Factors influencing infant sleep position: decisions do not differ by SES in African-American families

ObjectiveTo investigate factors influencing African-American parents’ knowledge, attitudes and practice regarding infant sleep position and determine if these differ by socioeconomic status (SES).MethodsA cross-sectional sample of 412 parents with infants ≤6 months of age participated in a validated survey of knowledge, attitudes and practice.ResultsThere was no significant difference in attitudes or practice, and knowledge was similar regarding infant sleep position between African-American parents of higher and lower SES. The healthcare provider recommendation of exclusive supine sleep position use was associated with increased knowledge, overall decreased use of the side position (5.0% vs 16.8%, p<0.01) and increased occasional use of the supine position in the lower SES group (81.6% vs 68.6%, p=0.03). It was not associated with increased positive parental attitudes about the supine sleep position in either group. Neither a senior caregiver living in the home nor observation of hospital personnel placing infants in a non-supine position was associated with differences in sleep position practices in either group.ConclusionsSleep position practices in African-American families do not differ by SES. Improved attitudes toward positioning and increased use of supine positioning may result if healthcare providers address common concerns and misconceptions about sleep position.

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Infant Sleep Position: Pediatricians' Advice to Parents

PEDIATRICS ◽

10.1542/peds.95.1.55 ◽

1995 ◽

Vol 95 (1) ◽

pp. 55-58

Author(s):

Bonnie B. Hudak ◽

Jane O'Donnell ◽

Nadine Mazyrka

Keyword(s):

Primary Care ◽

New York ◽

Primary Care Physicians ◽

Sleep Position ◽

Infant Sleep ◽

Sources Of Information ◽

Professional Literature ◽

Infant Sleep Position ◽

Supine Sleep ◽

Question Survey

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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