South Asian Parents Research Articles

Asthma management in British South Asian children: an application of the candidacy framework to a qualitative understanding of barriers to effective and accessible asthma care.

BackgroundIn the UK, people of South Asian origin with asthma experience excess morbidity, with hospitalisation rates three times those of the majority White population and evidence suggests that South Asian children with asthma are more likely to suffer uncontrolled symptoms and hospital admissions with acute asthma compared to White British children. This paper draws on data from The Management and Interventions for Asthma (MIA) study to identify the operation of barriers to optimal care and good asthma control for South Asian children.MethodsThe MIA study followed a multi-phase, iterative, participatory design, underpinned by the socio-ecological model. Findings presented here are from face-to face, semi-structured interviews with South Asian (Indian, Pakistani and Bangladeshi origin) parents and carers of a child with asthma (n = 49). Interviews were conducted in English or relevant South Asian languages using specially trained community facilitators. Data were transcribed verbatim and analysed according to the principles of interpretive thematic analysis, facilitated by the use of NVivo.ResultsSeven dimensions of candidacy are identified: identification of candidacy; navigation; the permeability of asthma services; appearances at health services; adjudications; offers and resistance and operating conditions in the local production of candidacy. The analysis demonstrates several ways in which a potential lack of alignment between the priorities and competencies of British South Asian families and the organization of health services combine to create vulnerabilities and difficulties in effectively managing childhood asthma.ConclusionsHealthcare systems have a responsibility to develop services that are sensitive and appropriate to the needs of their communities. In South Asian communities, further efforts are required to raise awareness of symptoms and effectively communicate how, when and where to seek help for children. There is a need for improved diagnosis and consistent, effectively communicated information, especially regarding medication. Parents made several suggestions for improving services: presentations about asthma at easily accessible community venues; an advice centre or telephone helpline to answer queries; opportunities for sharing experiences with other families; having information provided in South Asian languages; longer GP appointments; extended use of asthma nurses; and better education for healthcare professionals to ensure consistency of care and advice.

MG-113 A case ‘out of the blue’

Objective To delineate a retrospective diagnosis in a case of severe fixed encephalopathy. Case description Propositus was a male child, first born to 3rd degree consanguineous South Asian parents. Pregnancy, delivery and clinical examination at birth were normal. During the first months of life, he had generalised hypotonia with spontaneous dystonic leg extension spasm and frequent vomiting. All the developmental milestones were delayed, he never sat alone or never attained speech. From his available photographs head size appeared to be small, and esotropia and adducted thumbs were noted. Magnetic resonance imaging of his brain showed delayed myelination. He also had grade II/III gastro oesophageal reflux evidenced by GER Scintigraphy. Other investigations including routine biochemical and haematological parameters, neurometabolic screening and electrophysiological analysis were within normal limits. He was treated as spastic cerebral palsy from another centre without much improvement to the symptoms. Child expired at the age of 2 years followed by an attack of pneumonia; clinical exome test was performed later from his DNA. Results Long read sequencing revealed a homozygous, pathogenic novel variation p. Val112ProFSTer8 resulting from the deletion of exons 5–8 of CYB5R3 gene, associated with recessive hereditary methemoglobinemia (RHM) type II, which could explain the clinical profile. This large deletion was validated by polymerase chain reaction and carrier status of parents was established. Conclusion Type II RHM is a rare condition, with less than 100 cases reported worldwide. 1. Cyanosis is an invariable presenting feature and important clinical clue to methemoglobinemia. There was no history or documentation of cyanosis in our case. In the absence/failure to elicit the sign in children with severe encephalopathy, possibility of RHM might get overlooked. 2. Majority of the reported mutations in RHM type II are point mutations with two prior documentations of single exonic deletion. Ours is the first family with the largest deletion of multiple exons of CYB5R3 gene, thus expanding the genotype spectrum.

The experiences of British South Asian carers caring for a child with developmental disabilities in the UK

Purpose – The purpose of this paper is to explore the role of culture in shaping the caregiving experiences of British South Asian families caring for a child with developmental disabilities in the UK. In particular it explores how the coexistence of two distinct cultures (British/South Asian) impacts upon these caregiving experiences. Design/methodology/approach – A qualitative design using in-depth interviews and interpretative phenomenological analysis was used with seven parents identifying as British South Asian who had been born in the UK or had moved to the UK as young people. Findings – Three master themes emerged: living with loss, uncertainty and overwhelming responsibility; learning about disability and facing stigma; and having to cope. Research limitations/implications – Using a relatively homogeneous sample of carers this study provides an insight into how exposure to two different cultures shapes the understanding and adaptations of British South Asian carers in the UK. Social implications – Issues in the acculturation of these parents emerge which demonstrate the tensions they face in relating to both South Asian and Western cultural influences. The study makes recommendations for how services can work with such families in order to help them make sense of their children’s disability, access culturally appropriate support and cope with the numerous demands of being a caregiver. Originality/value – This paper contributes to a growing literature on the experience of South Asian parents who care for children with intellectual disabilities. It has important messages for workers about how to support these individuals most effectively.

Social support for South Asian parents with severe illness: a multiperspective qualitative study

Social support for South Asian parents with severe illness: a multiperspective qualitative study

A Longitudinal Analysis of UK Second-Generation Disadvantaged Immigrants

We consider the relative academic achievement in primary school of second-generation immigrant children in the UK. We use data for a cohort born in 1970 and find that children born to South Asian or Afro-Caribbean parents have significantly lower levels of cognitive achievement in both mathematics and language in primary school. Our analysis also reveals that the negative impact from being born to South Asian parents decreases during primary school while the negative effect from being born to Afro-Caribbean parents remains approximately stable. Evidence from the current education system suggests that although ethnic minority children have relatively low achievement on exit from primary school, they also experience considerable catch up and indeed overtake their White counterparts during secondary school. Our evidence shows that even as long ago as the late 1970s, some groups of ethnic minority pupils, namely those from South Asia, were showing signs of ‘catch up’ in primary school.

Understanding the experiences of South Asian parents who have a child with autism

This paper sought to investigate the experiences of South Asian parents living in the UK who have a child with autism. This had been identified as an under-represented cultural group by previous research in the field (Ravindran & Myers, 2012). Key ideas from sociocultural theory and intersectionality underpin the paper which is based on a study that aimed to explore how culture influenced parents’ construction and experience of their child’s autism.In-depth interviews were carried out with nine parents and the data was analysed using the Corbin and Strauss (2008) grounded theory model. The main finding was that parents’ construction of autism privileged ‘medical model perspectives’ and this was largely underpinned by cultural values and beliefs. This is turn had a significant impact on how they responded to their child’s autism label and how they worked with professionals. This paper reflects on how Educational Psychologists can use these insights to better support and understand the needs of South Asian families who have a child with autism.

South Asian parents’ experiences of health visiting services

South Asian parents’ experiences of health visiting services

"We Were Just Unwanted": Bussing, Migrant Dispersal, and South Asians in London

From 1963 to 1981, the London borough of Ealing bussed South Asian students away from neighborhood schools, citing a need to assimilate migrant students into British culture. The increasing number of migrants in the area and their supposed detrimental effect on education frightened local parents, who pressured Ealing Council to implement bussing to maintain a majority of white, “native” children in each school in the borough. The bussing system and its advocates, initially supported by the Department of Education and Science, relied on ill-defined ideas of assimilation and integration that privileged British cultural authority. The practice also lent itself to American comparisons: the idea of bussing as a progressive civil rights practice across the Atlantic provideda liberal gloss that obscured how bussing worked in different political contexts. This article examines the parties involved in bussing—including educational reformers, South Asian students and parents, and race relations authorities—who invested it with their own meanings and values, making competing arguments for the merit of the practice in England. It argues that despite its liberal transatlantic veneer, bussing made South Asian children vulnerable to racism and ostracization, a position which many parents and local organizations made abundantly clear. The borough terminated the practice only after the Race Relations Board found Ealing guilty of educational discrimination. The long debate over bussing’s legitimacy in London came to represent both national and international discourses of integration and segregation, even as Ealing officials pursued drastically different goals than their counterparts in the United States.

Preterm and postterm birth in immigrant- and Swedish-born parents: a population register-based study.

Ethnic minorities/immigrant groups tend to have increased risk for preterm birth. Less is known about this risk in diverse immigrant groups, couples of mixed ethnic-origin and in relation to duration of residence. Data from the Swedish Medical Birth Register on 1,028,303 mothers who gave birth to 1,766,026 singleton live born infants (1982-2002), was linked to the Education and Total Population Registers. Immigrant parents were identified by country of birth. Risk of early preterm, late preterm and postterm birth was analyzed using multinomial logistic regression. Polish, Yugoslavian, Iranian, South Asian, East Asian and Sub-Saharan African parents, Swedish mothers who had children with non-Swedish fathers, and parents from two different immigrant groups had higher risk of early preterm birth [adjusted relative risk (RR) (95% CI) 1.76 (1.24-2.50), 1.57 (1.31-1.87), 1.67 (1.30-2.14), 1.52 (1.07-2.16), 1.51 (1.08-2.10), 2.03 (1.32-3.12), 1.56 (1.45-1.67), and 1.55 (1.35-1.77) respectively] compared to Swedish-born parents. South Asian, Sub-Saharan African, and East Asian immigrants had a higher risk of late preterm birth compared to Swedish-born parents. North African and Middle Eastern, Somali, and Ethiopian/Eritrean groups had increased risk of postterm birth [adjusted RR 1.31 (1.16-1.47), 2.57 (2.31-2.86), 1.85 (1.67-2.04) respectively]. Adjustment for covariates did not substantially change associations. Immigrant mothers resident <3 years had higher risk for early preterm and postterm birth compared to residents >10 years [adjusted RR 1.46 (1.24-1.71) and 1.16 (1.11-1.23) respectively]. In addition to higher risk of preterm birth in select immigrant groups, some immigrant groups are also at higher risk of postterm birth. Shorter duration of residence is associated with higher risk of non-term deliveries.

Development of tailored and integrated health-care interventions to reduce inequalities in health outcomes: the Management and Interventions for Asthma (MIA) project

BackgroundSouth Asian children are more likely than others to suffer from their asthma and be admitted to hospital. The UK Public Health Outcomes Framework focuses on partnership across locally led systems to plan and deliver health-care services in the context of broader social determinants of health. The Management and Interventions for Asthma (MIA) project aimed to embody localism by using a collaborative, participatory model to develop an intervention designed to improve asthma management in South Asian children. MethodsThe project was multi-phase, iterative, and participatory, underpinned by the socio-ecological model of health, recognising the importance of issues arising from the individual, family, wider community, and organisational and environmental contexts of family health. Building on this model, the project worked collaboratively with linguistically and culturally competent community facilitators (CFs), to engage and develop a partnership between South Asian community members, parents and children living with asthma, health-care professionals (HCPs), and researchers. The study had four phases. Phase 1 consisted of an evidence review of barriers and facilitators to asthma management in South Asian children. Phase 2 explored lay understandings of asthma in South Asian children using focus groups (n=67) with members of South Asian communities (Indian, Pakistani, Bangladeshi) recruited by trained CFs. Phase 3 explored experiences of asthma management via semi-structured interviews with South Asian and White British parents and children (n=82 participants) recruited from the NHS and by CFs and included semi-structured interviews with HCPs (n=37). Focus groups and interviews were done in the preferred language of the participants. Focus group facilitators and interviewers were trained and supervised to reduce bias. Data were analysed with principles of interpretive thematic analysis facilitated by NVivo. Interviews with a comparison sample of White British parents and children (n=31) identified aspects of asthma management that could be addressed by generic interventions and those needing a tailored approach. Data from phases 1–3 were combined with thematic analysis to identify 11 key themes that needed to be addressed to optimise asthma management. In phase 4, an intervention planning framework was developed, with a novel modified intervention mapping approach incorporating psychological theory. Collaborative workshops, including parents, children, academics, and HCPs, were held to integrate data, develop an asthma intervention planning framework, and prioritise one aspect of asthma management to be used as an exemplar for the tailored intervention programme. FindingsThe 11 key themes were: being able to talk to doctors and nurses, being able to use services, community awareness of asthma, getting a diagnosis, having suitable information on asthma, medicines for asthma, school and my child's asthma, services available for asthma, quality of care, understanding asthma, and what to do day to day. Parents chose getting a diagnosis as a priority and a multifaceted programme, ACT (awareness, context, training) on asthma, was developed as an exemplar intervention, consisting of community awareness, education and training, clinical support, and a central advice centre, coordinated by a central team. Recruitment targets were exceeded and participants gave positive feedback. InterpretationKey issues in optimum asthma management in children arise at the patient, provider, and health-care system levels and interventions must address all these levels. Minority ethnic communities can be successfully engaged in collaborative intervention development with a community focused and culturally sensitive methodology. FundingNIHR Health Services and Delivery Research (HS&DR) Programme (09/2001/19). Views and opinions expressed those of the authors and do not necessarily reflect those of the HS&DR Programme, the NIHR, the NHS, or the Department of Health.

Role of Islamic religious and cultural beliefs regarding intellectual impairment and service use: A South Asian parental perspective

Empirical research has shown that some South Asian families from Muslim backgrounds may use fewer additional support services for their severely impaired children compared to other non-Muslim families. Often this has been attributed to socioeconomic factors and stereotypical views such as "the family's faith prohibits the use of specific services". This paper focuses on clarifying what Islam purports to say about impairment and considers how cultural influences may inadvertently influence some South Asian parents' decisions to use services for their severely impaired children. This work aims to improve professional-parent/patient communication by enhancing better understanding of Islam on impairment, and supporting non-Muslim professionals to appreciate the differences between Islamic religion and general South Asian cultural beliefs regarding disability. Fourteen parents from ten Pakistani and Bangladeshi families took part in semi-structured open-ended interviews. Grounded theory was used to analyse the data. The emerging theory suggested most first generation Muslim families from rural villages were unable to distinguish between Islamic religious and cultural beliefs on impairment, and risked missing out on essential services due to poor professional-parent/patient communication.

How to Stop a Deportation

O n an overcast September morning that seemed like any other, twenty-year-old Steve Li woke up early and began getting ready for his classes at the City College of San Francisco. He ignored the unexpected ringing of the doorbell, until it was replaced by an urgent pounding at the door. Moments later, as he stood in the bathroom, he heard his mother’s voice as she answered the door. What happened next is a nightmare familiar to some 11 million undocumented people who reside in the United States, many of whom live day to day with uncertainty. Deportations are on the rise. According to data from the Department of Homeland Security, last year they hit a record high of nearly 410,000, a rate double what it had been over the previous ten years. And that number doesn’t include “voluntary returns” — mostly people who are picked up by border patrol and forced to leave. Under the two Obama administrations, U.S. Immigration and Customs Enforcement (ICE) has deported more people than during Bush’s presidency. Nearly half of those deported in fiscal year 2012 had no criminal record, like Steve Li. Of those with criminal convictions, most were convicted of low-level offenses such as forgery, driving without a license, or drinking in public. Too often, individuals facing deportation have endured this process in isolation, sometimes further isolated by feelings of shame. But with increasing frequency, communities — often those with the fewest legal rights — are organizing to expose and resist the violence of deportation. It is an understatement to say that it is difficult to stop a deportation. Legal codes regulating immigration and deportation can be arcane and esoteric, and are described as among the most complicated of U.S. laws. Nevertheless, victories are possible. One ad hoc defense group convinced a state senator to intervene in a deportation. Another campaign halted a seemingly irreversible final removal order at the eleventh hour — the procedural equivalent of slamming the brakes on a train and watching it come to a screeching halt at the edge of a cliff. Other times, victory manifests in meaningful but less measurable forms: a box full of letters, an extension granted in an appeals process, or a packed room full of supporters.

G120 Knowledge and Attitudes; Essential Ingredients For Developing Co Produced Tailored Interventions For Asthma Management (MIA) in South Asian and White British Children

Childhood asthma is a chronic illness affecting quality of life and leading to higher mortality in the UK than other countries. In the UK, prescription rates for relievers and preventers...

A longitudinal analysis of UK second-generation disadvantaged immigrants

We consider the relative academic achievement in primary school of second-generation immigrant children in the UK. The education progress of these groups of children is of historical interest and is also relevant to the policy debate today, since ethnic minority students in England continue to have lower levels of achievement in primary school, though they go on to catch up with their white counterparts in secondary school. We use rich data for a cohort born in 1970 and find that children born to South Asian or Afro-Caribbean parents have significantly lower levels of cognitive achievement in both mathematics and language in primary school. Our analysis also reveals that the negative impact from being born to South Asian parents decreases during primary school, while the negative effect from being born to Afro-Caribbean parents remains approximately stable. Hence, our evidence shows that even as long ago as the late 1970s, while most ethnic minority groups had lower academic achievement in primary school, some groups of ethnic minority pupils, namely those from South Asia, were showing signs of ‘catch-up’.

D.P.11 Dual pathology identified by next generation sequencing in siblings with peripheral neuropathy, ataxia and retinal dystrophy

Two children, born to healthy consanguineous South Asian parents, presented with recurrent aspiration in infancy, peripheral neuropathy, ataxia and retinal dystrophy. The older child had pyrexias and pneumonia in infancy due to aspiration, requiring gastrostomy and fundoplication. Nystagmus was noted aged 8months with subsequent visual impairment and signs of rod-cone retinal dystrophy on ERG. By 18months she had severe motor delay, generalised hypotonia and absent lower limb reflexes. EMG and NCVs indicated a severe demyelinating neuropathy. By 5years she was markedly ataxic and had developed a progressive scoliosis. Cranial MRI demonstrated delayed myelination but no cerebellar abnormalities. No mutations were identified in the PMP22, MPZ or GDAP1 genes and transferrin IEF, ATM, aprataxin, senataxin and vitamin E levels were normal. Muscle biopsy showed some reduction of activity of respiratory chain complexes 4 and 5 but no underlying mitochondrial abnormality was identified. The younger sibling had a similar presentation but had silent aspiration which did not require surgery and had no scoliosis at age 7. Autozygosity mapping identified seven regions of autozygosity >2Mb, on chromosomes 5, 8, 11, 12(x2), 13 and 22. Using exome capture Agent SureSelect all exon kit on an ABI SOLiD 4.0 platform, seven homozygous variants were identified within these regions. One was a c.627T>G; p.Phe209Leu mutation in the PDE6A gene, known to cause Retinitis Pigmentosa 43. Another was a novel c.1585C>T; p.Arg529Cys variant in the SH3TC2 gene, which is associated with CMT type 4C. Both mutations were confirmed by Sanger sequencing. These genes are separated by only 800kb and are therefore unlikely to segregate independently. Attempts at reaching a clinical diagnosis in these siblings had been directed towards identifying a single underlying disorder. The molecular findings indicated that they had dual pathology, illustrating the diagnostic power of new genetic technologies.

The cultural context of care‐giving: qualitative accounts from South Asian parents who care for a child with intellectual disabilities in the UK

PurposeThis study aims to explore the cultural context of care‐giving amongst South Asian communities caring for a child with intellectual disabilities in the United Kingdom.Design/methodology/approachIn the context of the United Kingdom's Children's Intellectual Disability Services, the study set out to develop a culturally sensitive account of Sikh and Muslim parents' experiences of caring for a child with intellectual disabilities. Focus groups were conducted with parents from Sikh and Muslim support groups who were all accessing intellectual disability services for their children. Transcripts were analyzed using interpretative phenomenological analysis, a qualitative technique.FindingsThree master themes emerged from the analysis which were: Making sense of the disability; Feeling let down by services and Looking to the future. These themes reinforce findings from previous research particularly in relation to difficulties when making sense of the disabilities and difficult interactions with services.Practical implicationsThe study makes recommendations for service delivery to ethnic minority groups including being aware of intra‐group variations in the interpretations and responses of South Asian parents.Originality/valueUltimately, the study makes recommendations for developing culturally sensitive support and interventions for ethnic minority groups which is important given the increase in multi‐ethnic populations in the UK.

What accounts for the underachievement of South Asians in Hong Kong? The voices of Pakistani and Nepalese parents

Background: The research literature linking children's educational outcomes with levels of parental involvement has in many instances resulted in the location of disadvantage being placed on lack of parental involvement, something that has been the case with South Asian parents in Hong Kong (Au, K., Multicultural issues and literacy achievement, Mahwah, NJ: Lawrence Erlbaum Association, 2006; Jeynes, W.H., A meta-analysis – The effects of parental involvement on minority children's academic achievement, Education and Urban Society 35: 202–218, 2003; Hau, K.T., Tracking the adaptation and development of non-Chinese speaking children (NCS) in mainstream schools, Retrieved from http://www.edb.gov.hk/FileManager/EN/Content_7065/exe_summary%20eng.pdf, 2008; Tsung, L., Zhang, Q., and Cruickshank, K., Access to majority language and educational outcomes: South Asian background students in postcolonial Hong Kong, Diaspora, Indigenous and Minority Education 4, 1–16, 2010). Purpose: This small-scale research study examines the educational involvement of Pakistani and Nepalese parents, and explores the difficulties and challenges South Asians face to succeed in school. Design and methods: In-depth interviews were conducted with 10 South Asian parents (five Nepalese parents and five Pakistani parents). Interviews were semi-structured and consisted of open-ended questions about parents’ educational aspirations, ability in tutoring children with homework, and arrangement of home-learning activities. Transcribed interviews were subjected to content and thematic analysis. Results and discussion: The findings indicate that South Asian parents, despite high aspirations for the education of their children, feel that they lack the linguistic and cultural capital valued by the mainstream society in Hong Kong. This prevents effective involvement in the education of the children. Conclusion: Understanding the perspectives of the parents offers insights into ways in which access to educational outcomes can be denied in school contexts. It is suggested that there needs to be a greater focus on how inclusion/exclusion operates in school contexts in Hong Kong.

Family‐centred care: a qualitative study of Chinese and South Asian immigrant parents' experiences of care in paediatric oncology

Over the past two decades, there is increasing emphasis being placed upon providing family-centred care (FCC) in paediatric oncology settings. However, there is a lack of knowledge of FCC in paediatric oncology from the perspectives of immigrant parents. The purpose of this paper is to describe Chinese and South Asian immigrant parents' experiences of FCC in paediatric oncology settings in Canada. This study adopted a constructivist grounded theory approach. Fifty first generation Chinese and South Asian parents of children with cancer who were at least 6 months post-diagnosis were recruited from six Canadian paediatric oncology centres. Interviews were conducted in English, Cantonese, Mandarin, Urdu, Punjabi or Hindi, and transcribed into English. Analysis involved line-by-line, focused and theoretical coding, and the use of the constant comparison method. Findings indicated that overall parents were highly satisfied with the care and services they received, and their experiences were reflective of the key elements of FCC. However, there were some areas of concern identified by participants: parents not perceiving themselves as a member of the medical team; inconsistency in the quality and co-ordination of services among healthcare providers; disrespectful and mechanical manner of a few healthcare providers; and parents' discomfort with healthcare providers communicating sensitive health-related information directly with their child. In order to successfully provide family-centred services to immigrant parents of children with cancer, better communication of the elements of FCC between healthcare staff and families is needed to negotiate a clear role for the parents as partners of the healthcare team. Moreover, a better understanding of how family relationships are structured in immigrant families will assist healthcare providers to balance the best interests of the child with that of the family as a unit.

Birth size differences between white British and Pakistani origin infants by generation: Results from the Born in Bradford cohort study

BackgroundThere is a growing recognition that being born small is associated with risk of adult diseases such as Type 2 diabetes and cardiovascular disease, in addition to its known adverse...

Infant care practices related to sudden infant death syndrome in South Asian and White British families in the UK

In the UK, infants of South Asian parents have a lower rate of sudden infant death syndrome (SIDS) than White British infants. Infant care and life style behaviours are strongly associated with SIDS risk. This paper describes and explores variability in infant care between White British and South Asian families (of Bangladeshi, Indian or Pakistani origin) in Bradford, UK (the vast majority of which were Pakistani) and identifies areas for targeted SIDS intervention. A cross-sectional telephone interview study was conducted involving 2560 families with 2- to 4-month-old singleton infants enrolled in the Born in Bradford cohort study. Outcome measures were prevalence of self-reported practices in infant sleeping environment, sharing sleep surfaces, breast feeding, use of dummy or pacifier, and life style behaviours. We found that, compared with White British infants, Pakistani infants were more likely to: sleep in an adult bed (OR = 8.48 [95% CI 2.92, 24.63]); be positioned on their side for sleep (OR = 4.42 [2.85, 6.86]); have a pillow in their sleep environment (OR = 9.85 [6.39, 15.19]); sleep under a duvet (OR = 3.24 [2.39, 4.40]); be swaddled for sleep (OR = 1.49 [1.13, 1.97]); ever bed-share (OR = 2.13 [1.59, 2.86]); regularly bed-share (OR = 3.57 [2.23, 5.72]); ever been breast-fed (OR = 2.00 [1.58, 2.53]); and breast-fed for 8+ weeks (OR = 1.65 [1.31, 2.07]). Additionally, Pakistani infants were less likely to: sleep in a room alone (OR = 0.05 [0.03, 0.09]); use feet-to-foot position (OR = 0.36 [0.26, 0.50]); sleep with a soft toy (OR = 0.52 [0.40, 0.68]); use an infant sleeping bag (OR = 0.20 [0.16, 0.26]); ever sofa-share (OR = 0.22 [0.15, 0.34]); be receiving solid foods (OR = 0.22 [0.17, 0.30]); or use a dummy at night (OR = 0.40 [0.33, 0.50]). Pakistani infants were also less likely to be exposed to maternal smoking (OR = 0.07 [0.04, 0.12]) and to alcohol consumption by either parent. No difference was found in the prevalence of prone sleeping (OR = 1.04 [0.53, 2.01]). Night-time infant care therefore differed significantly between South Asian and White British families. South Asian infant care practices were more likely to protect infants from the most important SIDS risks such as smoking, alcohol consumption, sofa-sharing and solitary sleep. These differences may explain the lower rate of SIDS in this population.