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 Researchers survey responses from more than 34,000 mothers on how
often they followed four essential practices: placing infants to
sleep on their back; putting babies to bed in a crib or other safe
sleep surface; room sharing without bed sharing; and keeping soft
objects and loose bedding away from sleeping babies.
Overall, 78% of mothers put babies to sleep on their backs, but just
57% kept babies in their room without sharing a bed with them. Only
42% of mothers avoided giving babies stuffed animals, pillows and
other soft bedding, while just 32% used cribs or other safe sleep
surfaces.
When mothers had been instructed on safe sleep practices by doctors,
however, they were 12% to 28% more likely to put babies to bed in
the safest ways, researchers report in Pediatrics.
"Placing infants to sleep on their stomach is the most widely known
risk factor for sleep-related deaths, but there are other
sleep-related risks that parents need to be aware of such as side
sleeping, sleeping with blankets, pillows, or other soft objects,
and sleeping on shared surfaces like adult beds and couches," said
Ashley Hirai, lead author of the study and a senior scientist at the
Health Resources and Services Administration in Rockville, Maryland.
"The safest place for babies to sleep is on their backs, on separate
firm sleep surfaces (crib, bassinet, or Pack 'n Play) without any
soft bedding (blankets, pillows, or bumper pads) and in the same
room as caregivers," Hirai said by email.
Sudden Infant Death Syndrome (SIDS) has become much less common in
recent decades as doctors have urged parents to put infants to sleep
on their backs without blankets or other soft bedding and toys that
could pose a suffocation risk. But it remains a leading cause of
infant mortality, according to the American Academy of Pediatrics (AAP).
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In the current study, demographic factors like age, race, income or
education levels appeared to explain some variation - about 5 to 10
percentage points - in the proportion of mothers who said doctors
told them about safe sleep practices.
But demographics explained more of the variation - about 10 to 20
percentage points - in how often mothers followed the advice.
The survey questions didn't distinguish routine habits that led to
unsafe infant sleep from occasional or accidental unsafe practices.
"We don't know why families are more compliant with some of these
recommendations vs others," said Dr. Michael Goodstein, division
chief of WellSpan Neonatology and director of the York County Cribs
for Kids Program.
"I suspect that back sleeping is one of the more commonly followed
practices because we have been promoting it the longest and the
'back to sleep' campaign has been so successful in saving lives,"
Goodstein, who wasn't involved in the study, said by email.
Some knowledge gaps may also be cultural or generational, said Dr.
Lori Feldman-Winter of Cooper Medical School of Rowan University in
Camden, New Jersey.
"Many caregivers, such as young mothers, or grandmothers, who may
not have been reached by the 'back to sleep' (or safe to sleep)
campaigns do not know about the importance of placing a baby on
his/her back as a way to prevent SIDS," Feldman-Winter, who wasn't
involved in the study, said by email.
SOURCE: http://bit.ly/2pKJSZF Pediatrics, online October 21, 2019.
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