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Half of US infants sleep with potentially hazardous bedding
Although the use of blankets, pillows and quilts in the infant sleeping area has declined, approximately 50% of infants still sleep with potentially hazardous bedding, according to study findings published in Pediatrics.
“Soft objects and loose bedding such as these items can obstruct the infant airway and pose a suffocation risk,” Carrie K. Shapiro-Mendoza, PhD, MPH, senior scientist at the Maternal and Infant Health Branch of the CDC, and colleagues wrote. “In addition, this type of bedding is a recognized risk factor for [sudden infant death syndrome].”
To evaluate trends in bedding use, the researchers assessed data from the National Infant Sleep Position study, a cross-sectional telephone survey conducted from 1993 to 2010. Nighttime caregivers of infants aged younger than 8 months reported infant sleeping practices, including sleep position, location and use of potentially hazardous bedding.
The National Infant Sleep Position study underrepresented black, Hispanic and teenage mothers and mothers with less than a high school education.
Overall, 18,952 study participants completed surveys. Annual sample size ranged from 1,012 to 1,188 with an estimated average response rate of 71%.
Bedding use was highest overall among infants to teenage mothers (83.5%) and lowest among infants born at term (55.6%).
From 1993 to 2010, thick blankets and quilts/comforters were the most commonly used bedding covers, reportedly used by 37.6% and 19.9% of participants. Blankets and cushions were the most commonly used bedding placed under an infant, used by 29.2% and 3.7% of participants.
The percentage of infants covered with thick blankets or quilts/comforters significantly decreased during the study period (P<.0001), according to researchers.
“Interestingly, we observed a greater decline in bedding use over infants (quilts/comforters and thick blankets) compared with bedding (blankets) under infants,” Shapiro-Mendoza and colleagues wrote. “This finding raises a concern that parents may incorrectly perceive the recommendations as only pertaining to items covering or around the infant, and not include items under the infant.”
Analysis indicated bedding use over or under an infant decreased from an average of 85.9% in 1993 to 1995 to 54.7% in 2008 to 2010, indicating a 10% annual decline in the odds of using bedding (OR=.90; 95% CI, 0.89-0.90).
From 2007 to 2010, bedding use was most common among infants sleeping in adult beds, infants placed to sleep on their sides and infants sharing a sleep surface. During this time period, use of bedding was highest among infants with teenage mothers and mothers with less than high school education (77.1% and 72.6%, respectively). Young maternal age, non-white race and ethnicity, and having less than a college education were the strongest predictors of bedding use.
“The use of certain types of bedding in the infant sleep environment is a modifiable risk factor for SIDS and unintentional sleep-related suffocation,” the researchers wrote. “To reduce risk, the AAP recommends that soft objects and loose bedding not be placed in an infant’s sleeping environment. However, despite such recommendations, the use of bedding over and under the infant for sleep seems to have remained a common practice.”
Disclosure: The researchers report no relevant financial disclosures.
