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Himemiya-Hakucho A, Taketani A, Nakagawa A, Sakai H, Shigemoto A, Takase I. Practices and Awareness Regarding an Infant's Sleep Environment among Japanese Caregivers: A Cross-Sectional Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:471. [PMID: 38673381 PMCID: PMC11050700 DOI: 10.3390/ijerph21040471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/02/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024]
Abstract
Preventing sudden, unexpected infant death related to sleep, especially suffocation and sudden infant death syndrome, remains challenging globally. To evaluate factors associated with an unsafe sleep environment (SE) for infants in Japan, this cross-sectional study investigated the current status of practices and awareness among caregivers about a safe SE. Two hundred and fifty-four caregivers of infants in Yamaguchi Prefecture participated. Among the caregivers, 96.0% could not thoroughly practice a safe SE, although 65.0% had knowledge about a safe SE. More unsafe SE practices were significantly associated with 8- to 11-month-old infants than with 0- to 3-month-old infants, using the same practice as for an older child than with accessing information or a familiar person than with mass media as the most useful source of information. The differences in having knowledge were not associated with their practice. Many caregivers obtained information about an infant's SE from mass media and a familiar person. They preferred education via a face-to-face method by medical experts to raise awareness about a safe SE. Thus, efforts need to be developed in Japan in which experts who directly attend to caregivers can truly educate them to ensure that caregivers are continuously aware of the importance of an SE.
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Affiliation(s)
- Ayako Himemiya-Hakucho
- Department of Legal Medicine, Yamaguchi University Graduate School of Medicine, Yamaguchi 755-8505, Japan; (A.N.); (H.S.); (A.S.); (I.T.)
| | - Ayumi Taketani
- Undergraduate Courses of Medicine, Faculty of Medicine and Health Sciences, Yamaguchi University, Yamaguchi 755-8505, Japan;
| | - Aoi Nakagawa
- Department of Legal Medicine, Yamaguchi University Graduate School of Medicine, Yamaguchi 755-8505, Japan; (A.N.); (H.S.); (A.S.); (I.T.)
| | - Hiroki Sakai
- Department of Legal Medicine, Yamaguchi University Graduate School of Medicine, Yamaguchi 755-8505, Japan; (A.N.); (H.S.); (A.S.); (I.T.)
| | - Azumi Shigemoto
- Department of Legal Medicine, Yamaguchi University Graduate School of Medicine, Yamaguchi 755-8505, Japan; (A.N.); (H.S.); (A.S.); (I.T.)
| | - Izumi Takase
- Department of Legal Medicine, Yamaguchi University Graduate School of Medicine, Yamaguchi 755-8505, Japan; (A.N.); (H.S.); (A.S.); (I.T.)
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D'Souza L, Cassels T. Contextual considerations in infant sleep: Offering alternative interventions to families. Sleep Health 2023; 9:618-625. [PMID: 35768320 DOI: 10.1016/j.sleh.2022.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 05/03/2022] [Accepted: 05/19/2022] [Indexed: 10/17/2022]
Abstract
Infant sleep problems are one of the commonly reported reasons parents seek professional help, yet what constitutes a "sleep problem" depends on the models used to explain the development of infant sleep. The current models are based on research conducted in the western context where infant solitary sleeping is the norm. Parent-child co-sleeping is the norm in many cultures around the world. We argue that the primary focus of current research on parent-child interactions as the mediating context for the development of infant sleep problems has inherently made these models and ensuing interventions less sensitive and applicable to infant sleep problems in the context of co-sleeping families. When families present for help with infant sleep difficulties, extinction based behavioral interventions or interventions focused on reducing parental presence at bedtime are commonly recommended. These recommendations may not always align with cultural values and parenting practices of all families, therefore precluding these families from getting necessary help. In attempting to provide families with choices that depart from behavioral based interventions, this paper draws on research and adapts current models to propose an alternative to conceptualize perceptions of infant sleep problems that may be sensitive to and applied across various cultural and personal contexts. We attempt to provide a rationale for interventions that are inclusive and sensitive to families where reduced parental nighttime responsiveness may not be a preferred choice.
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Affiliation(s)
- Levita D'Souza
- Faculty of Education, Monash University, 19 Ancora Imparo Way, Clayton, Victoria, 3800, Australia.
| | - Tracy Cassels
- Evolutionary Parenting, 116 County Rd, 16 Milford, ON, K0K 2P0, Canada
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Infant Care Practices, Caregiver Awareness of Safe Sleep Advice and Barriers to Implementation: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137712. [PMID: 35805369 PMCID: PMC9265757 DOI: 10.3390/ijerph19137712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 11/29/2022]
Abstract
Modifiable infant sleep and care practices are recognised as the most important factors parents and health practitioners can influence to reduce the risk of sleep-related infant mortality. Understanding caregiver awareness of, and perceptions relating to, public health messages and identifying trends in contemporary infant care practices are essential to appropriately inform and refine future infant safe sleep advice. This scoping review sought to examine the extent and nature of empirical literature concerning infant caregiver engagement with, and implementation of, safe sleep risk-reduction advice relating to Sudden Unexpected Deaths in Infancy (SUDI). Databases including PubMed, CINAHL, Scopus, Medline, EMBASE and Ovid were searched for relevant peer reviewed publications with publication dates set between January 2000–May 2021. A total of 137 articles met eligibility criteria. Review results map current infant sleeping and care practices that families adopt, primary infant caregivers’ awareness of safe infant sleep advice and the challenges that families encounter implementing safe sleep recommendations when caring for their infant. Findings demonstrate a need for ongoing monitoring of infant sleep practices and family engagement with safe sleep advice so that potential disparities and population groups at greater risk can be identified, with focused support strategies applied.
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Cole R, Young J, Kearney L, Thompson JMD. Challenges parents encounter when implementing infant safe sleep advice. Acta Paediatr 2021; 110:3083-3093. [PMID: 34297875 DOI: 10.1111/apa.16040] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/21/2021] [Indexed: 01/21/2023]
Abstract
AIM To understand which safe sleep recommendations parents find most challenging to implement, identifying common barriers encountered; and investigate whether challenges are associated with practices employed. METHODS A cross-sectional survey of 3341 Australian families with young infants who birthed a live baby during April-May 2017. Caregivers were asked about infant care practices and family characteristics. Qualitative free-text items explored challenges faced with current safe sleep recommendations. RESULTS Nearly one-third (n = 1033, 31%) of caregivers reported difficulty with at least one safe sleep recommendation. Infant sleep position and avoiding bed-sharing were identified as the most challenging recommendations. Caregivers described barriers which influenced consistency in uptake of advice. Families who described difficulty with a recommendation were significantly less likely to consistently employ that advice compared to those who did not report difficulty (sleep position: 198/473,42% vs 2548/2837,90% [p < 0.0001]; own sleep space: (269/344,78% vs 1331/2884,46% [p < 0.0001]). When families encountered challenges, they often proposed alternate strategies with an inference their substitute action compensated potential increased risk. CONCLUSION Many families encounter difficulties implementing safe sleep advice; these challenges negatively impact care practices. Effective interventions meeting individual family needs, to provide safe sleep environments consistently, are necessary to improve sleep-related infant care and further reduce infant mortality.
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Affiliation(s)
- Roni Cole
- School of Nursing, Midwifery and Paramedicine University of the Sunshine Coast Sippy Downs Australia
- Sunshine Coast Health Institute Sunshine Coast Hospital and Health Service Birtinya Australia
| | - Jeanine Young
- School of Nursing, Midwifery and Paramedicine University of the Sunshine Coast Sippy Downs Australia
- Sunshine Coast Health Institute Sunshine Coast Hospital and Health Service Birtinya Australia
| | - Lauren Kearney
- School of Nursing, Midwifery and Paramedicine University of the Sunshine Coast Sippy Downs Australia
- Sunshine Coast Health Institute Sunshine Coast Hospital and Health Service Birtinya Australia
| | - John M. D. Thompson
- School of Nursing, Midwifery and Paramedicine University of the Sunshine Coast Sippy Downs Australia
- Paediatrics: Child and Youth Health School of Medicine University of Auckland Auckland New Zealand
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Ball HL, Taylor CE, Yuill CM. A Box to Put the Baby in: UK Parent Perceptions of Two Baby Box Programmes Promoted for Infant Sleep. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111473. [PMID: 34769989 PMCID: PMC8582985 DOI: 10.3390/ijerph182111473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/25/2021] [Accepted: 10/28/2021] [Indexed: 11/18/2022]
Abstract
Between 2016 and 2019, two different infant sleeping-box interventions were implemented in England: (1) shallow polypropylene baby boxes were distributed via a feasibility study to families with Sudden Infant Death Syndrome (SIDS) risk factors; and (2) a commercial–health system partnership scheme distributed cardboard baby boxes to new mothers in particular locations. We conducted parent evaluations of both interventions at the time of implementation. The views of 79 parents receiving polypropylene boxes and 77 parents receiving cardboard boxes were captured using online questionnaires and telephone interviews. Participants provided feedback on education received about using the box, their perception of the box design and materials, their experiences of using the box they received, and whether they would recommend it to others. Parents appreciated that both boxes provided a portable space to place their baby near them anywhere in the home, discouraging other riskier practices. The polypropylene box was rated more favourably regarding transparency, hygiene, and portability outside the home. A minority of parents found the idea of putting their baby in any box unappealing; however, younger mothers and smokers particularly appreciated the ability to safely co-sleep with their babies using the shallower box. Overall, the versatility of the polypropylene box scheme was more positively evaluated than the cardboard baby box scheme, which, stripped of its social value as part of a larger welfare provision, had minimal value for parents that received it.
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Affiliation(s)
- Helen L. Ball
- Department of Anthropology, Durham University, Durham DH1 3LE, UK;
- Correspondence:
| | | | - Cassandra M. Yuill
- School of Health Sciences, City, University of London, London EC1V 0HB, UK;
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Abstract
BACKGROUND There is great global variation in the sleeping arrangements for healthy newborn infants. Bed sharing is a type of sleeping practice in which the sleeping surface (e.g. bed, couch or armchair, or some other sleeping surface) is shared between the infant and another person. The possible physiological benefits include better oxygen and cardiopulmonary stability, fewer crying episodes, less risk of hypothermia, and a longer duration of breastfeeding. On the other hand, the most important harmful effect of bed sharing is that it may increase the risk of sudden infant death syndrome (SIDS). Studies have found conflicting evidence regarding the safety and efficacy of bed sharing during infancy. OBJECTIVES To evaluate the efficacy and safety of bed sharing, started during the neonatal period, on breastfeeding status (exclusive and total duration of breastfeeding), incidence of SIDS, rates of hypothermia, neonatal and infant mortality, and long-term neurodevelopmental outcomes. SEARCH METHODS We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL 2020, Issue 7) in the Cochrane Library; MEDLINE via PubMed (1966 to 23 July 2020), CINAHL (1982 to 23 July 2020), and LILACS (1980 to 23 July 2020). We also searched clinical trials databases, and the reference lists of retrieved articles, for randomised controlled trials (RCTs) and quasi-RCTS. SELECTION CRITERIA We planned to include RCTs or quasi-RCTs (including cluster-randomised trials) that included term neonates initiated on bed sharing within 24 hours of birth (and continuing to bed share with the mother in the first four weeks of life, followed by a variable time period thereafter), and compared them to a 'no bed sharing' group. DATA COLLECTION AND ANALYSIS We used standard methodological procedures as recommended by Cochrane. We planned to use the GRADE approach to assess the certainty of evidence. MAIN RESULTS Our search strategy yielded 6231 records. After removal of duplicate records, we screened 2745 records by title and abstract. We excluded 2739 records that did not match our inclusion criteria. We obtained six full-text studies for assessment. These six studies did not meet the eligibility criteria and were excluded. AUTHORS' CONCLUSIONS We did not find any studies that met our inclusion criteria. There is a need for RCTs on bed sharing in healthy term neonates that directly assess efficacy (i.e. studies in a controlled setting, like hospital) or effectiveness (i.e. studies conducted in community or home settings) and safety. Future studies should assess outcomes such as breastfeeding status and risk of SIDS. They should also include neonates from high-income countries and low- and middle-income countries, especially those countries where bed sharing is more prevalent because of cultural practices (e.g. Asian countries).
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Affiliation(s)
- Rashmi R Das
- Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, India
| | - Mari Jeeva Sankar
- Newborn Health Knowledge Centre, WHO Collaborating Centre for Training and Research in Newborn Care, Department of Pediatrics, All India Institute of Medical Sciences, Delhi, India
| | - Ramesh Agarwal
- Newborn Health Knowledge Centre, WHO Collaborating Centre for Training and Research in Newborn Care, Department of Pediatrics, All India Institute of Medical Sciences, Delhi, India
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Cornwell B, Yan X, Carlin RF, Fu L, Wang J, Moon RY. Social network influences on new mothers' infant sleep adjustments. Soc Sci Med 2021; 269:113585. [PMID: 33333376 PMCID: PMC7794038 DOI: 10.1016/j.socscimed.2020.113585] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 11/24/2020] [Accepted: 12/03/2020] [Indexed: 11/27/2022]
Abstract
Despite public awareness campaigns, some parents continue to engage in infant sleep practices that are considered risky by health experts, such as bedsharing or placing their infants on their stomachs. This study examines the role their social networks play in shaping parents' responsiveness to new information and/or suggestions about how they should place their infants for sleep, paying attention to the respective effects of health professionals and their close interpersonal ties. We collected data from a sample of 323 new mothers in Washington, D.C., who described their infant sleep practices and perceived personal social networks. We find evidence that mothers' social networks play a significant role in the likelihood that they adjust their infant sleep practices within the first few months of their infants' lives. Mothers are more likely to change sleep practices when health professionals and/or (lay) family members advise them to do so. The influence of network members is not always positive. For mothers who initially follow safe practices, their probability of change increases if their network members substantially espouse unsafe practices. Among mothers with initially unsafe practices, network members' level of support for safe sleep practices is not predictive of the likelihood of sleep practice change. Implications for potential interventions are discussed.
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Affiliation(s)
| | - Xuewen Yan
- Department of Sociology, Cornell University, Ithaca, NY, USA
| | - Rebecca F Carlin
- Goldberg Center for Community Pediatric Health, Children's National Health System, Washington, D.C., USA; Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, D.C., USA
| | - Linda Fu
- Goldberg Center for Community Pediatric Health, Children's National Health System, Washington, D.C., USA; Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, D.C., USA
| | - Jichuan Wang
- Center for Translational Science Children's National Health System, Washington, D.C., USA; Department of Epidemiology and Biostatistics George Washington University, Washington, D.C., USA
| | - Rachel Y Moon
- Department of Pediatrics University of Virginia, Charlottesville, VA, USA
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Pease A, Garstang JJ, Ellis C, Watson D, Ingram J, Cabral C, Blair PS, Fleming PJ. Decision-making for the infant sleep environment among families with children considered to be at risk of sudden unexpected death in infancy: a systematic review and qualitative metasynthesis. BMJ Paediatr Open 2021; 5:e000983. [PMID: 33754131 PMCID: PMC7938979 DOI: 10.1136/bmjpo-2020-000983] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 02/09/2021] [Accepted: 02/14/2021] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Advice to families to sleep infants on their backs, avoid smoke exposure, reduce excess bedcovering and avoid specific risks associated with cosleeping has greatly reduced sudden unexpected death in infancy (SUDI) rates worldwide. The fall in rates has not been equal across all groups, and this advice has been less effective for more socially deprived families. Understanding decision-making processes of families with infants at risk would support the development of more effective interventions. AIM To synthesise the qualitative evidence on parental decision-making for the infant sleep environment among families with children considered to be at increased risk of SUDI. METHODS This study was one of three related reviews of the literature for the Child Safeguarding Practice Review Panel's National Review in England into SUDI in families where the children are considered at risk of harm. A systematic search of eight online databases was carried out in December 2019. Metasynthesis was conducted, with themes extracted from each paper, starting with the earliest publication first. RESULTS The wider review returned 3367 papers, with 16 papers (across 13 studies) specifically referring to parental decision-making. Six overall themes were identified from the synthesis: (1) knowledge as different from action; (2) external advice must be credible; (3) comfort, convenience and disruption to the routine; (4) plausibility and mechanisms of protection; (5) meanings of safety and risk mitigation using alternative strategies; and (6) parents' own expertise, experience and instincts. CONCLUSION Interventions that are intended to improve the uptake of safer sleep advice in families with infants at risk of sleep-related SUDI need to be based on credible advice with mechanisms of protection that are understandable, consistent with other sources, widened to all carers of the infant and fit within the complex practice of caring for infants.
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Affiliation(s)
- Anna Pease
- Centre for Academic Child Health, University of Bristol Medical School, Bristol, UK
| | - Joanna J Garstang
- Children and Family Services, Birmingham Community Healthcare NHS Trust, Aston, UK
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Catherine Ellis
- Department of Nursing, Midwifery and Health, University of Northumbria at Newcastle, Newcastle upon Tyne, Tyne and Wear, UK
| | - Debbie Watson
- Children and Families Research Centre, School for Policy Studies, University of Bristol, Bristol, UK
| | - Jenny Ingram
- Centre for Academic Child Health, University of Bristol Medical School, Bristol, UK
| | - Christie Cabral
- Centre for Academic Primary Care, University of Bristol Medical School, Bristol, UK
| | - Peter S Blair
- Centre for Academic Child Health, University of Bristol Medical School, Bristol, UK
| | - Peter J Fleming
- Centre for Academic Child Health, University of Bristol Medical School, Bristol, UK
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Cole R, Young J, Kearney L, Thompson JMD. Awareness of infant safe sleep messages and associated care practices: findings from an Australian cohort of families with young infants. BMJ Paediatr Open 2021; 5:e000972. [PMID: 33718628 PMCID: PMC7908297 DOI: 10.1136/bmjpo-2020-000972] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/26/2021] [Accepted: 02/01/2021] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To investigate primary infant caregiver awareness of the current national public health safe sleep messages and the associations of awareness with care practices. DESIGN AND SETTING A cross-sectional survey in Queensland, Australia. All families with live babies birthed during April-May 2017 were eligible. Questionnaires were distributed when infants were approximately 3 months old. PARTICIPANTS Of the 10 200 eligible families, 3341 (33%) primary caregivers participated. MAIN OUTCOME MEASURES Participants were asked: to recall key safe sleeping messages they were aware of (unprompted); questions about their infant care practices; and to select the current, national six safe sleeping messages (prompted multi-choice). RESULTS Overall, the majority of families are aware of sleep-related infant mortality and sudden infant death (3178/3317, 96%); however, approximately one in four caregivers (867/3292, 26%) could not identify the current six messages to promote safer infant sleep in a multi-choice question. Despite being aware of the six key messages, some caregiver practices did not always align with advice (336/2423, 14% were not smoke-free; 349/2423, 14% were not usually supine for sleep; 649/2339, 28% employed practices which may increase risk of head or face covering; 426/2423, 18% were not receiving breastmilk). CONCLUSIONS There is considerable scope for improvement in parent awareness and ability to recall key safe sleep messages. Awareness of advice does not always translate into safe infant care. Health promotion messaging to encourage safer infant sleep, ultimately aimed at reducing sudden unexpected infant deaths, needs more effective supportive strategies and dissemination if future campaigns are to be successful.
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Affiliation(s)
- Roni Cole
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Maroochydore DC, Queensland, Australia.,Women's and Families Service Group, Sunshine Coast Hospital and Health Service, Sunshine Coast, Queensland, Australia
| | - Jeanine Young
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Maroochydore DC, Queensland, Australia
| | - Lauren Kearney
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Maroochydore DC, Queensland, Australia
| | - John M D Thompson
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Maroochydore DC, Queensland, Australia.,Department of Paediatrics: Child and Youth Health, The University of Auckland, Auckland, New Zealand
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10
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Cole R, Young J, Kearney L, Thompson JMD. Infant care practices and parent uptake of safe sleep messages: a cross-sectional survey in Queensland, Australia. BMC Pediatr 2020; 20:27. [PMID: 31964354 PMCID: PMC6975091 DOI: 10.1186/s12887-020-1917-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 01/07/2020] [Indexed: 12/21/2022] Open
Abstract
Background Globally, the incidence of sleep-related infant mortality declined dramatically following the first public health campaigns seen internationally in the 1990s to reduce the risks of sudden infant death. However, Australian Sudden Unexpected Death in Infancy (SUDI) rates have plateaued with little change in incidence since 2004 despite two further public health safe sleep campaigns. This study aims to describe contemporary infant care practices employed by families related to the current public health SUDI prevention program. Methods A cross-sectional survey of 3341 Queensland primary caregivers with infants approximately 3-months of age was conducted using the Queensland Registry of Births, Deaths and Marriages as a sampling frame. Surveys were returned either via reply-paid mail or online. Questionnaires explored prevalence of infant care practices and awareness of safe sleep recommendations. Univariable analysis was used to generate descriptive statistics for key variables. Results Overall, only 13% of families routinely practised all six ‘Safe Sleeping’ program messages. More than one third (1118, 34%) of infants had slept in a non-supine sleep position at some time. Potentially hazardous sleep environments were common, with 38% of infants sleeping with soft items or bulky bedding, or on soft surfaces. Nearly half, for either day- or night-time sleeps, were routinely placed in a sleep environment that was not designed or recommended for safe infant sleep (i.e. a bouncer, pram, beanbag). Most babies (84%) were reportedly smoke free before and after birth. Sleeping in the same room as their caregiver for night-time sleeps was usual practice for 75% of babies. Half (1600, 50%) of all babies shared a sleep surface in the last two-weeks. At 8-weeks, 17% of infants were no longer receiving any breastmilk. Conclusions The prevalence rates of infant care practices among this Australian population demonstrate many families continue to employ suboptimal practices despite Australia’s current safe sleep campaign. Strategic approaches together with informed decisions about pertinent messages to feature within future public health campaigns and government policies are required so targeted support can be provided to families with young infants to aid the translation of safe sleep evidence into safe sleeping practices.
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Affiliation(s)
- Roni Cole
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sippy Downs, Queensland, Australia. .,Women and Families Service Group, Sunshine Coast Hospital and Health Service, Birtinya, Queensland, Australia.
| | - Jeanine Young
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Lauren Kearney
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sippy Downs, Queensland, Australia.,Women and Families Service Group, Sunshine Coast Hospital and Health Service, Birtinya, Queensland, Australia
| | - John M D Thompson
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sippy Downs, Queensland, Australia.,Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
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Blair PS, Ball HL, McKenna JJ, Feldman-Winter L, Marinelli KA, Bartick MC, Noble L, Calhoun S, Elliott-Rudder M, Kair LR, Lappin S, Larson I, Lawrence RA, Lefort Y, Marshall N, Mitchell K, Murak C, Myers E, Reece-Stremtan S, Rosen-Carole C, Rothenberg S, Schmidt T, Seo T, Sriraman N, Stehel EK, Wight N, Wonodi A. Bedsharing and Breastfeeding: The Academy of Breastfeeding Medicine Protocol #6, Revision 2019. Breastfeed Med 2020; 15:5-16. [PMID: 31898916 DOI: 10.1089/bfm.2019.29144.psb] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
A central goal of the Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient.
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Affiliation(s)
- Peter S Blair
- Centre for Academic Child Health, University of Bristol, Bristol, United Kingdom
| | - Helen L Ball
- Infancy and Sleep Centre, Department of Anthropology, Durham University, Durham, United Kingdom
| | - James J McKenna
- Department of Anthropology, Santa Clara University, Santa Clara, California.,Mother-Baby Sleep Lab, Department of Anthropology, University of Notre Dame, South Bend, Indiana
| | - Lori Feldman-Winter
- Department of Pediatrics, Division of Adolescent Medicine, Cooper Medical School of Rowan University, Camden, New Jersey
| | - Kathleen A Marinelli
- Department of Pediatrics, University of Connecticut School of Medicine, Farmington, Connecticut.,Connecticut Children's Medical Center, Division of Neonatology, Hartford, Connecticut
| | - Melissa C Bartick
- Department of Medicine, Cambridge Health Alliance and Harvard Medical School, Cambridge Massachusetts
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The Mother-Infant Sleep Nexus: Night-Time Experiences in Early Infancy and Later Outcomes. THE MOTHER-INFANT NEXUS IN ANTHROPOLOGY 2020. [DOI: 10.1007/978-3-030-27393-4_9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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13
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Marinelli KA, Ball HL, McKenna JJ, Blair PS. An Integrated Analysis of Maternal-Infant Sleep, Breastfeeding, and Sudden Infant Death Syndrome Research Supporting a Balanced Discourse. J Hum Lact 2019; 35:510-520. [PMID: 31184521 DOI: 10.1177/0890334419851797] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Breastfeeding and the place of sleep for the mother and the infant have been controversial internationally due to reported concerns regarding infant deaths despite the known benefits of exclusive and prolonged breastfeeding, which are increased by breastfeeding at night. The aims of this integrated analysis were to (a) review breastfeeding and maternal and infant sleep research literature via historical, epidemiological, anthropological, and methodological lenses; (b) use this information to determine where we are currently in safeguarding both infant lives and breastfeeding; and (c) postulate the direction that research might take from this point forward to improve our knowledge and inform our policy and practice. Despite well-meaning but unsuccessful campaigns in some countries to dissuade parents from sleeping with their babies, many breastfeeding mothers and caregivers do sleep with their infants whether intentionally or unintentionally. Taking cultural contexts and socio-ecological circumstances into consideration, data supports policies to counsel parents and caregivers on safe sleep practices, including bed-sharing in non-hazardous circumstances, particularly in the absence of parental smoking, recent parental alcohol consumption, or sleeping next to an adult on a sofa. Further research with appropriate methodology is needed to drill down on actual rates of infant deaths, paying close attention to the definitions of deaths, the circumstances of the deaths, and confounding factors, in order to ensure we have the best information with which to derive public health policy. Introduction and use of the concept of "breastsleeping" is a plausible way to remove the negative connotations of "co-sleeping" and redirect ongoing data-driven discussions and education of best practices of breastfeeding and sleep.
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Affiliation(s)
| | - Helen L Ball
- 2 Infancy & Sleep Centre, Department of Anthropology, Durham University, Durham, UK
| | - James J McKenna
- 3 Mother-Baby Behavioral Sleep Laboratory, Department of Anthropology, University of Notre Dame, Notre Dame, Indiana, USA
| | - Peter S Blair
- 4 Centre of Academic Child Health, Bristol Medical School, University of Bristol, Bristol, UK
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Ball HL, Tomori C, McKenna JJ. Toward an Integrated Anthropology of Infant Sleep. AMERICAN ANTHROPOLOGIST 2019. [DOI: 10.1111/aman.13284] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Helen L. Ball
- Director, Parent–Infant Sleep LabDepartment of Anthropology, Durham University Durham DH1 3LE UK
| | - Cecilia Tomori
- Assistant Professor, Parent–Infant Sleep LabDepartment of Anthropology, Durham University Durham DH1 3LE UK
| | - James J. McKenna
- Director, Mother–Baby Sleep Lab, Department of AnthropologyUniversity of Notre Dame South Bend Indiana USA
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Fuentes-Vega S, Castro PJ, Van der Veer R. Co-sleeping versus sleep training: publications with advice for parents. REVISTA DE LA FACULTAD DE MEDICINA 2017. [DOI: 10.15446/revfacmed.v65n2.59514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introducción. Uno de los temas centrales en la crianza de los hijos, y que se sabe tiene muchas posiciones diferentes en las publicaciones, es el sueño en los bebés.Objetivo. Describir las diferentes posiciones de las publicaciones que ofrecen asesoramiento a los padres chilenos sobre el sueño en bebés durante las últimas dos décadas.Materiales y métodos. Se seleccionaron 63 publicaciones disponibles para su compra o de referencia en Chile de las dos últimas décadas, las cuales dan consejos a los padres en relación al sueño de los bebés. Estas publicaciones se analizaron para luego caracterizarlas en relación a las posiciones de colecho y entrenamiento del sueño.Resultados. Se encontró que el 65% de las publicaciones analizadas aconseja, de alguna forma, el colecho y el 76% menciona el entrenamiento del sueño, expresando una tendencia a defender o aceptar la estrategia conocida como “rutinas positivas” en lugar del “dejar llorar”.Conclusiones. Los padres chilenos se enfrentan con información contradictoria: existe un debate sobre la regulación del sueño infantil en Iberoamérica y la opinión de los expertos difiere de la encontrada en muestras anglosajonas.
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Pease A, Ingram J, Blair PS, Fleming PJ. Factors influencing maternal decision-making for the infant sleep environment in families at higher risk of SIDS: a qualitative study. BMJ Paediatr Open 2017; 1:e000133. [PMID: 29637151 PMCID: PMC5862195 DOI: 10.1136/bmjpo-2017-000133] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 07/24/2017] [Accepted: 07/26/2017] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Qualitative interviews with mothers of babies at higher risk of sudden infant death syndrome (SIDS) were carried out to understand their views and decision-making process on the infant sleep environment and safe sleep messages. DESIGN AND SETTING Twenty semi-structured interviews were conducted between February and November 2014 in deprived areas of Bristol, UK. Mothers were asked about their decision-making for the infant sleep environment and safe sleep messages including infant sleep position, co-sleeping, smoking, dummy use, feeding and disrupted routines. The interviews were transcribed, coded and thematic analysis carried out. PARTICIPANTS Participants were invited based on an algorithm developed in a previous SIDS case control study that identified an increased risk of SIDS from four demographic characteristics: young maternal age, smoking during pregnancy, three or more children, and a measure of deprivation. The presence of three, or more characteristics led to being invited to take part in the qualitative study. RESULTS Factors influencing mothers' adherence to the safe sleep messages included previous experience and the credibility of the advice given. They described disrupted routines that led to risky scenarios with a belief that occasional risks were acceptable. Where circumstances made following the advice more difficult they found alternative strategies to reduce the risk, including the use of movement monitors, regular checking and a belief that lighter maternal sleep in the presence of a baby was protective. CONCLUSIONS Safer sleep messages should be tailored to fit with the lived realities of mothers, especially those at higher risk. The traditional list of 'do's' and 'don'ts' was not well accepted by this group. Interventions that seek to influence this higher-risk group should acknowledge mothers' own protective instincts and consider their beliefs and understanding behind the safer sleep messages if they are to be effective and encourage this group to change.
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Affiliation(s)
- Anna Pease
- Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Jenny Ingram
- Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Peter S Blair
- Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Peter J Fleming
- Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, Bristol, UK
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