Abstract
Sleep-related infant deaths are a leading cause of infant mortality in Georgia, and these deaths are largely associated with unsafe sleep practices among caregivers. In early 2016, the Georgia Department of Public Health launched the Georgia Safe to Sleep Hospital Initiative, providing hospitals with safe infant sleep information and educational materials to be distributed to families and newborns. This study examined the knowledge and behaviors of a sample of Georgia parents after the implementation of the Hospital Initiative and identified the family characteristics and intervention components most closely associated with the knowledge and practice of safe infant sleep. The primary caretakers of all infants born in Georgia from August to October 2016 were invited to complete a web-based survey 1 month after hospital discharge. The final sample size included 420 parents of newborns, and the primary outcomes assessed included two measures of knowledge and four measures of infant sleep behaviors regarding infant sleep position and location. Most respondents demonstrated knowledge of the correct recommended sleep position (90%) and location (85%). Logistic regression revealed that receipt of information in the hospital was significantly correlated with safe sleep behaviors, and infant sleep habits tended to influence safe sleep practices. Additionally, Medicaid parents receiving bassinets from the hospital were 74% less likely to bed share (OR 0.26; 95% CI 0.007). Implementation of a statewide hospital initiative was associated with high levels of parental knowledge and behavior and may have been successful in reducing the practice of bed sharing among Medicaid parents.
Highlights
3700 sleep-related infant deaths, including sudden infant death syndrome (SIDS), ill-defined deaths, and accidental suffocation or strangulation in bed, occurred in the United States in 2015 [1]
In comparison to available state and national-level data on infant sleep knowledge and behaviors, our sample appeared to have a similar level of knowledge of safe sleep recommendations and a higher prevalence of practicing “back to sleep,” indicating that the Georgia Safe to Sleep Hospital Initiative may have been successful in its educational campaign to parents
It is possible that these results suggest an underlying risk factor common but not exclusive to Medicaid recipients that is more closely linked to safe infant sleep knowledge and behavior
Summary
3700 sleep-related infant deaths, including sudden infant death syndrome (SIDS), ill-defined deaths, and accidental suffocation or strangulation in bed, occurred in the United States in 2015 [1]. The risk of sleep-related infant death can be reduced if parents follow the safe sleep. Recommendations from the American Academy of Pediatrics (AAP) regarding the infant’s sleep position (supine), sleep location (in parents’ room on a separate sleep surface), and surrounding environment [1, 2]. These recommendations have been widely disseminated since 1992, adherence by parents and caregivers remains low [3, 4]. State-level data have identified sub-groups at higher risk for engaging in unsafe sleep practices and experiencing sleep-related infant deaths.
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