-2 tables, and are an estimate of the relative incidence (or risk) of the outcome associated with the exposure factor.

Adjusted analysis

After adjustment for all other significant factors, those that remained significantly associated with NDD were: vaccination (OR 3.1, 95% CI: 1.4, 6.8); male gender (OR 2.3, 95% CI: 1.2, 4.3); and preterm birth (OR 5.0, 95% CI: 2.3, 11.1). The apparently strong association between both vaccination and preterm birth and NDD suggested the possibility of an interaction between these factors.

In a final adjusted model designed to test for this possibility, controlling for the interaction of preterm birth and vaccination, the following factors remained significantly associated with NDD: vaccination (OR 2.5, 95% CI: 1.1, 5.6), nonwhite race (OR 2.4, 95% CI: 1.1, 5.4), and male gender (OR 2.3, 95% CI: 1.2, 4.4). Preterm birth itself, however, was not significantly associated with NDD, whereas the combination (interaction) of preterm birth and vaccination was associated with 6.6-fold increased odds of NDD (95% CI: 2.8, 15.5) (Table 8).

Table 8. Adjusted logistic regression analyses of risk factors and NDD*

*Number of observation read 666, number of observations used 629. NDD=47, Not NDD = 582


Following a recommendation of the Institute of Medicine [19] for studies comparing the health outcomes of vaccinated and unvaccinated children, this study focused on homeschool children ages 6 to 12 years based on mothers’ anonymous reports of pregnancy-related conditions, birth histories, physician-diagnosed illnesses, medications and healthcare use. Respondents were mostly white, married, and college-educated, upper income women who had been contacted and invited to participate in the study by the leaders of their homeschool organizations. Data from the survey were also used to determine whether vaccination was associated specifically with NDDs, a derived diagnostic category combining children with the diagnoses of learning disability, ASD and/or ADHD.

With regard to acute and chronic conditions, vaccinated children were significantly less likely than the unvaccinated to have had chickenpox and pertussis but, contrary to expectation, were significantly more likely to have been diagnosed with otitis media, pneumonia, allergic rhinitis, eczema, and NDD. The vaccinated were also more likely to have used antibiotics, allergy and fever medications; to have been fitted with ventilation ear tubes; visited a doctor for a health issue in the previous year, and been hospitalized. The reason for hospitalization and the age of the child at the time were not determined, but the latter finding appears consistent with a study of 38,801 reports to the VAERS of infants who were hospitalized or had died after receiving vaccinations. The study reported a linear relationship between the number of vaccine doses administered at one time and the rate of hospitalization and death; moreover, the younger the infant at the time of vaccination, the higher was the rate of hospitalization and death [55]. The hospitalization rate increased from 11% for 2 vaccine doses to 23.5% for 8 doses (r2 = 0.91), while the case fatality rate increased significantly from 3.6% for those receiving from 1-4 doses to 5.4 % for those receiving from 5-8 doses.

In support of the possibility that the number of vaccinations received could be implicated in risks of associated chronic illness, a comparison of unvaccinated, partially and fully vaccinated children in the present study showed that the partially vaccinated had increased but intermediate odds of chronic disease, between those of unvaccinated and fully vaccinated children, specifically for allergic rhinitis, ADHD, eczema, a learning disability, and NDD as a whole.

The national rates of ADHD and LD are comparable to those of the study. The U.S. rate of ADHD for ages 4-17 (twice the age range of children than the present study), is 11% [31]. The study rate of ADHD for ages 6 to 12 is 3.3%, and 4.7% when only vaccinated children are included. The national LD rate is 5% [32], and the study data show a rate of LD of 3.9% for all groups, and 5.6% when only vaccinated children are included. However, the ASD prevalence of 2.24% from a CDC parent survey is lower than the study rate of 3.3%. Vaccinated males were significantly more likely than vaccinated females to have been diagnosed with allergic rhinitis, and NDD. The percentage of vaccinated males with an NDD in this study (14.4%) is consistent with national findings based on parental responses to survey questions, indicating that 15% of U.S. children ages 3 to 17 years in the years 2006-2008 had an NDD [28]. Boys are also more likely than girls to be diagnosed with an NDD, and ASD in particular [29].

Vaccination was strongly associated with both otitis media and pneumonia, which are among the most common complications of measles infection [56,57]. The odds of otitis media were almost four-fold higher among the vaccinated (OR 3.8, 95% CI: 2.1, 6.6) and the odds of myringotomy with tube placement were eight-fold higher than those of unvaccinated children (OR 8.0, 95% CI: 1.0, 66.1). Acute otitis media (AOM) is a very frequent childhood infection, accounting for up to 30 million physician visits each year in the U.S., and the most common reason for prescribing antibiotics for children [58,59]. The incidence of AOM peaks at ages 3 to 18 months and 80% of children have experienced at least one episode by 3 years of age. Rates of AOM have increased in recent decades [60]. Worldwide, the incidence of AOM is 10.9%, with 709 million cases each year, 51% occurring in children under 5 years of age [61]. Pediatric AOM is a significant concern in terms of healthcare utilization in the U.S., accounting for $2.88 billion in annual health care costs [62].

Numerous reports of AOM have been filed with VAERS. A search of VAERS for “Cases where age is under 1 and onset interval is 0 or 1 or 2 or 3 or 4 or 5 or 6 or 7 days and Symptom is otitis media” [63] revealed that 438,573 cases were reported between 1990 and 2011, often with fever and other signs and symptoms of inflammation and central nervous system involvement. One study [64] assessed the nasopharyngeal carriage of S. pneumoniae, H. influenzae, and M. catarrhalis during AOM in fully immunized, partly immunized children with 0 or 1 dose of Pneumococcal Conjugate Vaccine-7 (PCV7), and “historical control” children from the pre-PCV-7 era, and found an increased frequency of M. catarrhalis colonization in the vaccinated group compared to the partly immunized and control groups (76% vs. 62% and 56%, respectively). A high rate of Moraxella catarrhalis colonization is associated with an increased risk of AOM [65].

Successful vaccination against pneumococcal infections can lead to replacement of the latter in the nasopharyngeal niche by nonvaccine pneumococcal serotypes and disease [66]. Vaccination with PCV-7 has a marked effect on the complete microbiota composition of the upper respiratory tract in children, going beyond shifts in the distribution of pneumococcal serotypes and known potential pathogens and resulting in increased anaerobes, gram-positive bacteria and gram-negative bacterial species. PCV-7 administration also correlates highly with the emergence and expansion of oropharyngeal types of species. These observations have suggested that eradication of vaccine serotype pneumococci can be followed by colonization of other bacterial species in the vacant nasopharyngeal niche, leading to disequilibria of bacterial composition (dysbiosis) and increased risks of otitis media. Long-term monitoring has been recommended as essential for understanding the full implications of vaccination-induced changes in microbiota structure [67].

The second aim of the paper focused on a specific health outcome and sought to determine whether vaccination remained associated with neurodevelopmental disorders (NDD) after controlling for other measured factors. After adjustment, the factors that remained significantly associated with NDD were vaccination, nonwhite race, male gender, and preterm birth. The apparently strong association between both vaccination and preterm birth and NDD suggested the possibility of an interaction between these factors. This was shown in a final adjusted model with interaction (controlling for the interaction of preterm birth with vaccination). In this model, vaccination, nonwhite race and male gender remained associated with NDD, whereas preterm birth itself was no longer associated with NDD. However, preterm birth combined with vaccination was associated with a 6.6-fold increased odds of NDD.

In summary, vaccination, nonwhite race, and male gender were significantly associated with NDD after controlling for other factors. Preterm birth, although significantly associated with NDD in unadjusted and adjusted analyses, was no longer associated with NDD in the final model with interaction. However, preterm birth and vaccination combined was strongly associated with NDD in the final adjusted model with interaction, more than doubling the odds of NDD compared to vaccination alone. Preterm birth has long been known as a major factor for NDD [68,69], but since preterm infants are routinely vaccinated, the separate effects of preterm birth and vaccination have not been examined. The present study suggests that vaccination could be a contributing factor in the pathogenesis of NDD but also that preterm birth by itself may have a lesser or much reduced role in NDD (defined here as ASD, ADHD and/or a learning disability) than currently believed. The findings also suggest that vaccination coupled with preterm birth could increase the odds of NDD beyond that of vaccination alone.

Potential limitations

We did not set out to test a specific hypothesis about the association between vaccination and health. The aim of the study was to determine whether the health outcomes of vaccinated children differed from those of unvaccinated homeschool children, given that vaccines have nonspecific effects on morbidity and mortality in addition to protecting against targeted pathogens [11]. Comparisons were based on mothers’ reports of pregnancy-related factors, birth histories, vaccinations, physician-diagnosed illnesses, medications, and the use of health services. We tested the null hypothesis of no difference in outcomes using chi-square tests, and then used Odds Ratios and 96% Confidence Intervals to determine the strength and significance of the association.

If the effects of vaccination on health were limited to protection against the targeted pathogens, as is assumed to be the case [21], no difference in outcomes would be expected between the vaccinated and unvaccinated groups except for reduced rates of the targeted infectious diseases. However, in this homogeneous sample of 666 children there were striking differences in diverse health outcomes between the groups. The vaccinated were less likely to have had chickenpox or whooping cough, as expected, but more likely to have been diagnosed with pneumonia and ear infections as well as allergies and NDDs.

What credence can be given to the findings? This study was not intended to be based on a representative sample of homeschool children but on a convenience sample of sufficient size to test for significant differences in outcomes. Homeschoolers were targeted for the study because their vaccination completion rates are lower than those of children in the general population. In this respect our pilot survey was successful, since data were available on 261 unvaccinated children.

To eliminate opportunities for subjectivity or opinion in the data, only factual information was requested and the questions involved memorable events such as physician-diagnosed diseases in a child. With regard to minimizing potential bias in the information provided by mothers, all communications with the latter emphasized neutrality regarding vaccination and vaccine safety. To minimize recall bias, respondents were asked to use their child’s vaccination records. To enhance reliability, closed-ended questions were used and each set of questions had to be completed before proceeding to the next. To enhance validity, parents were asked to report only physician-diagnosed illnesses.

Mothers’ reports could not be validated by clinical records because the survey was designed to be anonymous. However, self-reports about significant events provide a valid proxy for official records when medical records and administrative data are unavailable [70]. Had mothers been asked to provide copies of their children’s medical records it would no longer have been an anonymous study and would have resulted in few completed questionnaires. We were advised by homeschool leaders that recruitment efforts would have been unsuccessful had we insisted on obtaining the children’s medical records as a requirement for participating in the study.

A further potential limitation is under-ascertainment of disease in unvaccinated children. Could the unvaccinated have artificially reduced rates of illness because they are seen less often by physicians and would therefore have been less likely to be diagnosed with a disease? The vaccinated were indeed more likely to have seen a doctor for a routine checkup in the past 12 months (57.5% vs. 37.1%, p < 0.001; OR 2.3, 95% CI: 1.7, 3.1). Such visits usually involve vaccinations, which non-vaccinating families would be expected to refuse. However, fewer visits to physicians would not necessarily mean that unvaccinated children are less likely to be seen by a physician if their condition warranted it. In fact, since unvaccinated children were more likely to be diagnosed with chickenpox and whooping cough, which would have involved a visit to the pediatrician, differences in health outcomes are unlikely to be due to under-ascertainment. Strengths of the study include the unique design of the study, involving homeschool mothers as respondents, and the relatively large sample of unvaccinated children, which made it possible to compare health outcomes across the spectrum of vaccination coverage. Recruitment of biological mothers as respondents also allowed us to test hypotheses about the role of pregnancy-related factors and birth history as well as vaccination in NDD and other specific conditions. In addition, this was a within-group study of a demographically homogeneous population of mainly white, higher-income and college-educated homeschooling families in which the children were all 6-12 years of age. Information was provided anonymously by biological mothers, obviously well-informed about their own children’s vaccination status and health, which likely increased the validity of the reports. Conclusions

Assessment of the long-term effects of the vaccination schedule on morbidity and mortality has been limited [71]. In this pilot study of vaccinated and unvaccinated homeschool children, reduced odds of chickenpox and whooping cough were found among the vaccinated, as expected, but unexpectedly increased odds were found for many other physician-diagnosed conditions. Although the cross-sectional design of the study limits causal interpretation, the strength and consistency of the findings, the apparent “dose-response” relationship between vaccination status and several forms of chronic illness, and the significant association between vaccination and NDDs all support the possibility that some aspect of the current vaccination program could be contributing to risks of childhood morbidity. Vaccination also remained significantly associated with NDD after controlling for other factors, whereas preterm birth, long considered a major risk factor for NDD, was not associated with NDD after controlling for the interaction between preterm birth and vaccination. In addition, preterm birth coupled with vaccination was associated with an apparent synergistic increase in the odds of NDD above that of vaccination alone. Nevertheless, the study findings should be interpreted with caution. First, additional research is needed to replicate the findings in studies with larger samples and stronger research designs. Second, subject to replication, potentially detrimental factors associated with the vaccination schedule should be identified and addressed and underlying mechanisms better understood. Such studies are essential in order to optimize the impact of vaccination of children’s health.

Competing Interests

The authors declare that they have no financial interests that had any bearing on any aspect of the conduct or conclusions of the study and the submitted manuscript.

Author contributions

AM designed the study, contributed to data analysis and interpretation, and drafted the paper. BR designed the study, contributed to data collection, and edited the paper. AB contributed to data analyses and edited the paper. BJ contributed to data analyses and editing. All authors read and approved the final version of the paper.

Funding sources

This study was supported by grants from Generation Rescue, Inc., and the Children’s Medical Safety Research Institute, charitable organizations that support research on children’s health and safety. The funders had no role or influence on the design and conduct of the research or the preparation of reports.


The authors thank all those who contributed critical comments, suggestions and financial support for the project. We also thank the collaborating homeschool organizations and especially the mothers who participated in the survey.


This study was approved by the Institutional Review Board of Jackson State University and completed prior to Dr. Mawson’s tenure-track appointment at Jackson State University.


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Monasta L1, Ronfani L, Marchetti F, Montico M, Vecchi Brumatti L, et al. (2012) Burden of disease caused by otitis media: systematic review and global estimates. PLoS One 7: e36226. [Crossref]
Ahmed S1, Shapiro NL, Bhattacharyya N (2014) Incremental health care utilization and costs for acute otitis media in children. Laryngoscope 124: 301-305. [Crossref]
http://www.medalerts.org/vaersdb/findfield.php?TABLE=ON&GROUP1=AGE&EVENTS=ON&SYMPTOMS[]=Otitis+media+%2810033078%29&NUMDAYS[]=0&NUMDAYS[]=1&NUMDAYS[]=2&NUMDAYS[]=3&NUMDAYS[]=4&NUMDAYS[]=5&NUMDAYS[]=6&NUMDAYS[]=7&WhicAge=range&LOWAGE=0.0&HIGHAGE=1.0) (Accessed 25 August, 2016).
Revai K, McCormick DP, Patel J, Grady JJ, Saeed K, et al. (2006) Effect of pneumococcal conjugate vaccine on nasopharyngeal bacterial colonization during acute otitis media. Pediatrics 117: 1823–1829. [Crossref]
Faden H, Harabuchi Y, Hong JJ (1994) Epidemiology of Moraxella catarrhalis in children during the first 2 years of life: relationship to otitis media. J Infect Dis 169: 1312-1317. [Crossref]
Weinberger DM, Malley R, Lipsitch M (2011) Serotype replacement in disease after pneumococcal vaccination. Lancet 378: 1962-1973. [Crossref]
Biesbroek G, Wang X, Keijser BJ, Eijkemans RM, Trzcinski K, et al. (2014) Seven-valent pneumococcal conjugate vaccine and nasopharyngeal microbiota in healthy children. Emerg Infect Dis 20: 201-210.
Goldin RL, Matson JL (2016) Premature birth as a risk factor for autism spectrum disorder. Dev Neurorehabil 19: 203-206. [Crossref]
Padilla N, Eklöf E, Mårtensson GE, Bölte S, Lagercrantz H, et al. (2015) Poor brain growth in extremely preterm neonates long before the onset of autism spectrum disorder symptoms. Cereb Cortex 27: 1245-1252. [Crossref]
Short ME, Goetzel RZ, Pei X, Tabrizi MJ, Ozminkowski RJ, et al. (2009) How accurate are self-reports? Analysis of self-reported health care utilization and absence when compared with administrative data. J Occup Environ Med 51: 786-796. [Crossref]
Fisker AB, Hornshøj L, Rodrigues A, Balde I, Fernandes M, et al. (2014) Effects of the introduction of new vaccines in Guinea-Bissau on vaccine coverage, vaccine timeliness, and child survival: an observational study. Lancet Glob Health 2: e478-e487.

Saturday, May 13, 2017


Research done by Dr. Nils Bergman, father of kangaroo mother care, indicates that swaddled babies have high levels of cortisol in their bloodstream. This means they are in a state of high stress and are NOT sleeping. Instead, like the baby in this photo, the children are dissociating. Dissociation is similar to the "freeze" or "play dead" response that animals exhibit in the wild. It occurs in humans when trauma overloads the system (parasympathetic shock) and the spirit leaves the body because it is just too uncomfortable for the spirit to remain. So the body is left on automatic pilot with no soul at the helm. Breathing slows down, heart rate slows down, the body goes into a state of temporary paralysis.

Medical staff who teach parents to swaddle their baby to keep them quiet cannot be trusted. Parents should be encouraged to hold their babies, rock their babies, sing to their babies, nurture their babies, hold their babies skin-to-skin, and try to intuit why their babies are crying (BIRTH TRAUMA) and if necessary, help them heal. Instead, parents are being conditioned to dissociate too, and to not properly bond or care for their children.

Whatever the medical system says, I encourage you to do the opposite.

Excerpt (full article below):

"One core concern on the part of pediatricians, breastfeeding advocates, and others is that routine swaddling interferes with a mother’s intuitive response to her baby’s needs. “Crying is the baby’s language, his voice; it’s the only way he has to tell you he needs something,” stresses internationally-known breastfeeding advocate, pediatric nurse practitioner, and educator Kittie Franz. “Newborns are about need, not want. Before you use this tool (of swaddling), find out what he needs—don’t just shut him up.”

Dr. Fleiss goes even farther, suggesting that when an infant with unmet needs is swaddled and separated from his mother, the message he receives is: Give up. No one cares, no one is going to help you; solve it yourself.

“You can say swaddling works; it stops the baby from crying. But because something works doesn’t mean it’s a good thing to do,” Fleiss argues. “I tell parents not to swaddle, ever. When a baby is crying he’s saying where’s my mommy? He’s not saying wrap me up real tightly. He should be put to the breast, he should be talked to, sung to, held, loved...

In fact, many researchers and infant advocates now believe the apparent contentment of a swaddled baby may in fact be a sign of listlessness and shutting down, rather than of feeling comforted.”

Source Article:
The Question of Routine Swaddling

Remember the bumper sticker, “What Would Jesus Do?” Here’s a variation on that query: What would Jesus’ mommy do? We are told his mother wrapped her newborn in swaddling clothes. So if it’s good enough for baby Jesus…?

Yet simply because a practice has been widespread in various cultures and time periods doesn’t mean it is best for babies.

Likewise, even though routine swaddling may have popular authority on its side at the moment—through bestselling books, advertising, parent education organizations, and even the apparent evidence of first-hand experience—this does not in itself mean its benefits outweigh potential disadvantages in the light of current research and intuitive common sense.

Why Swaddle?

The obvious and well-promoted benefits of swaddling, of course, are a calmer baby who fusses less and sleeps more. Parents are given a chance to rest, relieved of the stress of an “excessively crying” infant. The swaddled baby appears calm and content.

Other advantages often mentioned include preventing baby from scratching her face with her fingernails, and keeping her from startling herself awake with her own movements. In addition, proponents claim swaddling reduces the risk of sudden infant death syndrome (SIDS) in babies placed on their backs to sleep, since with confined limbs they are less able to turn over into a prone position.

Why Even Question It?

For millions of new parents, the ubiquitous presence of pro-swaddling messages creates a reassuring sense of caring both for their baby’s needs and their own. For most, there seems no reason to question the practice. The idea that it elicits controversy may be surprising. Yet hidden behind this friendly face is a growing body of research from around the world that calls into question the benign, warm-and-cozy nature of routine swaddling of newborns and older infants.

It should be noted that the term swaddling means different things to different people. For some parents, loose wrapping with arms free is considered swaddling, while others use roomy sleep sacks that allow for movement within the bag. Here, however, we are referring to tight or constrictive wrapping using a swaddling blanket or cloth that holds the baby’s arms and legs straight. The blanket’s snugness is seen as providing a sense of comfort and security, and ensures the infant won’t pull it loose.

Wrapped in History

It was not only Jesus’ mother who wrapped her baby in swaddling clothes, which likely was cloth held in place by bandage-like strips of cloth wound around the infant. Some version of the practice of wrapping babies has taken place in many cultures worldwide and across time. Among the earliest evidence of swaddling, dating back several thousand years and perhaps originating in what is now central China, were various forms of the cradleboard.

As with American Indians and other later cultures, the cradleboard contained and protected babies during nomadic travels. Some current-day North American tribes continue to use cradleboards. In the Southwestern United States, for example, a Navajo mother may secure her baby in a cradleboard and prop it close to her while she works at her weaving loom.

Evolving motivations

Over the centuries, stated benefits of swaddling have included producing straight limbs and proper physical development, making babies stronger, preventing self-injury, allowing both parents to work in the fields, and providing babies with warmth and comfort. In 17th and 18th-century Europe the employment of swaddling by wet-nurses was often associated with neglect, with wet-nurses known to leave tightly wrapped babies unattended for hours.

Eighteenth-century philosopher Jean-Jacque Rousseau warned against some motivations for swaddling in his novel Emile: or, On Education: “A child unswaddled would need constant watching; well swaddled it is cast into a corner and its cries are ignored […]. It is claimed that infants left free would assume faulty positions and make movements, which might injure the proper development of their limbs.

“This is one of the vain rationalizations of our false wisdom which experience has never confirmed. Out of the multitude of children who grow up with the full use of their limbs among nations wiser than ourselves, you never find one who hurts himself or maims himself; their movements are too feeble to be dangerous, and when they assume an injurious position, pain warns them to change it.” 1

In 19th and 20th-century Europe, England, and America, sedatives such as paregoric (camphorated tincture of opium), alcohol, antihistamines, or children’s cold medicines were sometimes used instead of swaddling to calm and quiet fussy babies.

Swaddling Today

By the mid-20th century, American hospital maternity wards were turning to swaddling newborns as a means of relieving overwhelmed nurses when babies began being separated from their mothers and placed in the hospital nursery after birth.

Respected Los Angeles-based pediatrician Dr. Paul Fleiss invokes “disturbing mid-20th century photographs taken in factory-style maternity hospitals…(with) tightly swaddled newborn babies precision packed into orderly rows of sterile plastic bins. In these pictures, the babies are unmoving and still…like termite larvae in their egg cases.” Although many hospitals now embrace rooming-in, others continue to separate mother and infant and continue to rely on—and teach new parents—swaddling to quiet crying babies.

In recent years, routine swaddling by parents has grown increasingly popular, in large part as a result of the efforts of California-based pediatrician Dr. Harvey Karp. Dr. Karp’s best selling book, The Happiest Baby on the Block, and related DVDs have reached millions of parents in search of an easy way to quiet a crying baby. Numerous online chat rooms and parenting sites also attest to the mother-to-mother spread of “success stories” involving swaddling. As emphasized in Dr. Karp’s writings and educational programs, one significant attraction of swaddling is that fathers, as well as mothers, can have hands-on involvement in quieting baby.

Crying for a Reason

With all this in mind and assuming that modern parents don’t leave wrapped babies unattended for hours on end, what could be the downside of swaddling?

One core concern on the part of pediatricians, breastfeeding advocates, and others is that routine swaddling interferes with a mother’s intuitive response to her baby’s needs. “Crying is the baby’s language, his voice; it’s the only way he has to tell you he needs something,” stresses internationally-known breastfeeding advocate, pediatric nurse practitioner, and educator Kittie Franz. “Newborns are about need, not want. Before you use this tool (of swaddling), find out what he needs—don’t just shut him up.”

Dr. Fleiss goes even farther, suggesting that when an infant with unmet needs is swaddled and separated from his mother, the message he receives is: Give up. No one cares, no one is going to help you; solve it yourself.

“You can say swaddling works; it stops the baby from crying. But because something works doesn’t mean it’s a good thing to do,” Fleiss argues. “I tell parents not to swaddle, ever. When a baby is crying he’s saying where’s my mommy? He’s not saying wrap me up real tightly. He should be put to the breast, he should be talked to, sung to, held, loved.”

Comforted, or Shut Down?

In fact, many researchers and infant advocates now believe the apparent contentment of a swaddled baby may in fact be a sign of listlessness and shutting down, rather than of feeling comforted. Franz tells of a new product introduced some years ago at a medical conference. Plugged into a crib, the device vibrated its springs while emitting “white noise.” Fussy babies were believed to be calmed by the rhythmic movement and sounds. But photographs of the babies’ faces told another story.

“In the before photos the eyes were open, hands fisted, there was tightness around the nose and mouth, and the babies were crying,” Franz says. In photos taken as babies experienced the crib device, the hands were still fisted, there was the same furrowed brow and tightness around the eyes and mouth—but the babies were silent. Franz has observed a similar response among swaddled babies. “The baby is staying quiet but is not relaxed or happy. That led me to conclude the baby is shutting down,” she says.

More Sleep, Less Nursing

Breastfeeding advocates note a related and worrying aspect of swaddling, especially during a baby’s first days and weeks. Newborns who are routinely swaddled have been found to feed less frequently, suckle less effectively, and have greater weight loss than those left unswaddled with access to the breast. 2

One reason is that swaddled babies awaken less frequently and less fully, often falling asleep again while feeding. The American Academy of Pediatrics suggests that breastfed newborns need to feed eight to twelve times every 24 hours. Swaddled babies, however, often feed no more than six or seven times in a 24-hour period. 3 This is related to the natural progression of sleep states in infants. As a baby begins moving through the sleep stages from deep to light, her eyes move a little under closed lids and her mouth moves. As she rises into even lighter sleep, her arms begin to wave, or “cycle.” 4, 5 This arm movement serves as a natural cue to help wake baby for her feeding. If the arms are bound by swaddling, the baby may sink back into a deep sleep and miss a feeding.

Some years ago Franz, while working as a pediatric nurse practitioner in Santa Monica, California, noticed that breastfed babies often lost as much as 10 percent of their birth weight in the first week when they were swaddled. This is a higher than normal weight loss that calls for supplemental feeding to avoid rapid escalation downward into dangerous dehydration.

Franz began telling the parents of these swaddled babies to keep their babies un-swaddled for 24 hours, and in most cases the infants quickly began regaining weight. “Babies need to feed around the clock and when they’re kept swaddled they sleep through their cues. They don’t wake up to feed,” she explains. She adds that she noticed that the mothers who stopped swaddling were happy with the weight gain, but the fathers tended to be not so sure they wanted their babies “so awake” all the time.

Drug Babies

There are circumstances in which it may be appropriate to swaddle an infant as a temporary short-term intervention. One is the case of a baby—born to a drug-addicted mother, for example—whose central nervous system is immature, resulting in jitteriness or excessive erratic limb movement. Another is when an infant has too much muscle tone and her limbs remain stiffly extended or too tight. Both situations can negatively affect breastfeeding and swaddling can be helpful, Franz observes. However, she stresses that whenever she recommends swaddling it is always with room for the arms and legs to flex, rather than held straight at the baby’s sides.

Among the most commonly stated benefits of swaddling is the calming of babies who cry inconsolably from the pain and discomfort of colic. Yet a mother may not know whether her child has colic or is crying for other reasons, Franz notes. In such cases she recommends applying the “rule of threes”: If the infant is over three weeks and under three months old (the age range in which colic occurs), with bouts of crying for three hours a day, three times a week, he very well may be suffering from colic. But even a truly colicky baby may be helped more by being carried than by swaddling, since motion helps relieve colic symptoms by encouraging bowel movements and the passing of gas, Franz points out.

Temperature Regulation

While swaddling would appear to be a good way to keep a newborn warm and cozy, especially in cool climates, research indicates skin-to-skin contact with mother is the best way to regulate an infant’s temperature. In a study of 176 mothers and babies conducted in a Russian hospital, a team of Swedish, Russian, and Canadian researchers found that swaddled newborns placed in the hospital nursery were colder—as measured by foot temperatures—and consumed less mother’s milk than those not swaddled. 6

Bundled babies not only miss out on their mother’s physical warmth and comfort in cool environments; in overly warm circumstances swaddled babies can become dangerously overheated, leading to brain damage or even death. This is especially crucial among ethnic or cultural groups with a traditional belief that mother and her newborn should be kept very warm, or in cases where families have recently moved from a cold to a hot climate, Franz notes. “If a baby is swaddled and his onesie is damp from sweat, then he is at great risk of over heating,” she says.


It is important to note that most studies on swaddling compare swaddled and un-swaddled babies who in both cases are separated from their mothers, rather than looking at babies in skin-to-skin contact with mother. When skin-to-skin contact is introduced into the equation, the purported advantages of swaddling dramatically diminish in comparison.

South African researcher Dr. Nils Bergman suggests that through skin-to-skin contact, mother helps her baby “regulate,” or find the optimal set-points for future control of physiological functions including temperature, heart rate, breathing, and hormone levels. This results in thermal and behavioral synchrony between mother and baby.7, 8, 21

Bergman also notes that newborns are able to “self-regulate” by reaching their arms out to cool themselves down. “Keeping temperature in homeostasis requires freedom of movement,” he believes.

Wiggle Room

Babies are natural wigglers. Flexing and extending arms and legs, wiggling fingers, and moving around to whatever degree they can is one way of refining muscular control and assisting in the development of the nervous system, observes Dr. Fleiss. “Humans need total freedom of movement, not only so that blood can properly circulate to all the extremities, but for critically important neurological reasons that science is just now beginning to document,” he maintains.

Others point to the fact that flexion is the baby’s natural position. In the womb, a fetus’s arms are flexed with hands at the mouth. Tight swaddling with straight limbs not only forces an infant into an unnatural position, it prevents her from the self-soothing that comes from putting her hands to her mouth.

Hip Dysplasia

As swaddling has grown in popularity, so has concern about the potential for developmental dysplasia of the hip (DDH) in tightly swaddled newborns. 9,10,11 Hip dysplasia is a deformation or misalignment of the hip joint, which can lead later in life to premature degenerative joint disease and chronic pain, including early arthritis of the hip. The often-congenital condition can be exacerbated in a baby’s first days and weeks by forcing the legs to remain in extension through tight swaddling. In a technical report released Nov. 1, 2011, the American Academy of Pediatrics recommends against tight swaddling for this reason. The authors state: “This is particularly important, because some have advocated that the calming effects of swaddling are related to the “tightness” of the swaddling.”23


A more commonly noted risk is that of sudden infant death syndrome, which has been linked to babies sleeping prone (face down). In this sense, swaddling may offer some protection for young babies who are placed face up to sleep, since without the use of arms and legs they are unable to turn themselves over. However, in one study, some swaddled babies were able to turn themselves over onto a prone position by three months of age, suggesting that older swaddled babies may be at greater risk of SIDS even when placed supine, or face up, to sleep.12

In addition, an Australian case-control study found that among babies laid face down, those who were swaddled were at greater risk of SIDS than those (also face down) who were left un-swaddled.13 “These results suggest that if infants have to sleep in the prone position for a specific medical reason, they should be placed on a firm mattress and not swaddled,” the researchers conclude. (According to the American Academy of Pediatrics, one medical reason for placing a baby prone to sleep is infant gastroesophageal reflux.) Franz reminds us that even when sleeping prone, babies reflexively use their hands to push against the mattress to be able to lift and turn their heads, which helps protect the airway.

Whether sleeping prone or supine, swaddled babies in life-threatening situations may be subject to an added level of danger because swaddling inhibits arousal, according to a 2007 review of the research in the Journal of the American Academy of Pediatrics. 14 In addition, a too-high body temperature—resulting from swaddling in combination with an overly warm environment—is believed to be a possible contributory factor in SIDS.

Another potential health risk associated with tight swaddling is pneumonia and upper respiratory infections. One reason may be that a tightly wrapped chest restricts expansion of the lungs, which can increase susceptibility to infection. 15, 16

Officials Weigh In

While the American Academy of Pediatrics mentions swaddling as a possible aid in “prevention and management of pain and stress in the neonate,” 17 the AAP has no official policy on the practice. (Significant research suggests breastfeeding and skin-to-skin contact is an effective analgesic and is preferable to swaddling in this function. 18 19 20) The American SIDS Institute discourages the use of routine swaddling because of its potential to increase the risk of SIDS, according to Executive Director Betty McEntire. McEntire cites the risk factors of overheating, turning over to face-down position while swaddled, or pulling swaddling fabric loose. “Unless a baby needs swaddling, why take the chance?” she asks.

Attachment Parenting International also has no official policy on swaddling. However, because of the API’s focus on helping parents become more sensitive to their baby’s cues, co-founder Barbara Nicholson expresses concern that routine swaddling can mean parents become less closely attuned to their infant’s needs.

What Baby Really Needs

Nicholson and others note that other tools for soothing a baby can work at least as well as swaddling and have additional benefits. For example, carrying baby in a fabric baby carrier provides a similar sense of comfort but with the added stimulation of the mother’s movement and closeness to her body and the rhythm of her heartbeat. “What I love about a baby carrier is that the baby is up seeing the world. Babies are very observant, and they really love that motion,” she says. Other excellent tools for calming a fussy baby include skin-to-skin contact and gentle infant massage. “We (at API) talk a lot about the importance of touch,” Nicholson says.

Studies show that separation from mother creates stress in young babies. When babies in a 2006 study were held by their mothers much of the time in the early weeks after birth, crying was found to be significantly less than among those not held. 22 Dr. Fleiss agrees. “The best way to prevent crying is to keep your baby in your arms and be attentive to his beautifully subtle and effective communication efforts,” he believes. “Yes, this is a lot of work. Caring for babies is the hardest work there is, but it is also the most rewarding,” he stresses. “I guarantee that you will look back upon the physical closeness you experienced with your child during his babyhood as the most meaningful and cherished moments of your entire life.”

Franz offers parents a simple way to sort out conflicting advice. “See which basket the advice fits into: the good-for-the-parent basket or the good-for-the-baby basket,” she suggests. “Remember: You’re not managing an inconvenience; you’re raising a human being.”

Gussie Fauntleroy is a Crestone, Colorado-based writer whose work has appeared in national magazines including Orion, Arts & Antiques, Southwest Art, American Craft and Native Peoples. She is the author of three books about visual artists, and has written on a variety of topics for local and regional publications.

1 Rosseau, Jean-Jacque. Emile: Or, On Education, 1762. Quotes and historical information in this section were taken by permission from a webinar, “Swaddling: A Historical, Cultural, and Lactational Perspective,” presented in February 2011 by Linda Smith, an International Board Certified Lactation Consultant, Fellow with the American College of Childbirth Educators, and owner of Bright Future Lactation Resource Centre, Ltd. In Dayton, Ohio. See uslcaonline.org/edures.html and go to “webinars available on CD” to purchase the CD of Smith’s complete webinar.
2 Bystrova, K. Matthiesen, A.S. Widstrom, A.M., Ransjo-Arvidson, A.B., Vwlles-Nystrom, B., Vorontsov, I., et al. (2007) The effect of Russian Maternity Home routines on breastfeeding and neonatal weight loss with special reference to swaddling. Early Human Development, 83(1), 23-39.
3 Franco, P., Seret. N., Van Hees, J.N. Scaillet, S., Groswasser, J. & Kahn, A. (2005) Influence of swaddling on sleep and arousal characteristics of healthy infants. Pediatrics, 115 (5), 1307-1311.
4 Gerard CM, Harris KA, Thach BT. Spontaneous arousals in supine infants while swaddled and unswaddled during rapid eye movement and quiet sleep. Pediatrics, 2002 December;110(6):e70.
5 Richardson HL, Walker AM, Horne SC, (2010) Influence of swaddling experience on spontaneous arousal patterns and autonomic control in sleeping infants. The Journal of Paediatrics
6 Bystrova, Matthiesen, Widstrom, et al.
7 Bergman, NJ; Linley, LL; Fawcus, SR (2004) Randomized controlled trial of skin-to-skin contact from birth versus conventional incubator for physiological stabilization in 1200- to 2199-gram newborns. Acta Paediatrica, 93 (6), 779-785
8 Franco P, Scaillet S, Groswasser J, Kahn A. Increased cardiac autonomic responses to auditory challenges in swaddled infants. Sleep 2004 December 15;27(8):1527-32.
9 Mahan ST, Kasser JR (2008). Does swaddling influence developmental dysplasia of the hip? Pediatrics, 121 (1), 177–8
10 Sahin F, Akturk A, Beyazova U. et al (2004). Screening for developmental dysplasia of the hip: results of a 7-year follow-up study. Pediatrics International, 46(2):162
11 Mahan ST, Kasser JR (2008). Does swaddling influence developmental dysplasia of the hip? Pediatrics, 121 (1), 177–8
12 Beltman, M. (2000) Swaddling of infants: an old fashioned habit on its return [MSc degree paper], Utrecht University, Utrecht, Netherlands
13 Ponsonby, A.L., Dwyer, T., Gibbons, L.E., Cochrane, J.A., Wang, Y.G. (1993). Factors potentiating the risk of sudden infant death syndrome associated with the prone position. New England Journal of Medicine, 329(6), 377-
14 Kuis, Tom W.J. Schulpen and Monique P. L’Hoir, Bregje E. van Sleuwen, Adèle C. Engelberts, Magda M. Boere-Boonekamp, Wietse, Swaddling: A Systematic Review,Pediatrics 2007;120;e1097-e1106
15 Yurdakok K, Yavuz T, Taylor CE. (1990) Swaddling and acute respiratory infections. American Journal of Public Health, 80 :873 –875
16 Gerard CM, Harris KA, Thach BT (2002) Physiologic studies on swaddling: an ancient child care practice, which may promote the supine position for infant sleep. Journal of Pediatrics, 141:398–404
17 Committee on Fetus and Newborn, Committee on Drugs, Section on Anesthesiology, Section on Surgery and Canadian Paediatric Society, Fetus and Newborn Committee, Prevention and Management of Pain and Stress in the Neonate, Pediatrics
18 Shah, P. S., Aliwalas, L. I., & Shah, V. (2006). Breastfeeding or breast milk for procedural pain in neonates. Cochrane Database Syst Rev, 3, CD004950.
19 Carbajal, R., Veerapen, S., Couderc, S., Jugie, M., & Ville, Y. (2003). Analgesic effect of breast feeding in term neonates: randomized controlled trial. BMJ, 326(7379), 13.
20 Gray, L., Miller, L. W., Philipp, B. L., & Blass, E. M. (2002). Breastfeeding is analgesic in healthy newborns. Pediatrics, 109(4), 590-593.
21 Christensson, K., Siles, C., Moreno, L., Belaustequi, A., De La Fuente, P., Lagercrantz, H., et al. (1992). Temperature, metabolic adaptation and crying in healthy full-term newborns cared for skin-to-skin or in a cot. Acta Paediatr, 81(6-7), 488-493.
22 St James-Roberts, I., Alvarez, M., Csipke, E., Abramsky, T., Goodwin, J., & Sorgenfrei, E. (2006). Infant crying and sleeping in London, Copenhagen and when parents adopt a “proximal” form of care. Pediatrics, 117(6), e1146-1155.
23 Rachel Y. Moon, MD, lead author with AAP task for on sudden infant death syndrome, 2010-2011. SIDS and Other Sleep-Related Infant Deaths: Expansion of Recommendations for a Safe Infant Sleeping Environment, Pediatrics,128(5) November 2011, 304-307