Conversations with families about reducing the risk of sudden infant death syndrome

Pease, Anna; Blair, Peter S; Ingram, Jenny; Fleming, Peter

doi:10.12968/johv.2019.7.5.226

Cited by 6 publications

(5 citation statements)

References 34 publications

(27 reference statements)

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“…With respect to content of risk reduction efforts, first asking families what they know of AAP recommendations can help identify potential gaps in knowledge and provide opportunity to share updated recommendations, or recent recalls or bans on products marketed for infant sleep. Second, structured, open‐ended, and non‐judgmental conversational approaches have been suggested to help identify risky practices or areas where families are struggling, and can obtain information on middle‐of‐the‐night practices 25–28 . For example, in this sample, several families described difficulties with getting infant to sleep on a recommended surface, excessive spitting up, and accidentally falling asleep when caring for infant.…”

Section: Discussionmentioning

confidence: 99%

“…Second, structured, open-ended, and non-judgmental conversational approaches have been suggested to help identify risky practices or areas where families are struggling, and can obtain information on middle-of-thenight practices. [25][26][27][28] For example, in this sample, several families described difficulties with getting infant to sleep on a recommended surface, excessive spitting up, and accidentally falling asleep when caring for infant. Third, inquiring about mother's/family's sleep and well-being can serve as an entry point for conversations about ways to address exhaustion-some mothers in this sample noted their sleep or comfort impacted their decision-making.…”

Section: Practice Implicationsmentioning

confidence: 99%

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“Things changed very quickly”: Maternal intentions and decision‐making about infant sleep surface, location, and position

Salm Ward

2023

Birth

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IntroductionApproximately 3400 infants die suddenly and unexpectedly each year in the United States; many of these deaths include modifiable risk factors (such as a non‐supine position, sleeping on a soft surface, or loose bedding or items in the environment). Interventions have been successful at improving parental knowledge about recommendations to reduce risk of sleep‐related infant deaths, as well as improving intention to adopt recommendations. However, follow‐up studies have found a disconnect between knowledge/intentions to adhere to recommendations and actual practices. Exploring maternal decision‐making about infant sleep practices can better elucidate the disconnect between knowledge of infant sleep recommendations and the practice of it, and thus, inform more effective safe sleep interventions. The purpose of this study was to gain a more in‐depth understanding of decision‐making around infant sleep practices, and barriers and facilitators to adopting safe infant sleep recommendations.MethodsSemi‐structured in‐home interviews were conducted with 22 families (20 mothers and 2 mother–father dyads) of infants up to 6 months of age.ResultsThematic analysis of the transcripts revealed six themes: Plans changed when baby came, Trying things to figure out what works (infant preferences), Safety concerns, What's comfortable for me (maternal preferences), They say…(advice), and Trying to be careful.ConclusionThese results suggest that knowledge of infant sleep recommendations alone is not enough to ensure adherence and that decision‐making is a dynamic and ongoing process affected by multiple factors. Findings have implications for timing and content of risk reduction efforts, as well as for data collection in research studies.

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Section: Discussionmentioning

confidence: 99%

Section: Practice Implicationsmentioning

confidence: 99%

“Things changed very quickly”: Maternal intentions and decision‐making about infant sleep surface, location, and position

Salm Ward

2023

Birth

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“…Applied to infant sleep practices, this approach acknowledges that parents make decisions about infant sleep practices based on what works within their familial and household context. Risk reduction around decisions to bed-share has been suggested by others [ 19 , 30 , 31 , 46 , 50 , 52 , 53 , 54 , 55 ]. Consistent with a risk reduction approach, coaches acknowledge the possibility of unplanned bed-sharing occurring [ 56 , 57 ] and plan with families how to reduce potential risk if it occurs [ 53 ].…”

Section: Methodsmentioning

confidence: 99%

Feasibility and Acceptability of a Tailored Infant Safe Sleep Coaching Intervention for African American Families

Ward

McPherson

Kogan

2021

IJERPH

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Background: Approximately 3600 infants die suddenly and unexpectedly annually in the United States. Research suggests limitations of current behavioral interventions to reduce the risk for sleep-related deaths among African American families living in under-resourced neighborhoods. Guided by the theory of planned behavior and the socio-ecological model, the My Baby’s Sleep (MBS) intervention intends to reduce the risk for sleep-related infant deaths while addressing complex needs of African American families living in under-resourced neighborhoods. Objective: To assess feasibility and acceptability of MBS, a 7-month intervention that includes four home visits and multiple check-ins via phone and text message. Methods: This was a single-arm feasibility and acceptability study with quantitative and qualitive measures. African American families were recruited from community agencies that served an under-resourced metropolitan area. Results: Eight families (eight mothers, nine co-caregivers) completed the intervention. Families reported high acceptability of MBS content, process, and format, as evidenced by qualitative data and mean evaluation scores. Conclusion: MBS is feasible and acceptable among African American families living in under-resourced neighborhoods. These results suggest further investigation of MBS intervention efficacy in a large-scale randomized controlled trial.

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“…Our work with vulnerable families has shown that parents appreciate individually tailored advice that provides reasons, giving the how and why certain situations can increase risks for a baby. [28][29][30] The increased vulnerability exhibited among current SIDS deaths and continued exposure to several modifiable risk factors within the infant sleep environment despite widespread population-based risk reduction campaigns, suggest targeting resources to families most in need may reduce deaths further. Our specific recommendations based on these findings, are: 1.…”

Section: Recommendationsmentioning

confidence: 99%

Changes in background characteristics and risk factors among SIDS infants in England: cohort comparisons from 1993 to 2020

Pease,

Turner,

Ingram

et al. 2023

BMJ Open

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ObjectivesUsing the National Child Mortality Database, this work aims to investigate background characteristics and risk factors in the sleeping environment associated with sudden infant death syndrome (SIDS) and compare the prevalence with previous English SIDS case–control studies.DesignCohort of SIDS in 2020 compared with a combined analysis of two case–control studies conducted in 1993–1996 and 2003–2006.SettingEngland, UKParticipants138 SIDS deaths in 2020 compared with 402 SIDS deaths and 1387 age-equivalent surviving controls, combined from previous studies.ResultsThe increased vulnerability of SIDS infants identified in previous studies has become more marked. The infants who died in 2020 were younger (median=66 days (IQR: 34–118) vs 86 days (IQR: 52–148), p=0.003) with an increased prevalence of low birth weight (30.5% vs 21.6%, p=0.04) and preterm births (29.6% vs 19.3%, p=0.012). The excess of socioeconomically deprived families, male infants and high levels of maternal smoking during pregnancy were still evident. Among recent deaths, fewer infants were put down or found on their side; however, there was no significant change in the proportion of infants who were put down (15.6% vs 14.6%, p=0.81) and found prone (40.4% vs 35.3%, p=0.37), despite population wide risk reduction advice over three decades. The proportional increase observed in 2003–2006 of half the deaths occurring while sleeping next to an adult was maintained in 2020, and for the vast majority (90%), this was in hazardous circumstances (adult had consumed alcohol, smoked, slept on a sofa, or the infant was premature or low birth weight and less than 3 months old). More deaths also occurred when there was a disruption in infant care routine compared with previous observations (52.6% vs 20.7%, p<0.001).ConclusionsA more targeted approach is needed with vulnerable families emphasising the importance of sleeping infants on their back and proactive planning infant sleep when there are disruptions to the normal routine, in particular to avoid hazardous co-sleeping.

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Conversations with families about reducing the risk of sudden infant death syndrome

Cited by 6 publications

References 34 publications

“Things changed very quickly”: Maternal intentions and decision‐making about infant sleep surface, location, and position

“Things changed very quickly”: Maternal intentions and decision‐making about infant sleep surface, location, and position

Feasibility and Acceptability of a Tailored Infant Safe Sleep Coaching Intervention for African American Families

Changes in background characteristics and risk factors among SIDS infants in England: cohort comparisons from 1993 to 2020

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