Abstract
Objectives
Sleep-related infant deaths in the District of Columbia (DC) varies, with rates in certain geographical areas three times higher than DC and seven times higher than the national average. We sought to understand differences in infant sleep knowledge, beliefs, and practices between families in high-risk infant mortality and low-risk infant mortality areas in DC.
Methods
Caregivers of infants presenting to the emergency department were surveyed. The associations between location and safe sleep knowledge, beliefs, and practices were analyzed.
Results
Two hundred and eighty-four caregivers were surveyed; 105 (37%) were from the high-risk infant mortality area. The majority (68%) of caregivers reported placing their infant to sleep on their backs, sleeping in a crib, bassinet, or pack and play (72%), and were familiar with the phrase “safe sleep” (72%). Caregivers from the high-risk infant mortality area were more likely to report that their infants sleep in homes other than their own (aOR 1.53; 95% CI 1.23, 2.81) and other people took care of their infants while sleeping (aOR 1.76; 95% CI 1.17, 3.19), adjusting for race/ethnicity, education, marital status, and help with childcare. No differences in safe sleep knowledge, beliefs, and practices were present.
Conclusions for Practice
Infants from the high-risk infant mortality area were more likely to sleep in homes other than their own and have other caretakers while sleeping. Lack of differences in caregiver awareness of safe sleep recommendation or practices suggests effective safe sleep messaging. Outreach to other caregivers and study of unmet barriers is needed.
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Data Availability
The datasets generated and analyzed during the current study are not publicly available due to privacy of study participants but are available from the corresponding author on reasonable request.
Code Availability
All data were analyzed using SAS Analytics Software. Analysis code is available on request.
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Acknowledgements
This project was supported by a Children’s National Health Board Grant. We are indebted to the caregivers who took the time to complete this survey and make this research possible.
Funding
This work was supported by a Children’s Health Board grant. The funders played no role in the study design, analysis, or presentation.
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MBH conceptualized and designed the study, acquired funding, contributed to methodology and investigation, supervised and oversaw literature review, drafted the initial manuscript, reviewed and revised the manuscript, and approved the final manuscript as submitted. LRJ contributed to methodology and investigation, supervised and oversaw literature review, reviewed and revised the manuscript, and approved the final manuscript as submitted. GMB contributed to methodology and statistical analyses, reviewed and revised the manuscript, and approved the final manuscript as submitted. BTP contributed to the methodology and participant recruitment, reviewed and revised the manuscript, and approved the final manuscript as submitted. KAD contributed to methodology and investigation, supervised and oversaw literature review, reviewed and revised the manuscript, and approved the final manuscript as submitted.
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Howard, M.B., Jarvis, L.R., Badolato, G.M. et al. Variations in Safe Sleep Practices and Beliefs: Knowledge is not Enough. Matern Child Health J 26, 1059–1066 (2022). https://doi.org/10.1007/s10995-021-03341-x
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DOI: https://doi.org/10.1007/s10995-021-03341-x