Invalid health information is potentially lethal

Editor—A picture of the cover of Benjamin Spock's record breaking bestseller Baby and Child Care was used to illustrate a point Ferguson made in the section of his article subtitled, “From Dr Spock to drkoop.com.”¹ We are told that a Harvard pioneer in cybermedicine—Warner Slack—has compared the rapid growth of online health resources to the seismic impact of the publication of Spock's book, which, he suggested, had rapidly made it clear that well informed parents could take much better care of their kids.

By coincidence, I had used the same picture of the cover of Spock's book in the previous week at the Cochrane Colloquium in Cape Town, but to make a different point. In the edition of Baby and Child Care that I bought as a recent medical graduate in the mid-1960s, I had marked a passage which read: “There are two disadvantages to a baby's sleeping on his back. If he vomits, he's more likely to choke on the vomitus. Also he tends to keep his head turned towards the same side . . . this may flatten the side of his head . . . I think it is preferable to accustom a baby to sleeping on his stomach from the start.” No doubt like millions of his other readers, I passed on and acted on this apparently rational and authoritative advice.

We now know that the advice promulgated so successfully in Spock's book led to thousands, if not tens of thousands, of avoidable cot deaths. This should be a sobering warning to those who exploit the internet to promulgate health advice without ensuring that reliable empirical research evidence has shown that their prescriptions and proscriptions are more likely to help than to harm other people.