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Bryan MA, Evans YN, Gower A, Moreno MA. Does Exposure to Pediatrician or Parent Blog Content Influence Infant Safe Sleep Practices? Matern Child Health J 2023; 27:251-261. [PMID: 36604380 DOI: 10.1007/s10995-022-03579-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To examine whether exposure to safe sleep recommendations using a blog format changed infant sleep practices. METHODS We conducted a pilot randomized controlled trial via Qualtrics, a web-based platform, with a national sample of parents of children < 1 year old. Survey questions about infant sleep practices included: bed-sharing, location, position and objects present. Safe sleep was defined as not bed-sharing, in a crib, bassinet or playard, back positioning, and no other objects present except pacifiers. Participants were randomized to read one of the following: (1) pediatrician blog post, (2) parent blog post, or (3) no blog post. The blog posts contained the same content about infant sleep but varied by identified authorship. All participants received links to online content about safe sleep. Participants received a follow-up survey 2-4 weeks later with the same questions about infant sleep practices. We compared responses in pre- and post-surveys by type of blog post exposure using multivariable logistic regression models. RESULTS The average infant age (n = 1500) was 6.6 months (Standard Deviation 3.3). Most participants (74%) were female; 77% were married; 65% identified as white Non-Hispanic, 12% were black and 17% were Hispanic. 47% (n = 711) completed both surveys. We identified no differences in the odds of any of the four safe sleep practices after exposure to safe sleep recommendations in blog post format. CONCLUSION Although in-person advice has been associated with improved safe sleep practices, we did not identify changes in infant sleep practices after exposure to safe sleep advice using blog posts.
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Affiliation(s)
- Mersine A Bryan
- Department of Pediatrics, University of Washington, M/S CURE-4, PO Box 5371, Seattle, WA, 98145, USA.
- Seattle Children's Research Institute, Seattle, WA, USA.
| | - Yolanda N Evans
- Department of Pediatrics, University of Washington, M/S CURE-4, PO Box 5371, Seattle, WA, 98145, USA
- Seattle Children's Research Institute, Seattle, WA, USA
| | - Aubrey Gower
- Department of Pediatrics, University of Washington, M/S CURE-4, PO Box 5371, Seattle, WA, 98145, USA
| | - Megan A Moreno
- Department of Pediatrics, University of Wisconsin-Madison, Madison, WI, USA
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Bryan MA, Florence A, Gower AD, Evans YN, Moreno MA. Safe Sleep Behaviors and Factors Associated With Infant Second Sleep Practices. Pediatrics 2022; 149:e2021053935. [PMID: 35634879 DOI: 10.1542/peds.2021-053935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/23/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To examine the prevalence and safety of infant second-sleep practices. METHODS A cross-sectional online survey of parents with infants ≤12 months assessed parent-reported sleep practices: position, use of a separate sleep surface, and sleep location at 2 time points (sleep onset and after nighttime waking). A composite score examined if all 3 safe sleep practices were used at each time point. Safe sleep was defined as: supine position, sleeping in a separate space, and in a crib, bassinet, cradle, or playard. Wilcoxon sign rank test was used to examine changes between the time points. Poisson regression models compared parents who reported a second-sleep location with those who did not. RESULTS Of participants (n = 1500), 74% were female, 65% were White, 12% were Black, and 17% were of Hispanic ethnicity. Thirty-nine percent (n = 581) reported a second-sleep practice. Of parents who reported a second-sleep practice, 28% (n = 137) met all 3 safe sleep criteria at sleep onset; 9% (n = 42) met all 3 safe sleep criteria at both time points. A higher proportion of changes in sleep practices were to less-safe practices (P <.001). Factors associated with a second-sleep practice were parental age <25 years, parental race and ethnicity, first-time parents, homes with smoke exposure, and infants born at <37 weeks. CONCLUSIONS Less than 10% of infants met all 3 safe sleep criteria at sleep onset and after nighttime waking. Interventions focused on safe sleep should highlight the importance of safe sleep practices after nighttime waking.
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Affiliation(s)
- Mersine A Bryan
- University of Washington, Seattle, Washington
- Seattle Children's Research Institute, Seattle, Washington
| | | | | | - Yolanda N Evans
- University of Washington, Seattle, Washington
- Seattle Children's Research Institute, Seattle, Washington
| | - Megan A Moreno
- Department of Pediatrics, University of Wisconsin-Madison, Madison, Wisconsin
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Tucker MH, Toburen C, Koons T, Petrini C, Palmer R, Pallotto EK, Simpson E. Improving safe sleep practices in an urban inpatient newborn nursery and neonatal intensive care unit. J Perinatol 2022; 42:515-521. [PMID: 34987167 DOI: 10.1038/s41372-021-01288-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 11/19/2021] [Accepted: 11/25/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To improve safe sleep compliance in a newborn nursery (NN) and neonatal intensive care unit (NICU) to >80% in 1 year. STUDY DESIGN Prospective quality improvement study of infants admitted to a NN and NICU. Interventions were targeted at parent education, staff education, and system processes. RESULTS Compliance with safe sleep improved to >80% in both units. Tracking of process measures revealed NICU parents received safe sleep education 98-100% of the time. No change was observed in the balancing measures. Transfers from the NN to the NICU for temperature instability did not increase. Parent satisfaction with discharge preparedness did not change (98.2% prior to and 99.6% after). CONCLUSION We achieved improved compliance with safe sleep practices in our NN and NICU through education of staff and parents and improved system processes. We believe this will translate to improved safe sleep practices used by parents at home.
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Affiliation(s)
- Megan H Tucker
- Division of Neonatology, Department of Pediatrics, Children's Mercy Kansas City, University of Missouri-Kansas City, Kansas City, MO, United States.
| | - Cristy Toburen
- General Academic Pediatrics, Department of Pediatrics, Children's Mercy Kansas City, University of Missouri-Kansas City, Kansas City, MO, United States
| | - Trudy Koons
- Division of Neonatology, Department of Pediatrics, Children's Mercy Kansas City, University of Missouri-Kansas City, Kansas City, MO, United States
| | - Carol Petrini
- Department of Neonatology, Truman Medical Center, University of Missouri-Kansas City, Kansas City, MO, United States
| | - Rebecca Palmer
- Division of Neonatology, Department of Pediatrics, Children's Mercy Kansas City, University of Missouri-Kansas City, Kansas City, MO, United States.,Department of Neonatology, Children's Medical Center, Dallas, TX, United States
| | - Eugenia K Pallotto
- Division of Neonatology, Department of Pediatrics, Children's Mercy Kansas City, University of Missouri-Kansas City, Kansas City, MO, United States.,Department of Neonatology, Levine Children's Hospital, Atrium Health, Charlotte, NC, United States
| | - Elizabeth Simpson
- Division of Neonatology, Department of Pediatrics, Children's Mercy Kansas City, University of Missouri-Kansas City, Kansas City, MO, United States
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Safon CB, Heeren TC, Kerr SM, Clermont D, Corwin MJ, Colson ER, Moon RY, Kellams AL, Hauck FR, Parker MG. Disparities in Breastfeeding Among U.S. Black Mothers: Identification of Mechanisms. Breastfeed Med 2021; 16:140-149. [PMID: 33539248 PMCID: PMC7891211 DOI: 10.1089/bfm.2020.0310] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Objective: Disparities in U.S. breastfeeding rates persist among Black mothers according to birth country and between Black and White mothers, necessitating further investigation of modifiable mediating factors to inform interventions. This study seeks to examine the extent that social, maternal, infant factors and Theory of Planned Behavior (TPB) domains (attitudes, perceived control, and subjective norms) mediate the association of maternal race/birth country and breastfeeding continuation. Methods: A national cohort of 2,050 mothers self-identifying as U.S.-born non-Hispanic Black (n = 689), foreign-born non-Hispanic Black (n = 139), and U.S.-born non-Hispanic White (n = 1,222) was analyzed. Using logistic regression, associations of race/birth country and any/exclusive breastfeeding at 2-6 months were examined. Structural equation modeling was used to determine whether social, maternal, and infant factors and TPB domains mediate these relationships. Results: 40.0% of U.S.-born Black, 82.2% of foreign-born Black, and 57.3% of U.S.-born White mothers reported any breastfeeding at 2-6 months. Compared with U.S.-born Black mothers, odds of any breastfeeding were sevenfold higher among foreign-born Black mothers (odds ratio [OR] = 7.04 95% confidence interval [CI] = 4.80-10.31), which was explained partly by social/maternal/infant factors and TPB domains. Compared with U.S.-born White mothers, any breastfeeding was lower (OR = 0.54, 95% CI = 0.40-0.73) among U.S.-born Black mothers and higher (OR = 3.81, 95% CI = 2.48-5.87) among foreign-born Black mothers; these differences were also mediated by the aforementioned factors. Conclusions: Among Black mothers in the United States, breastfeeding continuation varied substantially by birth country. Promotion of interventions targeting positive attitudes, perceived control, and subjective norms may reduce disparities among Black and between Black and White mothers.
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Affiliation(s)
- Cara B Safon
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Timothy C Heeren
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Stephen M Kerr
- Slone Epidemiology Center, Boston University, Boston, Massachusetts, USA
| | - Daphney Clermont
- Slone Epidemiology Center, Boston University, Boston, Massachusetts, USA.,Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.,Cardinal Glennon Children's Hospital, St. Louis University, St. Louis City County, Missouri, USA
| | - Michael J Corwin
- Slone Epidemiology Center, Boston University, Boston, Massachusetts, USA.,Department of Pediatrics, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Eve R Colson
- Department of Pediatrics, Washington University, St. Louis, Missouri, USA
| | - Rachel Y Moon
- Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Ann L Kellams
- Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Fern R Hauck
- Department of Family Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Margaret G Parker
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Moon RY, LoCasale-Crouch J, Turnbull KLP, Colson E, Kellams A, Heeren T, Kerr S, Hauck FR, Corwin MJ. Investigating Mechanisms for Maternal Education Disparities in Enacting Health-Promoting Infant Care Practices. Acad Pediatr 2020; 20:926-933. [PMID: 32201345 PMCID: PMC7483851 DOI: 10.1016/j.acap.2020.03.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 03/10/2020] [Accepted: 03/14/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Although higher education and healthier practices are positively associated, the explanatory mechanisms for this association remain unclear. The purpose of this study was to better understand mechanisms underlying this association by examining maternal adherence to 2 health-promoting infant care practices: supine placement and breastfeeding. METHODS We analyzed nationally representative data from the Study of Attitudes and Factors Effecting Infant Care, which surveyed US mothers after infant birth and 2 months thereafter. Using the Theory of Planned Behavior as a framework, we used structural equation models to elucidate mediational pathways from maternal education to supine infant placement or any breastfeeding. RESULTS Data from 3297 mothers demonstrated 77.0% of infants usually were placed supine, and 57.8% received any breastfeeding. The overall direct effect of maternal educational level on supine placement and any breastfeeding was odds ratio (OR) 1.31 (95% confidence interval [CI] 1.11-1.54) and OR 2.82 (95% CI 2.35-3.37), respectively. In pathway analyses, the strongest associations with both supine position and breastfeeding were seen with positive attitudes (supine: aOR 18.96, 95% CI 9.00-39.92; breastfeeding: aOR 3.86, 95% CI 2.19-6.82) and positive social norms (supine: aOR 6.69, 95% CI 4.52-9.89; breastfeeding: aOR 5.17, 95% CI 4.28-6.23). Mothers with more education had higher odds of both positive attitudes and positive norms for the 2 practices. CONCLUSIONS The associations linking educational attainment with health practices are intricate, with multiple mediating pathways. Attitudes and social norms are powerful forces that mediate the association between maternal educational attainment and both infant supine positioning and breastfeeding, and may be important mediators for other health behaviors.
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Affiliation(s)
- Rachel Y Moon
- Department of Pediatrics, University of Virginia School of Medicine (RY Moon and A Kellams), Charlottesville, Va.
| | - Jennifer LoCasale-Crouch
- Curry School of Education and Human Development, University of Virginia (J LoCasale-Crouch and KLP Turnbull), Charlottesville, Va
| | - Khara L P Turnbull
- Curry School of Education and Human Development, University of Virginia (J LoCasale-Crouch and KLP Turnbull), Charlottesville, Va
| | - Eve Colson
- Department of Pediatrics, Washington University School of Medicine (E Colson), St. Louis, Mo
| | - Ann Kellams
- Department of Pediatrics, University of Virginia School of Medicine (RY Moon and A Kellams), Charlottesville, Va
| | - Timothy Heeren
- Slone Epidemiology Center, Boston University (T Heeren, S Kerr, and MJ Corwin), Boston, Mass; Department of Biostatistics, Boston University School of Public Health (T Heeren), Boston, Mass
| | - Stephen Kerr
- Slone Epidemiology Center, Boston University (T Heeren, S Kerr, and MJ Corwin), Boston, Mass
| | - Fern R Hauck
- Department of Family Medicine, University of Virginia School of Medicine (FR Hauck), Charlottesville, Va
| | - Michael J Corwin
- Slone Epidemiology Center, Boston University (T Heeren, S Kerr, and MJ Corwin), Boston, Mass
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6
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Mitchell EA, Yan X, Ren SY, Anderson TM, Ramirez JM, Lavista Ferres JM, Johnston R. Geographic Variation in Sudden Unexpected Infant Death in the United States. J Pediatr 2020; 220:49-55.e2. [PMID: 32061407 PMCID: PMC7995635 DOI: 10.1016/j.jpeds.2020.01.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 12/04/2019] [Accepted: 01/06/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVES To assess the geographic variation of sudden unexpected infant death (SUID) and test if variation in geographic factors, such as state, latitude, and longitude, play a role in SUID risk across the US. STUDY DESIGN We analyzed the Centers for Disease Control and Prevention's Cohort Linked Birth/Infant Death dataset (2005-2010; 22 882 SUID cases, 25 305 837 live births, rate 0.90/1000). SUID was defined as infant deaths (ages 7-364 days) that included sudden infant death syndrome, ill-defined and unknown cause of mortality, and accidental suffocation and strangulation in bed. SUID geographic variation was analyzed using 2 statistical models, logistic regression and generalized additive model (GAM). RESULTS Both models produced similar results. Without adjustment, there was marked geographic variation in SUID rates, but the variation decreased after adjusting for covariates including known risk factors for SUID. After adjustment, nine states demonstrated significantly higher or lower SUID mortality than the national average. Geographic contribution to SUID risk in terms of latitude and longitude were also attenuated after adjustment for covariates. CONCLUSION Understanding why some states have lower SUID rates may enhance SUID prevention strategies.
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Affiliation(s)
- Edwin A Mitchell
- Department of Paediatrics, Child and Youth Health, University of Auckland, Auckland, New Zealand
| | - Xiaohan Yan
- AI For Good Research Lab, Microsoft, Redmond, WA
| | | | - Tatiana M Anderson
- Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, WA
| | - Jan-Marino Ramirez
- Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, WA; Department of Neurological Surgery, University of Washington School of Medicine, Seattle, WA; Department of Pediatrics, University of Washington School of Medicine, Seattle, WA
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7
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Odeniyi AO, Embleton N, Ngongalah L, Akor W, Rankin J. Breastfeeding beliefs and experiences of African immigrant mothers in high-income countries: A systematic review. MATERNAL AND CHILD NUTRITION 2020; 16:e12970. [PMID: 32141195 PMCID: PMC7296807 DOI: 10.1111/mcn.12970] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 01/02/2020] [Accepted: 01/23/2020] [Indexed: 12/29/2022]
Abstract
Breastfeeding provides optimal nutrition for the healthy growth of infants and is associated with reduced risks of infectious diseases, child and adult obesity, type 2 diabetes, and other chronic diseases. Migration has been shown to influence breastfeeding especially among migrants from low-and-middle-income countries. This mixed-methods systematic review aimed to identify, synthesise, and appraise the international literature on the breastfeeding knowledge and experiences of African immigrant mothers residing in high-income countries. MEDLINE, CINAHL, Embase, PsychINFO, Scopus, and Web of Knowledge databases were searched from their inception to February 2019. Grey literature, reference, and citation searches were carried out and relevant journals hand-searched. Data extraction and quality assessment were independently carried out by two reviewers. An integrated mixed-methods approach adopting elements of framework synthesis was used to synthesise findings. The initial searches recovered 8,841 papers, and 35 studies were included in the review. Five concepts emerged from the data: (a) breastfeeding practices, showing that 90% of African mothers initiated breastfeeding; (b) knowledge, beliefs, and attitudes, which were mostly positive but included a desire for bigger babies; (c) influence of socio-demographic, economic, and cultural factors, leading to early supplementation; (d) support system influencing breastfeeding rates and duration; and (e) perception of health professionals who struggled to offer support due to culture and language barriers. African immigrant mothers were positive about breastfeeding and willing to adopt best practice but faced challenges with cultural beliefs and lifestyle changes after migration. African mothers may benefit from more tailored support and information to improve exclusive breastfeeding rates.
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Affiliation(s)
- Adefisayo O Odeniyi
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Nicholas Embleton
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.,Newcastle Neonatal Service, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - Lem Ngongalah
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Wanwuri Akor
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Judith Rankin
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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8
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Liu J, Parker MG, Lu T, Conroy SM, Oehlert J, Lee HC, Gomez SL, Shariff-Marco S, Profit J. Racial and Ethnic Disparities in Human Milk Intake at Neonatal Intensive Care Unit Discharge among Very Low Birth Weight Infants in California. J Pediatr 2020; 218:49-56.e3. [PMID: 31843218 PMCID: PMC7042029 DOI: 10.1016/j.jpeds.2019.11.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 11/13/2019] [Accepted: 11/13/2019] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To examine how infant and maternal factors, hospital factors, and neighborhood-level factors impact or modify racial/ethnic disparities in human milk intake at hospital discharge among very low birth weight infants. STUDY DESIGN We studied 14 422 infants from 119 California Perinatal Quality Care Collaborative neonatal intensive care units born from 2008 to 2011. Maternal addresses were linked to 2010 census tract data, representing neighborhoods. We tested for associations with receiving no human milk at discharge, using multilevel cross-classified models. RESULTS Compared with non-Hispanic whites, the adjusted odds of no human milk at discharge was higher among non-Hispanic blacks (aOR 1.33 [1.16-1.53]) and lower among Hispanics (aOR 0.83 [0.74-0.93]). Compared with infants of more educated white mothers, infants of less educated white, black, and Asian mothers had higher odds of no human milk at discharge, and infants of Hispanic mothers of all educational levels had similar odds as infants of more educated white mothers. Country of birth and neighborhood socioeconomic was also associated with disparities in human milk intake at discharge. CONCLUSIONS Non-Hispanic blacks had the highest and Hispanic infants the lowest odds of no human milk at discharge. Maternal education and country of birth were the biggest drivers of disparities in human milk intake, suggesting the need for targeted approaches of breastfeeding support.
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Affiliation(s)
- Jessica Liu
- Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatology, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA; California Perinatal Quality Care Collaborative, Palo Alto, CA
| | - Margaret G Parker
- Department of Pediatrics, Boston University School of Medicine, Boston Medical Center, Boston, MA
| | - Tianyao Lu
- Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatology, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA; California Perinatal Quality Care Collaborative, Palo Alto, CA
| | - Shannon M Conroy
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA; Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA
| | - John Oehlert
- Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatology, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA
| | - Henry C Lee
- Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatology, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA; California Perinatal Quality Care Collaborative, Palo Alto, CA
| | - Scarlett Lin Gomez
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA; Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA
| | - Salma Shariff-Marco
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA; Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA
| | - Jochen Profit
- Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatology, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA; California Perinatal Quality Care Collaborative, Palo Alto, CA.
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9
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Dennis CL, Brown HK, Brennenstuhl S, Haddad S, Marini FC, Stremler R. Prevalence and Predictors of Postpartum Maternal and Infant Bed-Sharing Among Chinese-Canadian Women. Behav Sleep Med 2020; 18:120-130. [PMID: 30585091 DOI: 10.1080/15402002.2018.1546179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Objective/Background: Our primary objective was to describe and identify predictors of any and predominant bed-sharing at 4 and 12 weeks postpartum among Chinese-Canadian mothers. Participants: We conducted a longitudinal study of 570 Chinese immigrant and Canadian-born women in Toronto, Ontario. Methods: Any bed-sharing, defined as sharing a bed or mattress for any part of the night on any night in the previous week, and predominant bed-sharing, defined as sharing a bed or mattress for most of the night, on more than half the nights of the previous week, were evaluated at 4 and 12 weeks postpartum. Predictors of bed-sharing, evaluated in multivariable logistic regression models, were background (age, parity, education, household size, delivery mode, social support), cultural (immigrant status, acculturative stress, acculturation, postpartum ritual uptake), and postpartum variables (mental health, breastfeeding problems, fatigue, sleep knowledge, plans for bed-sharing, perceptions of infant sleep problems, cognitions about infant sleep). Results: One in five women (20.7%) reported bed-sharing as the predominant sleep location for their infant at 4 weeks postpartum, with nearly half (45.6%) reporting any bed-sharing at this time. The prevalence of any bed-sharing remained relatively stable at 12 weeks postpartum (46.5%), while predominant bed-sharing increased to 30.1%. The most consistent predictors of any and predominant bed-sharing at 4 and 12 weeks postpartum were lower education level, greater acculturative stress, and predelivery plans to bed-share. Conclusions: These findings have implications for the development of clinical recommendations given to expectant and new parents to promote infant sleep practices that are consistent with American Academy of Pediatrics recommendations.
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Affiliation(s)
- Cindy-Lee Dennis
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - Hilary K Brown
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Interdisciplinary Center for Health & Society, University of Toronto Scarborough, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Women's College Research Institute, Women's College Hospital, Toronto, Canada
| | - Sarah Brennenstuhl
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Summer Haddad
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Flavia C Marini
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Robyn Stremler
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
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10
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Serra-Negra JM, Pereira AC, Carcavalli L, Paiva SM, Pordeus IA, Bendo CB. Children oral habits and their chronotype profile: is there an association? GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2019. [DOI: 10.23736/s0393-3660.18.03899-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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11
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Moon RY, Corwin MJ, Kerr S, Heeren T, Colson E, Kellams A, Geller NL, Drake E, Tanabe K, Hauck FR. Mediators of Improved Adherence to Infant Safe Sleep Using a Mobile Health Intervention. Pediatrics 2019; 143:e20182799. [PMID: 31015374 PMCID: PMC6564062 DOI: 10.1542/peds.2018-2799] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/01/2019] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To determine mediators of improvements in infant safe-sleep (SS) practices in a mobile health intervention. METHODS In a cluster-randomized controlled trial, mothers received SS intervention or breastfeeding control videos for 60 days. Maternal responses about infant sleep position and location (outcomes) and mediators (attitudes, perceived social norms, and perceived control) from the theory of planned behavior were assessed. Intervention effects on mediators and association between mediators and outcomes were examined. RESULTS Of 1600 recruited, 1263 mothers participated. Mothers receiving SS videos were more likely to have positive attitudes and norms for supine sleep (attitudes: adjusted odds ratio [aOR] = 2.35 [95% confidence interval (CI) 1.72 to 3.20]; norms: aOR = 1.75 [95% CI 1.27 to 2.42]) and recommended sleep location (attitudes: aOR = 1.91 [95% CI 1.54 to 2.36]; norms: aOR = 1.37 [95% CI 1.13 to 1.66]). Positive attitudes and norms toward supine sleep and room-sharing without bed-sharing were associated with higher odds of both practices (supine: aOR = 8.25 [95% CI 4.72 to 14.43] for positive attitudes and aOR = 6.67 [95% CI 4.25 to 10.46] for norms; room-sharing: aOR = 7.14 [95% CI 5.35 to 9.53] for positive attitudes and aOR = 4.44 [95% CI 3.03 to 6.51] for norms). Both positive attitudes and positive norms mediated the effect of the intervention. CONCLUSIONS The intervention achieved success in improving adherence to SS recommendations by changing maternal attitudes and norms about supine sleeping and room-sharing without bed-sharing. Recognition that these attitudes and norms appear to be the main drivers of mothers' choices regarding infant-sleep practices should inform health messaging strategies to promote SS.
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Affiliation(s)
| | | | | | - Timothy Heeren
- Slone Epidemiology Center and
- Department of Biostatistics, School of Public Health, Boston University, Boston, Massachusetts; and
| | - Eve Colson
- Department of Pediatrics, Yale University, New Haven, Connecticut
| | | | | | - Emily Drake
- Department of Family, Community, and Mental Health Systems, School of Nursing, University of Virginia, Charlottesville, Virginia
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