Knowledge, Attitudes, and Risk for Sudden Unexpected Infant Death in Children of Adolescent Mothers: A Qualitative Study

Caraballo, Michelle; Shimasaki, Suzuho; Johnston, Katherine; Tung, Gregory; Albright, Karen; Halbower, Ann C.

doi:10.1016/j.jpeds.2016.03.031

Cited by 35 publications

(38 citation statements)

References 18 publications

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“…There is widespread use of bumper images in the media and displays in stores (Joyner et al 2009; Kreth et al 2017) implying that bumpers are safe. Along with other studies (Colvin et al 2014; Caraballo et al 2016), we found that many mothers are unaware of the dangers of crib bumpers, with 59% of crib bumper mothers in our study choosing crib bumpers because “they are safe. ” Advising parents to avoid soft bedding, including crib bumpers, to prevent SIDS may be a confusing and mixed message for many parents.…”

Section: Discussionsupporting

confidence: 84%

Reports of Injury Risks and Reasons for Choice of Sleep Environments for Infants and Toddlers

Scheers¹,

Dayton

Batcher³

et al. 2019

Matern Child Health J

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ObjectiveCompare mothers’ reports of injuries for infants and toddlers sleeping with crib-bumpers/mesh-liners/no-barriers and reasons for these sleep environment choices.MethodsA cross-sectional survey of mothers subscribing to a parenting magazine and using crib bumpers (n = 224), mesh liners (n = 262), and no barriers (n = 842). Analyses of four possible injuries (face-covered, climb-out/fall, slat-entrapment, hit-head) including multivariate logistic regression adjusted for missing data/demographics and Chi squared analyses of reasons for mothers’ choices.ResultsMaternal reports of finding infants/toddlers with face covered had 3.5 times higher adjusted odds (aOR) for crib bumper versus mesh liner use. Breathing difficulties and wedgings were reported for infants/toddlers using crib bumpers but not mesh liners. Climb-outs/falls showed no significant difference in aORs for crib bumpers versus no-barriers and mesh liners versus no barriers. Reports of slat-entrapment were less likely for mothers using crib bumpers and mesh liners than using no barrier (aOR = .28 and .32). Reports of hit-heads were less likely for crib bumpers vs no barrier (aOR = .38) with no significant difference between mesh liners versus no barrier use. Mothers using crib bumpers and mesh liners felt their choice prevented slat-entrapment (89%, 91%); 93.5% of crib bumper users felt their choice prevented hit-heads. Significantly more mesh liner than crib bumper users chose them because “There is no suffocation risk” (64.1% vs. 40.6%), while 83.6% of no-barrier users chose them because “I was concerned about suffocation risk.”Conclusions for PracticeMothers appeared to be more concerned about preventing minor risks than suffocation. Understanding reasons for mothers’ use of barriers/no-barriers is important in tailoring counseling for mothers with infants/toddlers.Electronic supplementary materialThe online version of this article (10.1007/s10995-019-02803-7) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 84%

Reports of Injury Risks and Reasons for Choice of Sleep Environments for Infants and Toddlers

Scheers¹,

Dayton

Batcher³

et al. 2019

Matern Child Health J

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“…Despite evidence that breastfeeding has advantages for mother and child health (Stuebe 2009 ), breastfeeding rates remain low in the US among young, low-income and African-American women (McDowell et al 2008 ). Additionally, although the American Academy of Pediatrics (Task Force on Sudden Infant Death Syndrome 2016 ) recommends that infants be placed in supine sleep positions in their own beds in order to reduce the risk of sleep-related infant deaths, infants born to young, low-income mothers have a relatively high risk for prone placement and for co-sleeping (Colson et al 2009 ; Caraballo et al 2016 ).…”

Section: Introductionmentioning

confidence: 99%

Randomized Controlled Trial of Doula-Home-Visiting Services: Impact on Maternal and Infant Health

Hans

Edwards

Zhang

2018

Matern Child Health J

112

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Introduction Although home-visiting programs typically engage families during pregnancy, few studies have examined maternal and child health outcomes during the antenatal and newborn period and fewer have demonstrated intervention impacts. Illinois has developed an innovative model in which programs utilizing evidence-based home-visiting models incorporate community doulas who focus on childbirth education, breastfeeding, pregnancy health, and newborn care. This randomized controlled trial (RCT) examines the impact of doula-home-visiting on birth outcomes, postpartum maternal and infant health, and newborn care practices. Methods 312 young (M = 18.4 years), pregnant women across four communities were randomly assigned to receive doula-home-visiting services or case management. Women were African American (45%), Latina (38%), white (8%), and multiracial/other (9%). They were interviewed during pregnancy and at 3-weeks and 3-months postpartum. Results Intervention-group mothers were more likely to attend childbirth-preparation classes (50 vs. 10%, OR = 9.82, p < .01), but there were no differences on Caesarean delivery, birthweight, prematurity, or postpartum depression. Intervention-group mothers were less likely to use epidural/pain medication during labor (72 vs. 83%; OR = 0.49, p < .01) and more likely to initiate breastfeeding (81 vs. 74%; OR = 1.72, p < .05), although the breastfeeding impact was not sustained over time. Intervention-group mothers were more likely to put infants on their backs to sleep (70 vs. 61%; OR = 1.64, p < .05) and utilize car-seats at three weeks (97 vs. 93%; OR = 3.16, p < .05). Conclusions for practices The doula-home-visiting intervention was associated with positive infant-care behaviors. Since few evidence-based home-visiting programs have shown health impacts in the postpartum months after birth, incorporating doula services may confer additional health benefits to families.

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“… 18 In a study with adolescent mothers in the USA, the authors report how maternal instincts and information from mothers’ mothers overruled the safety advice given to them by health professionals. 19 Similarly, the mothers in our study made it clear that they needed credible sources of advice that worked with their own instincts, rather than against them. Our interpretation is that mothers do not perceive themselves as prioritising infant comfort over safety, as was suggested in the study with teen mothers, 19 but rather that they prioritise infant comfort over a small perceived risk of a very rare event.…”

Section: Discussionmentioning

confidence: 71%

“… 19 Similarly, the mothers in our study made it clear that they needed credible sources of advice that worked with their own instincts, rather than against them. Our interpretation is that mothers do not perceive themselves as prioritising infant comfort over safety, as was suggested in the study with teen mothers, 19 but rather that they prioritise infant comfort over a small perceived risk of a very rare event. Another US study 20 reported that the mothers talked about a maternal awareness of the baby during sleep, similar to the ‘mum sleep’ described in the current study.…”

Section: Discussionmentioning

confidence: 71%

Factors influencing maternal decision-making for the infant sleep environment in families at higher risk of SIDS: a qualitative study

Pease

Ingram

Blair

et al. 2017

bmjpo

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ObjectiveQualitative interviews with mothers of babies at higher risk of sudden infant death syndrome (SIDS) were carried out to understand their views and decision-making process on the infant sleep environment and safe sleep messages.Design and settingTwenty semi-structured interviews were conducted between February and November 2014 in deprived areas of Bristol, UK. Mothers were asked about their decision-making for the infant sleep environment and safe sleep messages including infant sleep position, co-sleeping, smoking, dummy use, feeding and disrupted routines. The interviews were transcribed, coded and thematic analysis carried out.ParticipantsParticipants were invited based on an algorithm developed in a previous SIDS case control study that identified an increased risk of SIDS from four demographic characteristics: young maternal age, smoking during pregnancy, three or more children, and a measure of deprivation. The presence of three, or more characteristics led to being invited to take part in the qualitative study.ResultsFactors influencing mothers’ adherence to the safe sleep messages included previous experience and the credibility of the advice given. They described disrupted routines that led to risky scenarios with a belief that occasional risks were acceptable. Where circumstances made following the advice more difficult they found alternative strategies to reduce the risk, including the use of movement monitors, regular checking and a belief that lighter maternal sleep in the presence of a baby was protective.ConclusionsSafer sleep messages should be tailored to fit with the lived realities of mothers, especially those at higher risk. The traditional list of ‘do’s’ and ‘don’ts’ was not well accepted by this group. Interventions that seek to influence this higher-risk group should acknowledge mothers’ own protective instincts and consider their beliefs and understanding behind the safer sleep messages if they are to be effective and encourage this group to change.

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Knowledge, Attitudes, and Risk for Sudden Unexpected Infant Death in Children of Adolescent Mothers: A Qualitative Study

Cited by 35 publications

References 18 publications

Reports of Injury Risks and Reasons for Choice of Sleep Environments for Infants and Toddlers

Reports of Injury Risks and Reasons for Choice of Sleep Environments for Infants and Toddlers

Randomized Controlled Trial of Doula-Home-Visiting Services: Impact on Maternal and Infant Health

Factors influencing maternal decision-making for the infant sleep environment in families at higher risk of SIDS: a qualitative study

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