Trends and Factors Associated With Infant Bed Sharing, 1993-2010

Abstract

Objective Determine trends and factors associated with bed-sharing. Design National Infant Sleep Position Study: Annual telephone surveys. Setting 48 contiguous United States. Participants Nighttime caregivers of infants born within the last 7 months between 1993 and 2010. Approximately 1000 interviews annually. Main Outcome Measure Infant usually bed-sharing. Results Of 18,986 participants, 11% reported usually bed-sharing. Bed-sharing increased between 1993 (6.0%) and 2010 (13.5%). While there was an increase for Whites from 1993 to 2000 (p<0.001), there was no significant increase from 2001 to 2010 (p=0.48). Blacks and Hispanics showed increase in bed-sharing throughout the period 1993 to 2010, with no difference between the two time periods (p=0.63 and 0.77, respectively). After accounting for study year, factors associated with increase in usually bed-sharing included: compared to college or more, maternal education less than high school (AOR = 1.4; 95% CI, 1.1–1.8), compared to White race, maternal race or ethnicity Black (AOR = 3.5; 95% CI, 3.0–4.1), Hispanic (AOR = 1.3; 95% CI, 1.1–1.6) and Other (AOR 2.5; 95% CI, 2.0–3.0), compared to household income ≥$50,000, less than $20 000 (AOR = 1.7; 95% CI, 1.4–2.0) and $20–$50,000 (AOR=1.3; 95%CI 1.1–1.5), compared with living in the Midwest, living in the West (AOR=1.6; 95%CI 1.4–1.9) or South (AOR=1.5; 95% CI=1.3–1.7), compared with infant age ≥16 weeks, less than 8 weeks (AOR = 1.5; 95%CI 1.2–1.7 and 8–15 weeks (AOR-1.3; 95% CI=1.2–1.5) and being born prematurely (AOR = 1.4; 95% CI, 1.2–1.6). Thirty-six percent of the participants reported talking to a doctor about bed-sharing. Compared with those who did not talk to a doctor, those who reported their doctors had a negative attitude were less likely to bed-share (AOR 0.66 (95% 0.53, 0.82), whereas a neutral attitude was associated with increased bed-sharing. (AOR 1.4; 95%CI 1.1–1.8). Conclusion Our findings of the continual increase in bed-sharing throughout the period 1993–2010 among Black and Hispanic infants suggests that the current recommendation about bed-sharing is not universally followed.

Sleep Environment Risks for Younger and Older Infants

“…These findings mirror data about sleep behaviors in different racial/ethnic groups in cross-sectional studies. 10,23,24 There are limitations inherent to this type of study. First, there were multiple individuals in multiple sites who were responsible for data entry, and the quality of the data varied.…”

“…9 However, the adoption of safe sleep practices has been inconsistent in home, child care, and health care settings. 10,11 Studies have examined differences in rates of sleep-related deaths among infants by age, but most have studied 1 risk factor or sought to separate the effects of different risk factors. 3,4,12,13 Less is known about how multiple elements of a safe sleep environment are associated with different rates of sleep-related infant death for younger and older infants.…”

Sofas and Infant Mortality

“…Other studies that have examined deaths on sofas have been epidemiologic analyses of SIDS deaths. 8,9,[13][14][15] Because there has recently been a shift in how the cause of death is coded for sudden and unexpected infant deaths in the United States, 7 we chose to examine all deaths occurring suddenly and unexpectedly. Nonetheless, we acknowledge that this encompasses deaths from causes that are both explained (eg, accidental suffocation) and unexplained (ill-defined and SIDS).…”

“…12 However, many infants continue to be placed in unsafe sleep environments. 13,14 Sleeping on sofas is extremely hazardous. Compared with sleeping on other surfaces (eg, beds, cribs), it increases the risk 49-to 67-fold.…”

Maternal Report of Advice Received for Infant Care

“…[9][10][11][12][13] Advice received by mothers from potentially influential sources such as medical professionals, family, and the media represents a potentially important modifiable factor that may influence mothers' choices about infant care practices. [13][14][15][16][17][18][19] However, relatively little is known about the frequency with which mothers receive such advice and the extent to which advice given is consistent with evidence-based guidelines.…”