Pēpē‐infant sleep practices and sudden unexpected death in infancy (SUDI) in Aotearoa New Zealand

Insufficient sleep is a strong risk factor for unhealthy weight gain in children. Māori (the indigenous population of Aotearoa (New Zealand)) children have an increased risk of unhealthy weight gain compared to New Zealand European children. Interventions around sleep could provide an avenue for improving health and limiting excessive weight gain with other meaningful benefits for whānau (extended family) well-being. However, current messages promoting good sleep may not be realistic for many Māori whānau. Using qualitative methods, the Moe Kitenga project explored the diverse realities of sleep in 14 Māori whānau. We conclude that for infant sleep interventions to prevent obesity and improve health outcomes for Māori children, they must take into account the often pressing social circumstances of many Māori whānau that are a barrier to adopting infant sleep recommendations, otherwise sleep interventions could create yet another oppressive standard that whānau fail to live up to.

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Safe sleep practices in a New Zealand community and development of a Sudden Unexpected Death in Infancy (SUDI) risk assessment instrument

BMC Pediatrics ◽

10.1186/1471-2431-14-263 ◽

2014 ◽

Vol 14 (1) ◽

Cited By ~ 6

Author(s):

Barbara C Galland ◽

Andrew Gray ◽

Rachel M Sayers ◽

Anne-Louise M Heath ◽

Julie Lawrence ◽

...

Keyword(s):

Risk Assessment ◽

New Zealand ◽

Assessment Instrument ◽

Sudden Unexpected Death ◽

Unexpected Death ◽

Safe Sleep ◽

Risk Assessment Instrument

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Interventions to Improve Safer Sleep Practices in Families With Children Considered to Be at Increased Risk for Sudden Unexpected Death in Infancy: A Systematic Review

Frontiers in Pediatrics ◽

10.3389/fped.2021.778186 ◽

2022 ◽

Vol 9 ◽

Author(s):

Catherine Ellis ◽

Anna Pease ◽

Joanna Garstang ◽

Debbie Watson ◽

Peter S. Blair ◽

...

Keyword(s):

Systematic Review ◽

At Risk ◽

Health Education ◽

Mode Of Delivery ◽

Sudden Unexpected Death ◽

Quality Data ◽

Infant Sleep ◽

Unexpected Death ◽

Information Giving ◽

Increased Risk

Background: Advice to families to follow infant care practices known to reduce the risks of Sudden Unexpected Death in Infancy (SUDI) has led to a reduction in deaths across the world. This reduction has slowed in the last decade with most deaths now occurring in families experiencing social and economic deprivation. A systematic review of the literature was commissioned by the National Child Safeguarding Practice Review Panel in England. The review covered three areas: interventions to improve engagement with support services, parental decision-making for the infant sleep environment, and interventions to improve safer sleep practices in families with infants considered to be at risk of SUDI.Aim: To describe the safer sleep interventions tested with families with infants at risk of SUDI and investigate what this literature can tell us about what works to reduce risk and embed safer sleep practices in this group.Methods: Eight online databases were systematically searched in December 2019. Intervention studies that targeted families with infants (0–1 year) at increased risk of SUDI were included. Studies were limited to those from Western Europe, North America or Australasia, published in the last 15 years. The Quality Assessment Tool for Studies with Diverse Designs was applied to assess quality. Data from included studies were extracted for narrative synthesis, including mode of delivery using Michie et al.'s Mode of Delivery Taxonomy.Results: The wider review returned 3,367 papers, with 23 intervention papers. Five types of intervention were identified: (1) infant sleep space and safer sleep education programs, (2) intensive or targeted home visiting services, (3) peer educators/ambassadors, (4) health education/raising awareness interventions, (5) targeted health education messages using digital media.Conclusion: Influencing behavior in families with infants at risk of SUDI has traditionally focused on “getting messages across,” with interventions predominantly using education and awareness raising mechanisms. This review found evidence of interventions moving from “information giving” to “information exchange” models using personalized, longer term relationship-building models. This shift may represent an improvement in how safer sleep advice is implemented in families with infants at risk, but more robust evidence of effectiveness is required.Systematic Review Registration:https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/901091/DfE_Death_in_infancy_review.pdf, identifier: CRD42020165302.

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Decision-making for the infant sleep environment among families with children considered to be at risk of sudden unexpected death in infancy: a systematic review and qualitative metasynthesis

BMJ Paediatrics Open ◽

10.1136/bmjpo-2020-000983 ◽

2021 ◽

Vol 5 (1) ◽

pp. e000983

Author(s):

Anna Pease ◽

Joanna J Garstang ◽

Catherine Ellis ◽

Debbie Watson ◽

Jenny Ingram ◽

...

Keyword(s):

Decision Making ◽

At Risk ◽

Sudden Unexpected Death ◽

Infant Sleep ◽

Unexpected Death ◽

Parental Decision ◽

Parental Decision Making ◽

Increased Risk ◽

Sleep Environment ◽

Families With Children

BackgroundAdvice to families to sleep infants on their backs, avoid smoke exposure, reduce excess bedcovering and avoid specific risks associated with cosleeping has greatly reduced sudden unexpected death in infancy (SUDI) rates worldwide. The fall in rates has not been equal across all groups, and this advice has been less effective for more socially deprived families. Understanding decision-making processes of families with infants at risk would support the development of more effective interventions.AimTo synthesise the qualitative evidence on parental decision-making for the infant sleep environment among families with children considered to be at increased risk of SUDI.MethodsThis study was one of three related reviews of the literature for the Child Safeguarding Practice Review Panel’s National Review in England into SUDI in families where the children are considered at risk of harm. A systematic search of eight online databases was carried out in December 2019. Metasynthesis was conducted, with themes extracted from each paper, starting with the earliest publication first.ResultsThe wider review returned 3367 papers, with 16 papers (across 13 studies) specifically referring to parental decision-making. Six overall themes were identified from the synthesis: (1) knowledge as different from action; (2) external advice must be credible; (3) comfort, convenience and disruption to the routine; (4) plausibility and mechanisms of protection; (5) meanings of safety and risk mitigation using alternative strategies; and (6) parents’ own expertise, experience and instincts.ConclusionInterventions that are intended to improve the uptake of safer sleep advice in families with infants at risk of sleep-related SUDI need to be based on credible advice with mechanisms of protection that are understandable, consistent with other sources, widened to all carers of the infant and fit within the complex practice of caring for infants.

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Moe Kitenga: a qualitative study of perceptions of infant and child sleep practices among Māori whānau

10.26686/wgtn.12551525 ◽

2020 ◽

Author(s):

Molly George ◽

Reremoana Theodore ◽

Rosalina Richards ◽

Barbara Galland ◽

Rachael Taylor ◽

...

Keyword(s):

Weight Gain ◽

New Zealand ◽

Extended Family ◽

Well Being ◽

Infant Sleep ◽

Aotearoa New Zealand ◽

Increased Risk ◽

Unhealthy Weight ◽

Good Sleep ◽

Improve Health

Insufficient sleep is a strong risk factor for unhealthy weight gain in children. Māori (the indigenous population of Aotearoa (New Zealand)) children have an increased risk of unhealthy weight gain compared to New Zealand European children. Interventions around sleep could provide an avenue for improving health and limiting excessive weight gain with other meaningful benefits for whānau (extended family) well-being. However, current messages promoting good sleep may not be realistic for many Māori whānau. Using qualitative methods, the Moe Kitenga project explored the diverse realities of sleep in 14 Māori whānau. We conclude that for infant sleep interventions to prevent obesity and improve health outcomes for Māori children, they must take into account the often pressing social circumstances of many Māori whānau that are a barrier to adopting infant sleep recommendations, otherwise sleep interventions could create yet another oppressive standard that whānau fail to live up to.

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Moe Kitenga: a qualitative study of perceptions of infant and child sleep practices among Māori whānau

10.26686/wgtn.12551525.v1 ◽

2020 ◽

Author(s):

Molly George ◽

Reremoana Theodore ◽

Rosalina Richards ◽

Barbara Galland ◽

Rachael Taylor ◽

...

Keyword(s):

Weight Gain ◽

New Zealand ◽

Extended Family ◽

Well Being ◽

Infant Sleep ◽

Aotearoa New Zealand ◽

Increased Risk ◽

Unhealthy Weight ◽

Good Sleep ◽

Improve Health

Insufficient sleep is a strong risk factor for unhealthy weight gain in children. Māori (the indigenous population of Aotearoa (New Zealand)) children have an increased risk of unhealthy weight gain compared to New Zealand European children. Interventions around sleep could provide an avenue for improving health and limiting excessive weight gain with other meaningful benefits for whānau (extended family) well-being. However, current messages promoting good sleep may not be realistic for many Māori whānau. Using qualitative methods, the Moe Kitenga project explored the diverse realities of sleep in 14 Māori whānau. We conclude that for infant sleep interventions to prevent obesity and improve health outcomes for Māori children, they must take into account the often pressing social circumstances of many Māori whānau that are a barrier to adopting infant sleep recommendations, otherwise sleep interventions could create yet another oppressive standard that whānau fail to live up to.

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International comparison of sudden unexpected death in infancy rates using a newly proposed set of cause-of-death codes

Archives of Disease in Childhood ◽

10.1136/archdischild-2015-308239 ◽

2015 ◽

Vol 100 (11) ◽

pp. 1018-1023 ◽

Cited By ~ 40

Author(s):

Barry J Taylor ◽

Joanna Garstang ◽

Adele Engelberts ◽

Toshimasa Obonai ◽

Aurore Cote ◽

...

Keyword(s):

New Zealand ◽

The Netherlands ◽

International Comparison ◽

International Comparisons ◽

Sudden Infant Death ◽

Sudden Unexpected Death ◽

Sudden Infant ◽

Unexpected Death ◽

Icd 10 ◽

Over Time

BackgroundComparing rates of sudden unexpected death in infancy (SUDI) in different countries and over time is difficult, as these deaths are certified differently in different countries, and, even within the same jurisdiction, changes in this death certification process have occurred over time.AimsTo identify if International Classification of Diseases-10 (ICD-10) codes are being applied differently in different countries, and to develop a more robust tool for international comparison of these types of deaths.MethodsUsage of six ICD-10 codes, which code for the majority of SUDI, was compared for the years 2002–2010 in eight high-income countries.ResultsThere was a great variability in how each country codes SUDI. For example, the proportion of SUDI coded as sudden infant death syndrome (R95) ranged from 32.6% in Japan to 72.5% in Germany. The proportion of deaths coded as accidental suffocation and strangulation in bed (W75) ranged from 1.1% in Germany to 31.7% in New Zealand. Japan was the only country to consistently use the R96 code, with 44.8% of SUDI attributed to that code. The lowest, overall, SUDI rate was seen in the Netherlands (0.19/1000 live births (LB)), and the highest in New Zealand (1.00/1000 LB). SUDI accounted for one-third to half of postneonatal mortality in 2002–2010 for all of the countries except for the Netherlands.ConclusionsThe proposed set of ICD-10 codes encompasses the codes used in different countries for most SUDI cases. Use of these codes will allow for better international comparisons and tracking of trends over time.

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