Predicting Transition to the Supine Sleep Position in Preterm Infants

Objective. The American Academy of Pediatrics' (AAP) recommendation for side or supine sleep position in healthy babies has generated much controversy. We surveyed primary care physicians to determine the effect of the AAP statement on physician attitude toward infant sleep position and advice to parents. Methods. We sent a 23-question survey to 194 physicians in Western New York. The survey addressed their attitude toward the AAP recommendations and its impact on their advice to parents. Results. Of the 149 physicians treating newborns, 121 (82%) completed the questionnaire; 98% were aware of the AAP statement. The most common sources of information were the AAP (86%) and professional literature (77%). Of the respondents, 79% agreed with the AAP statement. Reasons for reservation were lack of data (64%), potential adverse consequences of supine position (52%), and their own experience (47%). Gender, years in practice, and type of reimbursement did not influence attitude toward the AAP recommendation. The AAP statement increased the frequency with which physicians routinely discussed sleep position from 34 to 70% (P < .02). Physicians recommending the prone position decreased from 57 to 7% (P < .001), while those recommending supine sleep position increased from 10 to 42% (P < .001). Conclusions. Most physicians agreed with the AAP statement and more frequently discussed sleep position following the AAP recommendations. However, they did not routinely recommend supine sleep position. The majority (69%) recommended the side position even though it is unstable. Although the AAP statement has increased discussion of infant sleep position by primary care physicians in WNY, only a minority recommend that infants sleep supine.

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Parents’ choice of non-supine sleep position for newborns: A cross-sectional study

Journal of Health Visiting ◽

10.12968/johv.2014.2.9.500 ◽

2014 ◽

Vol 2 (9) ◽

pp. 500-504

Author(s):

Charlotte Wright ◽

Hannah Beard ◽

Jennifer Cox ◽

Paula Scott ◽

Joyce Miller

Keyword(s):

Cross Sectional Study ◽

Sleep Position ◽

Sectional Study ◽

Cross Sectional ◽

Supine Sleep

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Skull Morphology Affected by Different Sleep Positions in Infancy

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_1995_032_0413_smabds_2.3.co_2 ◽

1995 ◽

Vol 32 (5) ◽

pp. 413-419 ◽

Cited By ~ 6

Author(s):

Chiung-Shing Huang ◽

Hsin-Chung Cheng ◽

Wen-Yuan Lin ◽

Jein-Wein Liou ◽

Yu-Ray Chen

Keyword(s):

Cleft Lip ◽

The Body ◽

Head Length ◽

Sleep Position ◽

Head Width ◽

Cephalic Index ◽

Craniofacial Skeleton ◽

Skull Morphology ◽

Supine Sleep ◽

The Relationship

In Infancy, prior to cranial suture and fontanel calcification, the craniofacial skeleton can be easily deformed by an externally exerted force. In this study, the relationship between the sleep position and skull morphology was investigated. A group of 81 cleft lip and/or palate infants without other systemic anomalies was first seen in the craniofacial center at approximately 1 month of age. The sleep position of each infant was recorded as supine, prone, or mixed type. The body and skull growth were longitudinally measured at 1, 3, and 6 months of age. Infants sleeping in the supine sleep position tended to have a wider head width, shorter head length, and a larger cephalic Index by 6 months of age. The opposite phenomena were observed in the prone sleep group. The mixed sleep group tended to have head width, head length, and cephalic index between those of the supine sleep group and the prone sleep group. During the first 3 months of life, the sleep position could mold the skull primarily in the dimension of head width. In conclusion, the supine sleep position may promote brachycephaly and the prone sleep position dolichocephaly.

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Sudden Infant Death Syndrome Rates Subsequent to the American Academy of Pediatrics Supine Sleep Position

Medical Care ◽

10.1097/00005650-199806000-00017 ◽

1998 ◽

Vol 36 (6) ◽

pp. 938-942 ◽

Cited By ~ 13

Author(s):

Eric Gibson ◽

Neil Fleming ◽

David Fleming ◽

Jennifer Culhane ◽

Fern Hauck ◽

...

Keyword(s):

American Academy ◽

Sudden Infant Death Syndrome ◽

Infant Death ◽

Sudden Infant Death ◽

Sleep Position ◽

Sudden Infant ◽

American Academy Of Pediatrics ◽

Supine Sleep

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Parents' choice of non-supine sleep position for newborns: a cross-sectional study

British Journal of Midwifery ◽

10.12968/bjom.2014.22.9.625 ◽

2014 ◽

Vol 22 (9) ◽

pp. 625-629 ◽

Cited By ~ 1

Author(s):

Charlotte Wright ◽

Hanna Beard ◽

Jennifer Cox ◽

Paula Scott ◽

Joyce Miller

Keyword(s):

Cross Sectional Study ◽

Sleep Position ◽

Sectional Study ◽

Cross Sectional ◽

Supine Sleep

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Supine Sleep Positioning, EMLA for Lumbar Puncture, and Home Gavage for Preterm Infants

Neonatal Network The Journal of Neonatal Nursing ◽

10.1891/0730-0832.23.5.75 ◽

2004 ◽

Vol 23 (5) ◽

pp. 75-77

Author(s):

Gail McCain

Keyword(s):

Preterm Infants ◽

Research Evidence ◽

Nursing Practice ◽

Research Review ◽

Column Editor ◽

Research Publication ◽

Neonatal Nursing ◽

Supine Sleep ◽

Sleep Positioning ◽

E Mail

This column highlights selected research abstracts from published studies and systematic reviews about neonatal care. The original abstracts, from peer-reviewed journals, are followed with a commentary by the column editor. The goal of this column is to inform the readers of Neonatal Network:® The Journal of Neonatal Nursing about the most up-to-date research evidence for use in neonatal nursing practice. If you would like to see a particular research publication, research review, or research-based guideline in this column, please advise the column editor (E-mail: gmccain.com).

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Maxillary Dental Arch Affected by Different Sleep Positions in Unilateral Complete Cleft Lip and Palate Infants

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_1994_031_0179_mdaabd_2.3.co_2 ◽

1994 ◽

Vol 31 (3) ◽

pp. 179-184 ◽

Cited By ~ 7

Author(s):

Chiung-Shing Huang ◽

Hsin-Chung Cheng ◽

Yu-Ray Chen ◽

M. Samuel Noordhoff

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Longitudinal Change ◽

Sleep Position ◽

Dental Arch ◽

Initial Visit ◽

Arch Width ◽

Supine Sleep ◽

The Relationship ◽

Maxillary Arch

The development of the dental arch is well designed for adaptive and compensatory growth. In this study, the relationship between the sleep position and dental arch development was Investigated. A group of 42 infants with unilateral complete cleft lip and palate with either prone (16) or supine (26) sleep position were seen in the craniofacial center. All infants were less than 1 month of age at the initial visit. Dental impressions of the maxillary arch were taken at the initial visit and just before cheiloplasty. Ten arch dimensions were measured in each dental cast and the longitudinal change in each dimension was compared between the prone sleep group and the supine sleep group. Statistically significant changes were detected in the growth rate of the following dimensions: intercanine width, intertuberosity width, alveolar cleft width, anterior cleft width, and posterior cleft width. This study indicated that sleep position affected maxillary arch development. Infants sleeping in the prone sleep position tended to have narrower arch width and cleft width.

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Sleep in the Supine Position During Pregnancy is Associated with Fetal Cerebral Redistribution

Journal of Clinical Medicine ◽

10.3390/jcm9061773 ◽

2020 ◽

Vol 9 (6) ◽

pp. 1773

Author(s):

Nicole Robertson ◽

Satomi Okano ◽

Sailesh Kumar

Keyword(s):

Risk Factor ◽

Cardiac Function ◽

Cerebral Artery ◽

Supine Position ◽

Population Attributable Risk ◽

Fetal Brain ◽

Late Pregnancy ◽

Sleep Position ◽

Maternal Sleep ◽

Supine Sleep

The supine sleep position in late pregnancy is a major risk factor for stillbirth, with a population attributable risk of 5.8% and one in four pregnant women reportedly sleeping in a supine position. Although the mechanisms linking the supine sleep position and late stillbirth remain unclear, there is evidence that it exacerbates pre-existing maternal sleep disordered breathing, which is another known risk factor for adverse perinatal outcomes. Given that maternal sleep position is a potentially modifiable risk factor, the aim of this study was to characterize and correlate uteroplacental and fetal hemodynamics, including cardiac function, in a cohort of women with apparently uncomplicated pregnancies with their nocturnal sleep position. This was a prospective observational cohort study at an Australian tertiary obstetric hospital. Women were asked to complete a series of questions related to their sleep position in late pregnancy after 35 weeks of completed gestation. They also underwent an ultrasound assessment where Doppler indices of various fetoplacental vessels and fetal cardiac function were measured. Regional cerebral perfusion was also assessed. Pregnancy outcome data was extracted from the electronic hospital database for analysis. A total of 274 women were included in the final analysis. Of these, 78.1% (214/274) reported no supine sleep, and 21.9% (60/274) reported going to sleep in a supine position. The middle cerebral artery, anterior cerebral artery, and vertebral artery pulsatility indices were all significantly lower in the supine sleep cohort, as was the cerebroplacental ratio. There were no significant differences in the mode or indication for delivery or in serious neonatal outcomes, including 5-min Apgar score < 7, acidosis, and neonatal intensive care unit admission between cohorts. Women in the supine cohort were more likely to have an infant with a BW > 90th centile (p = 0.04). This data demonstrates fetal brain sparing in association with the maternal supine sleep position in a low-risk population. This data contributes to the growing body of literature attempting to elucidate the etiological pathways responsible for the association of late stillbirth with the maternal supine sleep position.

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