Understanding the Obstacles and Influences in Adopting Infant Safe Sleep Practices

Abstract

Background About 3,500 infants die annually within their first year of life from Sudden Unexplained Infant Death (SUID) and its subset Sudden Infants Death Syndrome (SIDS), making it the single leading cause of infant mortality in the U.S. Evidence indicates adherence to infant Safe Sleep Guidelines developed by the American Academy of Pediatrics (AAP) reduces these mortality rates. Still, since an initial decline following the 1994 guidelines introduction, SIDS rates have leveled, and SUID rates have increased. In addition, SUID rates per 100,000 live births are twice as high among Black and Native American infants than white. The AAP last updated the guidelines in 2016 and is scheduled to issue the next updated guidelines in late 2021. Objective To examine perceptions of the AAP guidelines held by parents and health care providers as they relate to guidelines comprehension and compliance, and to share this information with the AAP 2021 guidelines task force. Methods First Candle commissioned a qualitative research study in 2020, consisting of three online focus groups in three different states to identify perceptions and potential barriers to guidelines adoption by family members and providers, the outcomes of which were shared with the AAP for review as its guidelines task force develops the updated version to be released in 2021. Results Regarding how the AAP guidelines were viewed, there were responses across geographic and sociocultural variation regarding varying levels of general comprehension and trust in them, depending on the resource and acceptance of the language used. Additional factors were the emotional and practical realities of parenting, cultural and family traditions, and the belief that parental volition in decision-making is important. Conclusion Evidence-based protocols regarding infant safe sleep practices and their impact on reducing infant mortality rates may have proven value. Still, professional caregivers and family members feel that more cultural context and personal relevance are needed in presentation and communication if families are to trust and consider them for adoption and compliance.