Not All Parents Place Their Babies "Back to Sleep," Yale Research Finds

Placing infants on their backs for sleep can help reduce the risk of Sudden Infant Death Syndrome (SIDS). But a study by Yale School of Medicine researchers and their colleagues shows that while the practice helped reduce the incidence of SIDS, it has reached a plateau since guidelines were released by the National Institute of Child Health and Human Development.

Published in the December issue of the Archives of Pediatric and Adolescent Medicine, the study is based on data from the National Infant Sleep Position Study, an annual telephone survey of about 1,000 households with infants. The team tracked behavior change after the “Back to Sleep” campaign was initiated in 1994. The study was conducted as a way to track infant care practices related to SIDS.

“We looked at the behavior of 15,000 caregivers over the last 15 years and found that, although there was an increase in caregivers following the guidelines, in the last five years, the number of people putting babies on their back to sleep has leveled off,” said lead author Eve Colson, M.D., associate professor of pediatrics at Yale School of Medicine. “We also found that African Americans still lag behind caregivers of other races by about 20 percent in following this practice.”

Colson and her team also identified three key factors linked to whether caregivers place infants on their backs to sleep: whether the caregiver received a physician’s recommendation to place the baby only on the back for sleep, fear that the infant might choke and concerns for the infant’s comfort.

In fact, said Colson, in the past five years, these factors have become even more important than race in determining whether parents will follow the recommended guidelines.

“If we can teach people that comfort and choking are not issues and if we can make sure that doctors advise their patients that the back is the only safe position for infant sleep, then we may be able to overcome this leveling-off of the practice that we have seen over the last five years,” she said. “For the first time, we have identified modifiable factors—comfort, choking and advice—that can be used in public health campaigns to decrease the incidence of SIDS and possibly to bridge the racial gap.”

Other authors on the study include Denis Rybin, Theodore Colton and Michael J. Corwin, M.D., of Boston University; Lauren A. Smith M.D., of the Massachusetts Department of Public Health; and George Lister, M.D., of University of Texas Southwestern Medical Center at Dallas.

The study was supported by the National Institute of Child Health and Human Development.

Citation: Arch of Pediatr Adolesc Med. Vol. 163, No. 12 (December, 2009).

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