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Safe sleeping practices not followed in most infants, finds study

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Only about a quarter of young infants always sleep alone on an approved sleep surface like a crib or bassinet, as recommended by the American Academy of Pediatrics, finds a study in Pediatrics.

The researchers conducted the study to examine the prevalence of safe infant sleep practices and variation by sociodemographic, behavioural, and health care characteristics, including provider advice.

They used 2016 Pregnancy Risk Assessment Monitoring System data from 29 states and examined maternal report of 4 safe sleep practices indicating how their infant usually slept: (1) back sleep position, (2) separate approved sleep surface, (3) room-sharing without bed-sharing, and (4) no soft objects or loose bedding as well as receipt of health care provider advice corresponding to each sleep practice.

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Most mothers reported usually placing their infants to sleep on their backs (78.0%), followed by room-sharing without bed-sharing (57.1%). Fewer reported avoiding soft bedding (42.4%) and using a separate approved sleep surface (31.8%). Reported receipt of provider advice ranged from 48.8% (room-sharing without bed-sharing) to 92.6% (back sleep position). Differences by sociodemographic, behavioral, and health care characteristics were larger for safe sleep practices (∼10–20 percentage points) than receipt of advice (∼5–10 percentage points). Receipt of provider advice was associated with increased use of safe sleep practices, ranging from 12% for room-sharing without bed-sharing (adjusted prevalence ratio: 1.12; 95% confidence interval: 1.09–1.16) to 28% for back sleep position (adjusted prevalence ratio: 1.28; 95% confidence interval: 1.21–1.35). State-level differences in safe sleep practices spanned 20 to 25 percentage points and did not change substantially after adjustment for available characteristics.

Over 30,000 U.S. women who gave birth in 2016 answered questions about sleep practices when their infants were on average 4 months old. Among the other findings:

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  • Some 78% reported putting their babies to sleep on their backs most of the time.
  • Just 41% always shared a room with their baby without bed-sharing.
  • Only 42% reported not putting soft objects or loose bedding in the sleeping area; blankets were the most common soft item used.
  • Most mothers said they were advised by a provider to have their babies sleep supine without soft bedding, but just half were told to room-share without bed-sharing.

The researchers concluded that safe infant sleep practices, especially those other than back sleep position, are suboptimal, with demographic and state-level differences indicating improvement opportunities. Receipt of provider advice is an important modifiable factor to improve infant sleep practices.

The researchers note that “provider advice is an important, modifiable factor to improve safe sleep practice.”

Pediatrics article (Free abstract)

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Source: Pediatrics

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