Orientações adotadas nas maternidades dos hospitais-escola do Brasil, sobre posição de dormir

Abstract

The prone sleeping position has been causally linked to sudden infant death syndrome (SIDS). This survey aimed to determine whether maternity hospitals in Brazil were promoting the prone sleeping position for newborns. Information was also collected on SIDS prevention messages. The study adopted a multicenter collaborative approach in hospitals with training in pediatrics, using questionnaires. Correctly completed questionnaires were received from 55 hospitals. The number of deliveries/year varied at the hospitals from 240 to 11,000 (median 2,750). The majority of hospitals encouraged the lateral (side) sleeping position in the normal care nurseries (44.4%) and at discharge (67%). In conclusion, the majority of hospitals surveyed are not promoting the supine sleeping position or any other intervention for SIDS prevention, although verbal information is provided to parents about breastfeeding (100%), immunization (100%), and smoking (85%).

Intenção das mães em colocar o bebê para dormir em decúbito dorsal: um estudo de base populacional

“…The implementation of the "Back to Sleep" campaign from 1991 halved the rate of sudden infant death in the United States, Austra- lia and England. This led the post-neonatal mortality rate in these countries to fall from 2/1,000 to 1/1,000 live births, although its mechanism is still not well known 2,11 . The prevalence ratio for mothers aged 30 years and over for the intention of putting the baby to sleep belly up in relation to adolescent mothers was 0.68 (95% CI: 0.52-0.88).…”

“…It is also interesting to note that, when studying sudden death as an outcome, the greater age of mothers, even after controlling for several confounding factors, appears as a protective factor, while younger age appears as a risk factor 6,7,11 . This suggests that this young mother does not have so much autonomy and that, in daily life, she may be suffering from her mother's influence, that is, from the child's grandmother.…”

“…The risk of dying from SIDS is substantially higher among poorer families 3,6,7,10,11 . Higher levels of mothers schooling and household income provides mothers with greater knowledge, safety and independence, and this can be reflected in the intention to place the baby to sleep in the supine position.…”

“…There is sufficient evidence that sleep in dorsal decubitus reduces the occurrence of sudden infant death 2,11 . Thus, it is recommended that health professionals relay, insist and encourage mothers to put the newborn to sleep in this position.…”

“…A single study conducted in 55 hospital institutions with a Medical Residency in Pediatrics revealed that, in 44% of them, the baby slept in the lateral decubitus position (side) 11 . In addition, two-thirds of these services recommended mothers to put the baby to sleep at home in this same position.…”