Position for newborn sleep: Associations with parents' perceptions of their nursery experience

Background: In the United States, sudden infant death syndrome is the leading cause of death among infants between the ages of 1 and 12 months. Although its etiology is unclear, infants who sleep in the prone or side positions are at increased risk. The objective of this study was to examine the association between the perceptions of inner city parents about teaching and modeling during the postpartum period of infant sleeping position, and their choice of sleeping position for their infants. Methods: A convenience sample of parents of 100 healthy infants who came for the 2-week well-child visit at an urban primary care center were invited to complete a questionnaire and to report on the position in which infants were placed for sleep. Results: Forty-two percent of parents reported that they usually placed their infants in the supine position for sleep; 26 percent placed their infants to sleep in the prone position at least some of the time. Parents who reported being told by a doctor or a nurse to have their infants sleep in the supine position were more likely to choose that position. Similarly, those who reported seeing their infants placed to sleep exclusively in the supine position in the hospital were also more likely usually to choose that position. Parents who reported that they both were told by a doctor or a nurse to put their infants to sleep in the supine position and reported seeing their infants exclusively placed that way in the nursery were the most likely usually to choose that position for their infants to sleep. Conclusions: Perceptions by parents of instructions from a doctor or a nurse of the position in which the infants were placed in the nursery were associated with the position parents reported placing their infants to sleep at home. Efforts to promote the supine sleeping position in the inner-city setting should address both practices and education provided to parents in the nursery during the postpartum hospital stay and should be sufficiently powerful to align their perceptions of the postpartum experience with current American Academy of Pediatrics recommendations.