Pēpē‐infant sleep practices and sudden unexpected death in infancy in Aotearoa New Zealand

Abstract

Objective To explore pēpē [infant] sleep practices and the key motivators among selected Māori and non‐Māori māmā [mothers] in Auckland, New Zealand, in relation to the risk of sudden unexpected death in infancy (SUDI). Methods Qualitative research underpinned by a kaupapa Māori cultural framework was undertaken. In‐depth face‐to‐face interviews occurred in the homes of māmā with young pēpē born in Counties Manukau, Auckland. Interview transcripts were analyzed using general purpose thematic analysis. Results Thirty māmā participated, including 17 Māori. Two‐thirds of māmā reported previous or current bed sharing. The fundamental human need for adequate sleep motivated half the māmā in the present study, and especially Māori māmā, to bed share. The second most common reason given was closeness and convenience. This was followed by breastfeeding, which was cited as a reason by Māori māmā only. These findings were interpreted in terms of intrinsic fear, culture, and māmā deployment of knowledge. Conclusion Service providers are encouraged to respond to the lived experiences and cultural realities, values, and beliefs of māmā when designing and delivering effective SUDI prevention interventions. Innovative approaches for providing structured and opportunistic, culturally appropriate education and support around safe sleep are likely to be well‐received by māmā and their whānau [family/ies].

The lives of women and babies matter: A call for action in Indigenous and First Nations women’s health and wellbeing

“…The articles in this special edition use positive approaches. This is done in order to empower women in healthcare, 12 to develop and trial culturally safe and community-based approaches, 2,6 to partner with communities, 3,5 to employ Indigenous methods and knowledge, 8,14 to privilege Indigenous voices, 4,9,10,11 to move towards risk assessment and management tailored to Indigenous populations and context, 15,16 and to explore women's experiences in new ways. 1,9,13 Much of the research responds to the silence/invisibility of First Nations and Indigenous women by challenging the norms of women's healthcare provision, such as persistent discrepancies in structural/social determinants of health, healthcare access and health outcomes, systemic racism, and trauma.…”

“…Macfarlane et al 14 explored infant sleep practices among Māori and non-Māori mothers in Aotearoa New Zealand, specifically the risk of sudden unexpected death in infancy, and found that the need for adequate sleep motivates many mothers to share a bed with their infant. The authors encouraged service providers to "respond to the lived experiences and cultural realities, values, and beliefs of māmā (mothers)", 14 a call that applies to all facets of Indigenous and First Nations women's health and wellbeing and is at the heart of this Special Issue. Now, more than ever, is the time for us all to go on the hikoi (journey) to reject the silence and acceptance around Indigenous disparities in death and morbidity.…”

“…The issue highlights the voices of those usually not heard in research, in clinical care, and in health service design, [1][2][3][4][5][6] and calls out the silence and invisibility commonly imposed on Indigenous women. [7][8][9][10][11] This Special Issue includes calls from Indigenous researchers through Indigenous-led and -conducted research; and calls from Indigenous women, either through telling the stories of their health and healthcare journeys, 1,12,13,14 or through risk factors and health outcomes being made visible in quantitative data, 8,15,16 or through looking at existing literature in new ways. 7,9,10,11…”

“…This Special Issue includes calls from Indigenous researchers through Indigenous‐led and ‐conducted research; and calls from Indigenous women, either through telling the stories of their health and healthcare journeys, 1,12,13,14 or through risk factors and health outcomes being made visible in quantitative data, 8,15,16 or through looking at existing literature in new ways 7,9,10,11 …”