Change in the Prevalence of Prone Sleeping at Three Months of Age † 511

Abstract

The Back to Sleep campaign was begun in mid-1994 to reduce the prevalence of prone infant sleeping from 40-50% to < 10%. Using data from an ongoing longitudinal study of early infant care practices, we assessed trends in prone sleeping from 6/95 - 9/97. Mother-infant pairs are recruited at birth hospitals in Massacusetts and Ohio and followed for six months. Descriptive data are collected at enrollment; information on sleep position and other infant care practices is collected by follow-up mail/phone questionnaire. From 6/95 - 12/95 mothers of 1607 three month (9-16 weeks) old infants (birthweight≥ 2500g) responded to a question asking the position their infant was placed to sleep on the previous night. From 1/97 - 9/97 mothers of 2028 three month old infants responded to this question. In each year, 80% of mothers were White, 10% Black, and 10% Hispanic. Stratified analyses were performed for prevalence of prone sleeping in 1995 and 1997. Relative risks and 95% confidence intervals (CI) presented in the Table describe the reduction in prevalence of prone sleeping from 1995 to 1997. Trends were similar for Black and Hispanic infants, so data were pooled. There was a significant reduction in the prevalence of prone sleeping across all strata. The greatest decline was observed among infants of highly educated(high = college degree), minority mothers. These associations between race, education, and prone sleeping remain after controlling for other factors through multiple logistic regression. The prevalence of prone sleeping is approaching the target of 10% among infants of highly educated mothers regardless of race/ethnicity, however, prone sleeping remains higher among infants of less educated mothers, especially minorities. These data may be useful in directing future efforts for the Back to Sleep campaign.