AAP reports significant gaps in safe infant sleep practices

New research in the November 2019 Pediatrics found gaps in of safe infant sleep practices among U.S. families, highlighting areas for improvement in efforts to prevent roughly 3,500 infant deaths each year from sleep-related causes.

For the study, “Prevalence and Factors Associated with Safe Infant Sleep Practices,” researchers examined 2016 Pregnancy Risk Assessment Monitoring System data collected by the Centers for Disease Control and Prevention and health departments in 29 states. They analyzed reports from mothers about the use of four safe sleep practices — placing infants to sleep on their backs, using separate, firm sleep surfaces, not using soft bedding in the infant’s crib, and placing the crib in the same room with caregivers. Reports from mothers on whether they had received advice from health care providers about these practices was also examined.

Researchers found that infant sleep practices, especially those other than back sleep position, were less than ideal, with demographic and state-level differences. Overall, most mothers reported usually placing their infants to sleep on their backs (78 percent). However, fewer reported room-sharing without bed-sharing (57percent), avoiding soft bedding (42 percent) and using a separate approved sleep surface (32 percent).

Several demographic and racial/ethnic differences were identified in the study. For example, non-Hispanic black mothers had the lowest prevalence of using the back sleep position (62 percent), while non-Hispanic American Indian/Alaska Native Mothers had the lowest prevalence of avoiding soft bedding (25.6 percent). Mothers who said they received advice about safe sleep practices from health care providers were more likely to practice them, authors of the study found.

While more than 90 percent of mothers reported receiving provider advice to place their infant on their backs to sleep, receiving advice on other safe sleep practices was less frequently reported. The study authors concludes that increasing efforts to reach population groups with multiple overlapping risks for sudden unexpected infant death, such as smoking, and unsafe sleep practices such as use of soft bedding, and shared sleep surfaces, may improve outcomes.