Abstract
BackgroundGlobally, the incidence of sleep-related infant mortality declined dramatically following the first public health campaigns seen internationally in the 1990s to reduce the risks of sudden infant death. However, Australian Sudden Unexpected Death in Infancy (SUDI) rates have plateaued with little change in incidence since 2004 despite two further public health safe sleep campaigns. This study aims to describe contemporary infant care practices employed by families related to the current public health SUDI prevention program.MethodsA cross-sectional survey of 3341 Queensland primary caregivers with infants approximately 3-months of age was conducted using the Queensland Registry of Births, Deaths and Marriages as a sampling frame. Surveys were returned either via reply-paid mail or online. Questionnaires explored prevalence of infant care practices and awareness of safe sleep recommendations. Univariable analysis was used to generate descriptive statistics for key variables.ResultsOverall, only 13% of families routinely practised all six ‘Safe Sleeping’ program messages. More than one third (1118, 34%) of infants had slept in a non-supine sleep position at some time. Potentially hazardous sleep environments were common, with 38% of infants sleeping with soft items or bulky bedding, or on soft surfaces. Nearly half, for either day- or night-time sleeps, were routinely placed in a sleep environment that was not designed or recommended for safe infant sleep (i.e. a bouncer, pram, beanbag). Most babies (84%) were reportedly smoke free before and after birth. Sleeping in the same room as their caregiver for night-time sleeps was usual practice for 75% of babies. Half (1600, 50%) of all babies shared a sleep surface in the last two-weeks. At 8-weeks, 17% of infants were no longer receiving any breastmilk.ConclusionsThe prevalence rates of infant care practices among this Australian population demonstrate many families continue to employ suboptimal practices despite Australia’s current safe sleep campaign. Strategic approaches together with informed decisions about pertinent messages to feature within future public health campaigns and government policies are required so targeted support can be provided to families with young infants to aid the translation of safe sleep evidence into safe sleeping practices.
Highlights
The incidence of sleep-related infant mortality declined dramatically following the first public health campaigns seen internationally in the 1990s to reduce the risks of sudden infant death
Sudden unexpected death in infancy (SUDI) is a term used to describe and classify deaths of apparently well infants for whom the cause of death is not immediately obvious and who would be expected to thrive; it includes sleep-related infant deaths classified as Sudden Infant Death Syndrome (SIDS), asphyxia, undetermined or ill-defined [4,5,6]
Given individual vulnerable babies at risk of Sudden Unexpected Death in Infancy (SUDI) cannot currently be identified [4, 17] risk factors amenable to change have been the target of public health campaigns
Summary
The incidence of sleep-related infant mortality declined dramatically following the first public health campaigns seen internationally in the 1990s to reduce the risks of sudden infant death. Australian Sudden Unexpected Death in Infancy (SUDI) rates have plateaued with little change in incidence since 2004 despite two further public health safe sleep campaigns. Modifiable infant care practices are recognised as the most important factors parents and health practitioners can influence in order to reduce the risk of sleep-related infant mortality [1,2,3]. The relationship between sleep-related infant mortality and modifiable infant care practices is well established [9,10,11,12], with 90–95% of sudden infant deaths associated with one or more recognised risk factors [13,14,15]. Given individual vulnerable babies at risk of SUDI cannot currently be identified [4, 17] risk factors amenable to change have been the target of public health campaigns
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