Safe sleep, every sleep: Reducing infant deaths in Indigenous communities

Abstract

Introduction: Co-sleeping is a culturally valued practice by many Indigenous families, however is associated with sudden unexpected death in infancy (SUDI) in hazardous circumstances. Aim: To evaluate a safe sleep strategy comprising a safe sleep enabler embedded in education in collaboration with Aboriginal and Torres Strait Islander families with high risk for SUDI. Methods: The Pepi-pod Program, comprising a safe sleep enabler, safe sleeping parent education and safety briefing; and family commitment to share safe sleeping messages in social networks, was delivered to Aboriginal and Torres Strait Islander families with identified SUDI risks, recruited through Queensland maternal and child health services (n = 10 services, 25 communities) across metropolitan, regional and rural/remote areas. Parent questionnaires administered face-to-face or by telephone within 2 weeks of receiving the Pepi-pod; then monthly thereafter until pod use ceased. Health service feedback was conducted via focus group at participating sites. Results: The program was acceptable to families (n = 112 recruited to date) and raised awareness of, and improved consistency with, safe sleeping recommendations. All families recruited had identified risk factors. Midwifery and health worker feedback relating to implementation of the program indicated that the program was feasible, flexible, sustainable, and built local workforce capacity with integration into current service models. Conclusion: This is the first evaluation of a safe sleep enabler in Australia. Program principles are applicable to mainstream services which care for vulnerable families and high risk infants. Evaluating innovative and culturally respectful strategies to reduce SUDI risk through enabling safe sleep environments, which support community ownership, develop midwifery and multidisciplinary team skills, and reorient services from safe sleep advice to safe sleep action, will better inform the evidence-base used by educators, clinicians, researchers and policy makers in supporting parents and reducing infant deaths.