A Hospital-Based Infant Safe Sleep Intervention and Safe Sleep Practices Among Young Women: A Prospective Longitudinal Study

Abstract

IntroductionThe rates of sudden unexpected infant death (SUID) are still high in the U.S. The longitudinal effects of SUID preventive education on infant safe sleep practices are less known. The current study evaluated the effects of a comprehensive hospital-based, SUID preventive intervention on safe infant sleep practices in the first six months of life and to identify factors associated with infant sleep practices.MethodsUsing a one-group pretest and multiple posttest design, the current quantitative study examined the impacts of the infant safe sleep intervention among 411 women recruited at a large, urban, university medical center. Participants were prospectively followed and completed four surveys from childbirth. Linear mixed models were used to evaluate the effects of the SUID prevention program on four sleep practice outcomes, including removing unsafe items from the sleeping environment, bed sharing, room sharing without bed sharing, and placing the infant in a supine sleep position.ResultsCompared to the baseline, participants were less likely to use unsafe items (e.g., soft bedding) in infants' sleeping areas over time. However, we found that participants reported more frequent bed sharing at 3-month and 6-month follow-ups, compared to the baseline.ConclusionsOverall, maternal education and family income were positively related to healthy infant safe sleep practices. A hospital-based preventive intervention pairing an educational initiative with home-visiting services might improve safe sleep practices to remove accidental suffocation risks from the infant sleep environment. Significance StatementWhat is already known on this subject? Despite large public health efforts, rates of sudden unexpected infant death have stagnated across the U.S. in recent years. The majority of caregivers implement some of the American Academy of Pediatrics (AAP) safe sleep guidelines, such as safe sleep position. Few caregivers, however, follow other AAP recommendations such as not using any soft and loose bedding that present a potential suffocation hazard.What this study adds? A hospital-based preventive intervention was effective in removing unsafe items from infants' sleeping area. The development of policy and practice initiatives to prevent the use of unsafe items in an infant sleeping environment should be further encouraged.