Monday, November 18, 2019

Prevalence and Factors Associated With Safe Infant Sleep Practices

New Article on Infant Safe Sleep: Prevalence and Factors Associated With Safe Infant Sleep Practices

OBJECTIVES: To examine prevalence of safe infant sleep practices and variation by abstract
sociodemographic, behavioral, and health care characteristics, including provider advice.

METHODS: Using 2016 Pregnancy Risk Assessment Monitoring System data from 29 states, we
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 bedsharing, and (4) no soft objects or loose bedding as well as receipt of health care provider
advice corresponding to each sleep practice.

RESULTS: 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.

CONCLUSIONS: 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.

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