Factors Associated with Bed-Sharing for African American and White Mothers in Wisconsin

Abstract

Mother-infant bed-sharing has been associated with a higher risk of sleep-related infant deaths, which affects African Americans at a disproportionately higher rate. Although “separate but proximate sleep surfaces” for infants has been recommended since 2005, bed-sharing remains a common practice, especially among African Americans. This study examined factors associated with bed-sharing among African American and White mothers. Separate logistic regression models were constructed for African American and White respondents to the 2007–2010 Wisconsin Pregnancy Risk Assessment and Monitoring System. The sample consisted of 806 African Americans and 1,680 Whites (N = 2,486). A significantly larger proportion of African Americans (70.6 %) reported bed-sharing than Whites (53.4 %). For both races, partner-related stress was significantly associated with bed-sharing; no significant differences were found between the two racial groups. For African Americans, partner stress (OR 1.8: 1.2–2.6) and maternal education of 13–15 years (OR 2.0: 1.2–3.4) or ≥16 years (OR 2.7: 1.1–6.3) was associated with increased odds of bed-sharing. For Whites, partner stress (OR 1.3: 1–1.8), breastfeeding (OR 2.5: 1.9–3.1), income of $35,000–$49,999 (OR 1.6: 1.2–2.3), being unmarried (OR 1.5: 1.1–2.2), needing money for food (OR 1.6: 1.1–2.3), and non-supine sleep (OR 1.8: 1.2–2.6) were associated with increased odds of bed-sharing. Differences were found in bed-sharing factors between racial groups which suggests a need for culturally-relevant, tailored safe infant sleep interventions. Providers should ask families about their infant’s sleeping environment and address safety issues within that environment. More research is needed on the context and reasons for bed-sharing.

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Acknowledgments

We gratefully acknowledge Mary K. Madsen, PhD, RN; Ron A. Cisler, PhD; Jennifer Doering, PhD, RN; Paul Florsheim, PhD; the Center for Urban Population Health; a Dissertation Grant from the University of Wisconsin–Milwaukee College of Health Sciences; and statistical support from the Statistical Consulting Center at the University of Georgia. Wisconsin Pregnancy Risk Assessment Monitoring System (PRAMS) data were collected and provided by the PRAMS Project in the Division of Public Health, Wisconsin Department of Health Services. The Centers for Disease Control and Prevention Cooperative Agreement grant number UR6/DP000492 provided funding to WDHS for data collection and some staff support. The PRAMS Working Group is also acknowledged.

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Correspondence to Trina C. Salm Ward.

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Salm Ward, T.C., Ngui, E.M. Factors Associated with Bed-Sharing for African American and White Mothers in Wisconsin. Matern Child Health J 19, 720–732 (2015). https://doi.org/10.1007/s10995-014-1545-5

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Keywords

  • Bed-sharing
  • Co-sleeping
  • PRAMS
  • Infant sleep
  • Racial disparities