PEDIATRICS Vol. 122 Supplement October 2008, pp. S113-S120 (doi:10.1542/10.1542/peds.2008-1315o)
SUPPLEMENT ARTICLE |
Infant Sleeping Arrangements and Practices During the First Year of Life
a Departments of Family Medicine and Public Health Sciences, University of Virginia School of Medicine, Charlottesville, Virginia
b Pregnancy and Perinatology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
c Center for Food Safety and Applied Nutrition, Department of Health and Human Services, Food and Drug Administration, College Park, Maryland
OBJECTIVES. Our goal was to examine the sleeping arrangements for infants from birth to 1 year of age and to assess the association between such arrangements and maternal characteristics.
METHODS. Responses to the 3-, 6-, 9-, and 12-month questionnaires from the Infant Feeding Practices Study II were analyzed to assess sleep arrangements, including bed sharing, the latter defined as mother ever (in a given time frame) slept with the infant on the same sleeping surface for nighttime sleep. Women were also asked about the reasons for bed sharing or not bed sharing.
RESULTS. Approximately 2300 women responded at 3 months, and 1800 at 12 months. At 3 months, 85% of the infants slept in the same room as their mother, and at 12 months that rate was 29%. At 3 months, 26% of the mothers did not use the recommended supine position for their infant's nighttime sleep. The rate of noncompliance increased to 29% by 6 months and 36% by 12 months. The bed-sharing rates were 42% at 2 weeks, 34% at 3 months, and 27% at 12 months. Approximately two thirds of those who bed shared with their infant also shared the bed with their husband or partner, and 5% to 15% shared it with other children. The major reasons for bed sharing were to calm a fussy infant, facilitate breastfeeding, and help the infant and/or mother sleep better. The major reasons for not lying down with the infant were safety concerns. Non-Hispanic black mothers were more likely than non-Hispanic white mothers to use nonsupine infant sleep positions and to bed share.
CONCLUSIONS. More than one third of the women in this cohort were noncompliant with safe-sleeping guidelines when their infant was 3 months old. Health care providers need to advise parents of current recommendations and discuss the risks and benefits of their choices for infant sleeping practices.
Key Words: sleep • sudden infant death syndrome • SIDS • suffocation • infant mortality • risk reduction • health campaigns • breastfeeding
Abbreviations: SIDS—sudden infant death syndrome • AAP—American Academy of Pediatrics • IFPS—Infant Feeding Practices Study • aOR—adjusted odds ratio • CI—confidence interval • SES—socioeconomic status
Accepted Jun 4, 2008.
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