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Despite SIDS risk, 56% of parents inconsistently use safe infant sleep positions
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Although the rate of sudden infant death syndrome has declined in the United States following the Back-to-Sleep campaign — which encouraged supine sleeping positions for infants and avoidance of soft bedding — more than half of parents are inconsistent in avoiding unsafe prone or side sleeping positions.
“Sudden unexpected infant death, which includes sudden infant death syndrome (SIDS), remains the leading cause of post-neonatal infant death in the United States,” Eve R. Colson, MD, from the department of pediatrics at the Yale School of Medicine, and colleagues wrote. “To decrease sudden unexpected infant death, the AAP has recommended since 2005 that infants be placed exclusively in the supine position for sleep. Despite this recommendation, not all infants are placed supine for sleep.”
To examine the prevalence of possibly unsafe infant sleep positions, whether these sleep positions were intentionally selected by their mothers and the factors that dictated maternal choices on sleep positions, Colson and colleagues surveyed a nationally representative sample of mothers (n = 3,297) of infants aged 2 to 6 months.
Survey questions included the mother’s choice of typical infant sleeping position, all sleeping positions used by the mother, if the mother intended to place her infant in the supine position — and how often she actually carried through with this intended practice — and whether the mother had received information from her health care provider that was consistent with safe sleep recommendations.
Among surveyed mothers, 73.3% noted that they typically placed their infants in the supine position for sleep; however, only 43.7% of mothers reported that they exclusively placed infants in the safe position, with many intent on this position placement when putting the infant to bed yet failing to do so in actual practice.
“Position changes are of particular concern given studies revealing that infants who are unaccustomed to prone sleeping are especially at risk when placed in that position and that those placed to sleep on their sides can easily roll to the prone position,” Colson and colleagues wrote.
Following multiple logistic regression analysis, the researchers also found that black mothers — compared with white mothers — and those with less than a high school education were significantly more likely to intend to place their infants in a non-supine position.
Additionally, the researchers observed that advice from the mother’s physician significantly influenced their choice of sleep position, and mothers who reported receiving advice that was consistent with AAP recommendations were less likely to intend to place their infants in either prone or side positions.
“We demonstrate that it is still common for infants to be placed in unsafe sleep positions, and the use of unsafe sleeping positions increases when expanded beyond the usual choice,” Colson and colleagues wrote. “Maternal race and education continue to be factors associated with choice of infant sleeping position, as does advice from a doctor. Future research can be aimed at using these findings to inform and then to test the efficacy of educational interventions to change practice.”
Disclosure: The researchers report no relevant financial disclosures.
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