[1690.4] Reports of Infant Sleep Behaviors from a National Sample of Mothers: the Study of Attitudes and Factors Affecting Infant Care (SAFE)

Eve R. Colson, Marian Willinger, Nicole L. Santomauro, Timothy C. Heeren, Michael J. Corwin. Pediatrics, Yale University School of Medicine, New Haven, CT; Pregnancy and Perinatology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD; Slone Epidemiology Center, Boston University, Boston, MA; Epidemiology, Boston University School of Public Health, Boston, MA.

BACKGROUND: The AAP recommends infants sleep on their backs and share a room but not a bed. Studies about infant care practices have not been nationally representative.
OBJECTIVE: To determine percentages of mothers following AAP recommendations in a nationally representative sample of mothers of young infants.
DESIGN/METHODS: Using probability sampling and the AHA list of birth hospitals, we recruited mothers from 32 U.S. maternity hospitals. Targeted enrollment had a goal of recruiting a total sample of 1250 mothers, including 25% Black mothers, 25% Hispanic mothers and 50% all other mothers. When the infant was 2-6 months of age, mothers completed an in-depth survey either online or over the telephone about infant care practices including bedsharing and infant sleeping position. SUDAAN statistical software was used to perform weighting and adjust for cluster sampling. Weighted results of demographics were obtained for comparison with national data. Prevalence estimates and 95% CI were calculated for each infant care practice, for the total population and within race/ethnicity strata.
RESULTS: Of the 1,276 mothers enrolled from 1/2011 to 2/2013, 1,030 (81%) completed the follow-up survey. The targeted unweighted percentages were achieved, and after statistical weighting was performed, demographics closely matched National Vital Statistics Reports birth data for 2011. For example weighted maternal characteristics were: 61% White, 13% Black and 25% Hispanic; 57% married, and maternal age 8% 14-19 yrs., 24% 20-24 yrs., 29% 25-29 yrs., and 36% 30+ yrs. Table shows the weighted estimated national prevalence and 95% CI of mothers reporting usual bedsharing, usual supine sleep and usual prone sleep overall and by race.

BehaviorOverall % (95%CI)White % (95%CI)Black % (95%CI)Hispanic % (95%CI)

Usual Bedsharing

18.5 (13.5, 23.4)

13.7 (10.3, 17.0)

18.4 (11.6, 25.3)

28.0 (14.5, 41.6)

Usual Supine Sleeping

72.3 (66.1, 78.5)

75.4 (69.7, 81.0)

58.0 (44.3, 71.8)

69.9 (62.4, 77.4)

Usual Prone Sleeping
10.3 (7.2, 13.4)

10.4 (6.4,14.4)

21.6 (14.1, 29.1)

7.1 (1.6,12.6)

CONCLUSIONS: Overall, the estimated national prevalence of prone infant sleeping is close to the Back to Sleep Campaign goal of <10%, however, prone infant sleeping is reported by over 20% of Black mothers. The estimated national prevalence of bedsharing is quite high at 18.5%, and is reported by 28.0% of Hispanic mothers.


Session: Platform Session: Perinatal Epidemiology (2:45 PM - 4:45 PM)
Date/Time: Saturday, May 3, 2014 - 3:30 PM
Room: West 109 - Vancouver Convention Centre
Course Code: 1690


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