Implementation of Safe Sleep Practice Recommendations for Infants in Inpatient Wards

Factors Associated with Safe Infant Sleep Practices in Saudi Arabia

Purpose

To assess mothers’ approaches to infant sleep practices.

Patients and Methods

A cross-sectional survey study was conducted on mothers with babies aged below five months who were attending paediatric clinics between November 1st, 2020, and January 5th, 2021, in Riyadh, Saudi Arabia.

Results

A total of 522 mothers participated in this study. A total of 38.9% practised exclusive formula feeding. A total of 61.9% of the participants practised the supine position. The majority (93.3%) of the mothers shared a room with their babies, while 34.7% shared a bed. Only 6.9% did not use any soft bedding. Age was a significant predictor associated with participant practices regarding sleeping and feeding positions (p < 0.05). Having two or more children was associated with improper sleeping practices (p < 0.05). Being non-Saudi and having a university degree or higher were associated with having a higher risk of unsafe practices regarding bed-sharing (p < 0.05). On the other hand, being contacted by a doctor, nurse, or other healthcare worker about safe sleep practices were an important factor that influenced safe practices regarding feeding (p < 0.05). Receiving care at a private hospital was associated with safer practices regarding sleeping position and bed-sharing (p < 0.05).

Conclusion

We observed high-risk sleeping practices among Saudi mothers. This includes using soft bedding and unsafe sleeping positions. The importance of this study lies in the future implementation of this result through public health measures aimed at at-risk populations.

Developmental Dysplasia of Hip and Post-natal Positioning: Role of Swaddling and Baby-Wearing

INTRODUCTION

Traditional swaddling, which implies restrictive immobilisation of the infant's lower limbs with the hips in forced extension and adduction, has been shown to be a risk factor for Developmental Dysplasia of Hip (DDH).

METHODS

We reviewed the literature regarding the correlation between DDH and post-natal positioning by swaddling and baby-wearing, to draw awareness of healthcare professionals towards an important risk factor for DDH that has often been overlooked.

RESULTS

There is overwhelming evidence in the literature, by both experimental and clinical studies, that proves the close association between improper post-natal positioning of the baby's hips in extension-adduction and an increased incidence of DDH. On the other hand, "hip safe" swaddling which allows unrestricted flexion-abduction movements of the infants' hips, and the use of baby-wearing devices which keep the lower limbs in an attitude of hip flexion-abduction and knee flexion, is optimal for hip development. Populations which practice these "hip-safe" techniques of infant immobilisation have a lower incidence of DDH as compared to those which practice restrictive immobilisation. Furthermore, populations which have adopted "hip-safe" positioning have demonstrated a significant decrease in the incidence of DDH. Understanding this association is vital, since this is a modifiable risk factor, rectification of which can decrease the incidence of DDH.

CONCLUSION

Policy makers and governments must design educational campaigns tailored to their respective populations to increase awareness regarding the benefits of "hip-safe" techniques of infant positioning, since this simple intervention has the potential of decreasing the incidence of DDH.