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Massare BA, Irvin CN, Hicks SD. Increased Sleep Latency and Decreased Sleep Duration are Associated With Elevated Risk of Bed Sharing Among Mother-Infant Dyads. Clin Pediatr (Phila) 2024; 63:708-713. [PMID: 37488931 PMCID: PMC11070114 DOI: 10.1177/00099228231188211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
Bed sharing increases risk of sleep-related infant deaths. We hypothesized that infant sleep difficulties increase bed sharing, independent of social determinants of health (SDOH). In total, 191 mother-infant dyads in a prospective, longitudinal cohort study completed the Brief Infant Sleep Questionnaire at 1, 4, 6, and 12 months. Sleep characteristics at 1 month (latency, duration, night awakenings) were compared between dyads with/without bed sharing in the first 12 months. Infants who participated in bed sharing slept fewer hours at night (7.1 ± 1.7 hours vs 8.3 ± 1.5 hours, P = .001, d = -0.79), and took longer to fall asleep (0.7 ± 0.6 hours vs 0.5 ± 0.5 hours, P = .021, d = 0.43), even when controlling for SDOH variables that influence bed sharing. Maternal perception of sleep problems did not differ between groups (P = .12). Our findings suggest that infants with quantifiable sleep difficulties at 1 month are more likely to bed share.
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Affiliation(s)
- Brittany A. Massare
- Department of Pediatrics, Penn State College of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Christine N. Irvin
- Department of Pediatrics, Penn State College of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Steven D. Hicks
- Department of Pediatrics, Penn State College of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
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Murata Y, Sakakibara H. Neck Hair-Thread Tourniquet Syndrome by Co-sleeping With Family: A Case Report and Literature Review. Cureus 2023; 15:e39620. [PMID: 37256166 PMCID: PMC10226386 DOI: 10.7759/cureus.39620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2023] [Indexed: 06/01/2023] Open
Abstract
Neck hair-thread tourniquet syndrome (NHTTS) is a rare condition that can be a pediatric emergency, occurring when a hair or thread becomes tightly wrapped around a body part, leading to vascular or tissue damage. NHTTS commonly affects infants and young children and can result in severe complications if not promptly diagnosed and treated. The unusual nature of this event, the diffuse petechial hemorrhage on the face, and the presentation of ligature marks extending around the neck led us to admit the child to the general pediatric ward for follow-up and further investigation of the possibility of non-accidental trauma. Co-sleeping is a common cultural practice in Japan where parents sleep in close proximity to their infants. This case report aims to raise awareness among pediatricians and parents about the possibility of NHTTS occurring in infants who co-sleep, particularly when a strand of hair becomes entangled around their neck, about the early detection and appropriate management of NHTTS. And we also summarize the reported NHTTS cases.
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Affiliation(s)
- Yuki Murata
- Department of Pediatrics, Tokyo Metropolitan Children's Medical Center, Tokyo, JPN
| | - Hiroshi Sakakibara
- Department of Pediatrics, Tokyo Metropolitan Children's Medical Center, Tokyo, JPN
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Mitchell EA, Rajay A, Freeman L, McIntosh C. Falls of newborn infants in a New Zealand hospital: A case series. J Paediatr Child Health 2023; 59:253-257. [PMID: 36367052 PMCID: PMC10099460 DOI: 10.1111/jpc.16275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 09/15/2022] [Accepted: 10/30/2022] [Indexed: 11/13/2022]
Abstract
AIM The fall of a newborn baby to the hospital floor is a devastating experience for the family and staff caring for the mother and baby. The aim of this study was to report our experience in an ethnically diverse and socioeconomically disadvantaged community. METHODS The study was a retrospective case series of all baby falls in the Counties Manukau Health (New Zealand) post-natal care wards, birthing suites and birthing units from 2015 to 2018. Information from the incident reporting system was used to identify the circumstances surrounding the fall. In addition, medical records of the mother and the baby were examined for the admission during which the fall occurred. RESULTS There were 32 cases (rate 12.1/10 000 live births). Mothers of babies who fell were more likely to present late for antenatal care, to smoke and be obese. They were more likely to have delivered by caesarean. Falls were more likely to occur at night and around weekends. In most instances (84%) the mother fell asleep with baby on the bed while breastfeeding. There were no major injuries. CONCLUSIONS The rate of baby falls is considerably greater than previous reports. Recommendations are made to reduce this occurrence. These can be incorporated into safe sleep education.
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Affiliation(s)
- Edwin A Mitchell
- Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
| | - Aakash Rajay
- Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
| | - Lesa Freeman
- Patient Safety and Quality Assurance Lead, Counties Manukau Health (CMDHB), Auckland, New Zealand
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MacFarlane ME, Thompson JMD, Wilson J, Lawton B, Taylor B, Elder DE, Baker N, McDonald GK, Zuccollo J, Schlaud M, Fleming P, Mitchell EA. Infant Sleep Hazards and the Risk of Sudden Unexpected Death in Infancy. J Pediatr 2022; 245:56-64. [PMID: 35120985 DOI: 10.1016/j.jpeds.2022.01.044] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 01/20/2022] [Accepted: 01/26/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To examine the effects of infant sofa-sleeping, recent use by caregivers of alcohol, cannabis, and/or other drugs, and bed type and pillows, on the risk of sudden unexpected death in infancy (SUDI) in New Zealand. STUDY DESIGN A nationwide prospective case-control study was implemented between March 2012 and February 2015. Data were collected during interviews with parents/caregivers. "Hazards" were defined as infant exposure to 1 or more of sofa-sleeping and recent use by caregivers of alcohol, cannabis, and other drugs. The interaction of hazards with tobacco smoking in pregnancy and bed sharing, including for very young infants, and the difference in risk for Māori and non-Māori infants, also were assessed. RESULTS The study enrolled 132 cases and 258 controls. SUDI risk increased with infant sofa-sleeping (imputed aOR [IaOR] 24.22, 95% CI 1.65-356.40) and with hazards (IaOR 3.35, 95% CI 1.40-8.01). The SUDI risk from the combination of tobacco smoking in pregnancy and bed sharing (IaOR 29.0, 95% CI 10.10-83.33) increased with the addition of 1 or more hazards (IaOR 148.24, 95% CI 15.72-1398), and infants younger than 3 months appeared to be at greater risk (IaOR 450.61, 95% CI 26.84-7593.14). CONCLUSIONS Tobacco smoking in pregnancy and bed sharing remain the greatest SUDI risks for infants and risk increases further in the presence of sofa-sleeping or recent caregiver use of alcohol and/or cannabis and other drugs. Continued implementation of effective, appropriate programs for smoking cessation, safe sleep, and supplying safe sleep beds is required to reduce New Zealand SUDI rates and SUDI disparity among Māori.
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Affiliation(s)
| | - John M D Thompson
- Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
| | - Jessica Wilson
- Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
| | - Beverley Lawton
- Centre for Women's Health Research, Victoria University of Wellington, Wellington, New Zealand
| | - Barry Taylor
- Women's and Children's Health, University of Otago, Otago, New Zealand
| | - Dawn E Elder
- Department of Paediatrics and Child Health, University of Otago, Wellington, New Zealand
| | - Nick Baker
- Department of Paediatrics, Nelson-Marlborough Hospital, Nelson, New Zealand
| | | | - Jane Zuccollo
- National Perinatal Pathology Service (NPPS), Auckland City Hospital, Auckland, New Zealand
| | - Martin Schlaud
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Peter Fleming
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, United Kingdom
| | - Edwin A Mitchell
- Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
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MacFarlane M, Thompson JMD, Mitchell EA, Lawton B, McLardy EM, Jonas SD, Tepania-Palmer G, Roa T, Warren G, Jowsey T. Pēpē-infant sleep practices and sudden unexpected death in infancy in Aotearoa New Zealand. Int J Gynaecol Obstet 2021; 155:305-317. [PMID: 34473352 DOI: 10.1002/ijgo.13910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 09/01/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To explore pēpē [infant] sleep practices and the key motivators among selected Māori and non-Māori māmā [mothers] in Auckland, New Zealand, in relation to the risk of sudden unexpected death in infancy (SUDI). METHODS Qualitative research underpinned by a kaupapa Māori cultural framework was undertaken. In-depth face-to-face interviews occurred in the homes of māmā with young pēpē born in Counties Manukau, Auckland. Interview transcripts were analyzed using general purpose thematic analysis. RESULTS Thirty māmā participated, including 17 Māori. Two-thirds of māmā reported previous or current bed sharing. The fundamental human need for adequate sleep motivated half the māmā in the present study, and especially Māori māmā, to bed share. The second most common reason given was closeness and convenience. This was followed by breastfeeding, which was cited as a reason by Māori māmā only. These findings were interpreted in terms of intrinsic fear, culture, and māmā deployment of knowledge. CONCLUSION Service providers are encouraged to respond to the lived experiences and cultural realities, values, and beliefs of māmā when designing and delivering effective SUDI prevention interventions. Innovative approaches for providing structured and opportunistic, culturally appropriate education and support around safe sleep are likely to be well-received by māmā and their whānau [family/ies].
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Affiliation(s)
- Melanie MacFarlane
- Department of Paediatrics: Child and Youth Health, Te Whare Wānanga o Tāmaki Makaurau-University of Auckland, Auckland, New Zealand
| | - John M D Thompson
- Department of Paediatrics: Child and Youth Health, Te Whare Wānanga o Tāmaki Makaurau-University of Auckland, Auckland, New Zealand
| | - Edwin A Mitchell
- Department of Paediatrics: Child and Youth Health, Te Whare Wānanga o Tāmaki Makaurau-University of Auckland, Auckland, New Zealand
| | - Beverley Lawton
- Te Tātai Hauora O Hine-Centre for Women's Health Research, Te Herenga Waka-Victoria University of Wellington, Wellington, New Zealand
| | | | | | | | - Tom Roa
- Te Pua Wānanga ki te Ao-Faculty of Māori and Indigenous Studies, Te Whare Wānanga o Waikato-University of Waikato, Hamilton, New Zealand
| | | | - Tanisha Jowsey
- Centre for Medical and Health Sciences Education, Te Whare Wānanga o Tāmaki Makaurau, Auckland, New Zealand
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Anderson TM, Allen K, Ramirez J, Mitchell EA. Circadian variation in sudden unexpected infant death in the United States. Acta Paediatr 2021; 110:1498-1504. [PMID: 33251652 PMCID: PMC8246563 DOI: 10.1111/apa.15695] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 11/23/2020] [Accepted: 11/25/2020] [Indexed: 02/06/2023]
Abstract
Aim To determine which factors are associated with sudden unexpected infant death (SUID) by time of day. Methods Data were analysed from the National Fatality Review Case Reporting System (2006‐2015). Out of 20 005 SUID deaths in 37 states, 12 191 (60.9%) deaths had a recorded nearest hour of discovery of the infant. We compared distribution patterns between time of death and 118 variables to determine which were significantly correlated with SUID time of death using advanced statistical modelling techniques. Results The 12‐hour time periods that were most different were 10:00 to 21:00 (daytime) and 22:00 to 09:00 (nighttime). The main features that were associated with nighttime SUID were bed sharing, younger infants, non‐white infants, placed supine to sleep and found supine, and caregiver was the parent. Daytime SUID was associated with older infants, day care, white infants, sleeping in an adult bed and prone sleep position. Factors not associated with time of death were sex of the infant, smoking and breastfeeding. Conclusion Sudden unexpected infant death deaths that occur at night are associated with a separate set of risk factors compared to deaths that occur during the day. However, to minimise risk, it is important to practice safe sleep guidelines during both nighttime and daytime sleep.
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Affiliation(s)
| | | | - Jan‐Marino Ramirez
- Seattle Children’s Research Institute Seattle WA USA
- Departments of Neurological Surgery and Pediatrics University of Washington School of Medicine Seattle WA USA
| | - Edwin A. Mitchell
- Department of Paediatrics: Child and Youth Health University of Auckland Auckland New Zealand
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Chang CT, Shunmugam P, Abdul Aziz NA, Abdul Razak NS, Johari N, Mohamad N, Ghazali R, Rajagam H, Hss AS. Exploring Malaysian mothers' plans on sleeping arrangement with their newborn. J Paediatr Child Health 2020; 56:426-431. [PMID: 31654469 DOI: 10.1111/jpc.14646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 09/02/2019] [Accepted: 09/10/2019] [Indexed: 11/26/2022]
Abstract
AIM Bed sharing is defined as a newborn sleeping in the same bed with an adult. Bed sharing may put the newborn at risk of suffocation due to accidental smothering. METHODS This was a quasi-experimental study conducted in a tertiary referral hospital. Healthy post-delivery Malaysian mothers were randomly selected and enrolled into the control or the intervention group. On the day of discharge, mothers in the intervention group were interviewed face-to-face in the post-natal ward on their plans for sleeping arrangement with their newborn. After the interview, mothers were advised not to bed share with their newborn and were given an educational leaflet on safe sleeping practices. One week after discharge, mothers in both groups were interviewed over the telephone regarding their actual sleeping arrangements with their newborn using the same questionnaire. Logistic regression was performed to determine factors associated with reduced bed sharing. RESULTS A total of 94 mothers and 95 mothers were recruited to the control and intervention group, respectively. The baseline bed-sharing prevalence was similar between groups: 60.6% in the control group and 61.1% in the interventional group. The proportion of mothers who bed shared with their newborn reduced from 61.1 to 37.9% after the intervention (P < 0.001). Most mothers in the control group opted for bed sharing to ease breastfeeding (68.4%). Mothers in the control group had a 5.9 times higher odds of bed sharing. CONCLUSIONS In this study, the majority of mothers practiced bed sharing at baseline. A significant proportion of mothers changed their sleeping practices after receiving the intervention in the form of an information leaflet.
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Affiliation(s)
- Chee-Tao Chang
- Clinical Research Centre, Hospital Raja Permaisuri Bainun, Ministry of Health Malaysia, Ipoh, Malaysia
| | - Pavithrah Shunmugam
- Clinical Research Centre, Hospital Raja Permaisuri Bainun, Ministry of Health Malaysia, Ipoh, Malaysia
| | | | - Noor Shahizan Abdul Razak
- Allied Health Science College Sultan Azlan Shah, Ministry of Health Malaysia, Tanjung Rambutan, Malaysia
| | - Nurhidayatun Johari
- Allied Health Science College Sultan Azlan Shah, Ministry of Health Malaysia, Tanjung Rambutan, Malaysia
| | - Norazra Mohamad
- Allied Health Science College Sultan Azlan Shah, Ministry of Health Malaysia, Tanjung Rambutan, Malaysia
| | - Roswati Ghazali
- Allied Health Science College Sultan Azlan Shah, Ministry of Health Malaysia, Tanjung Rambutan, Malaysia
| | - Haymalatha Rajagam
- Allied Health Science College Sultan Azlan Shah, Ministry of Health Malaysia, Tanjung Rambutan, Malaysia
| | - Amar-Singh Hss
- Clinical Research Centre, Hospital Raja Permaisuri Bainun, Ministry of Health Malaysia, Ipoh, Malaysia
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Elsey T, Keller PS, El-Sheikh M. The role of couple sleep concordance in sleep quality: Attachment as a moderator of associations. J Sleep Res 2019; 28:e12825. [PMID: 30790373 DOI: 10.1111/jsr.12825] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 12/10/2018] [Accepted: 12/18/2018] [Indexed: 12/31/2022]
Abstract
Despite most American adults sharing a bed with a romantic partner, sleep research has examined sleep primarily as an individual behaviour. A growing body of research indicates that couple bed sharing may have an impact on sleep quality, but the current study is the first to examine whether such associations may differ based on attachment security. A sample of 179 cohabiting heterosexual couples completed daily sleep diaries and surveys of their attachment security, avoidance and anxiety. Data were analysed using multilevel modelling. Greater attachment security and lower attachment avoidance were associated with greater subjective sleep quality. Greater sleep concordance (time in bed with partners) was associated with better subjective sleep quality for women with lower attachment security and higher attachment avoidance. Findings suggest that couple bed sharing may benefit the subjective sleep quality of women who have lower attachment security.
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Affiliation(s)
- Taylor Elsey
- Department of Developmental Psychology, University of Kentucky, Lexington, Kentucky
| | - Peggy S Keller
- Department of Developmental Psychology, University of Kentucky, Lexington, Kentucky
| | - Mona El-Sheikh
- Department of Human Development and Family Studies, Auburn University, Auburn, Alabama
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Stiffler D, Ayres B, Fauvergue C, Cullen D. Sudden infant death and sleep practices in the Black community. J SPEC PEDIATR NURS 2018; 23:e12213. [PMID: 29479813 DOI: 10.1111/jspn.12213] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 11/30/2017] [Accepted: 01/24/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE A Black infant dies every 13 hours in the state of Indiana. The overall infant mortality rate in 2013 was 7.2 deaths per 1000 live births, but for Black infants, the rate was 15.3 deaths per 1000 live births. For over 20 years, placing an infant to sleep on his back has decreased the death rate from sudden unexpected infant death (SUID) and sudden infant death syndrome (SIDS), but many Black families continue to advocate bed sharing, prone sleeping, and inappropriate bedding/sleep surfaces, predisposing an infant to a significantly higher risk for SUID/SIDS. Therefore, the purpose of this study is to understand why Black women are less likely than White women to follow safe sleep recommendations for their infants. DESIGN A rigorous search of the literature was performed by searching the Web of Science, OVID, CINAHL, PsychINFO, and PubMed using the search terms: infant or child, death, loss, SIDS, SUID, qualitative, African American, Black, culture, safe sleep, experiences, and United States. A total of 217 articles were obtained. After review of inclusion and exclusion criteria and critical appraisal, only seven articles remained for the research study. METHODS The meta-synthesis of these seven original qualitative studies was performed using the Qualitative Assessment and Review Instrument from the Joanna Briggs Institute to assist with data management. Data were extracted and representative quotations were categorized. Categories were arranged into like themes. Themes were then synthesized with meta-aggregation. RESULTS A total of 17 subthemes were identified and were formulated into three primary themes: convenience, safety, and culture. The final synthesized theme was that Black mothers are motivated by their beliefs. PRACTICE IMPLICATIONS Black mothers tend to believe that SUIDS/SIDS is a random occurrence and is not preventable, so they see a little reason to make their infant sleep in a cold, hard crib, when they could sleep in a warm, comfortable bed with them. Nurses should work with Black mothers to understand their cultural beliefs while educating them about safe sleep practices.
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Affiliation(s)
| | - Brook Ayres
- Indiana University Health, Indianapolis, IN, USA
| | | | - Deborah Cullen
- Indiana University School of Nursing, Indianapolis, IN, USA
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Kim E, Lee R, Cain KC. Cosleeping, sleep disturbances, children's behavioral problems, and parenting self-efficacy among Korean American families. J Child Adolesc Psychiatr Nurs 2017; 30:112-120. [PMID: 28983997 DOI: 10.1111/jcap.12182] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 08/05/2017] [Accepted: 09/10/2017] [Indexed: 11/30/2022]
Abstract
The purpose of this study was to compare sleep disturbances of children and their mothers, children's behavioral problems, and parenting self-efficacy between Korean American families who coslept and those who did not cosleep. Forty-eight mothers of children between 3 and 8 years of age completed the following surveys: Children's Sleep Habits Questionnaire, Pediatric Symptom Checklist, Pittsburgh Sleep Quality Index, Parenting Self-Efficacy Questionnaire, and Acculturation Rating Scale for Mexican Americans II. Overall, 48% (n = 23) of families coslept, and families with younger children coslept more than families with older children (x2=12.48,p<.05). When the families were divided into non-cosleeping (i.e., rarely) and cosleeping (i.e., sometimes and usually) groups, 100% of the cosleeping children had sleep disturbances compared to 56% of the non-cosleeping children (x2=8.67,p<.01). For mothers, 28% (n = 7) of the non-cosleeping mothers reported sleep disturbances, compared to 52% (n = 12) of the cosleeping mothers (x2=2.93,p=.08). Children's behavioral problems were not different between the two groups (F = 1.78, p = NS). Cosleeping mothers reported lower parenting self-efficacy than non-cosleeping mothers (F = 6.26, p < .05). When providing care to Korean American families with young children, their cosleeping, sleep disturbances, and parenting self-efficacy need to be addressed.
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Affiliation(s)
- Eunjung Kim
- Department of Family and Child Nursing, University of Washington, Seattle, WA, USA
| | - Rachel Lee
- Seattle Public Schools, Seattle, WA, USA
| | - Kevin C Cain
- School of Nursing, University of Washington, Seattle, WA, USA
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Dempers JJ, Coldrey J, Burger EH, Thompson V, Wadee SA, Odendaal HJ, Sens MA, Randall BB, Folkerth RD, Kinney HC. The Institution of a Standardized Investigation Protocol for Sudden Infant Death in the Eastern Metropole, Cape Town, South Africa ,. J Forensic Sci 2016; 61:1508-1514. [PMID: 27677096 DOI: 10.1111/1556-4029.13204] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 09/30/2015] [Accepted: 01/04/2016] [Indexed: 11/27/2022]
Abstract
The rate for the sudden infant death syndrome (SIDS) in Cape Town, South Africa, is estimated to be among the highest in the world (3.41/1000 live births). In several of these areas, including those of extreme poverty, only sporadic, nonstandardized infant autopsy, and death scene investigation (DSI) occurred. In this report, we detail a feasibility project comprising 18 autopsied infants with sudden and unexpected death whose causes of death were adjudicated according to the 1991 NICHD definitions (SIDS, n = 7; known cause of death, n = 7; and unclassified, n = 4). We instituted a standardized autopsy and infant DSI through a collaborative effort of local forensic pathology officers and clinical providers. The high standard of forensic investigation met international standards, identified preventable disease, and allowed for incorporation of research. We conclude that an effective infant autopsy and DSI protocol can be established in areas with both high sudden unexpected infant death, and elsewhere. (SUID)/SIDS risk and infrastructure challenges.
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Affiliation(s)
- Johan J Dempers
- Division of Forensic Medicine and Pathology, Department of Pathology and Western Cape Forensic Pathology Health Services, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Jean Coldrey
- Department of Obstetrics and Gynecology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Elsie H Burger
- Division of Forensic Medicine and Pathology, Department of Pathology and Western Cape Forensic Pathology Health Services, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Vonita Thompson
- Western Cape Forensic Pathology Service, Cape Town, South Africa
| | - Shabbir A Wadee
- Division of Forensic Medicine and Pathology, Department of Pathology and Western Cape Forensic Pathology Health Services, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Hein J Odendaal
- Department of Obstetrics and Gynecology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Mary Ann Sens
- Department of Pathology, University of North Dakota, Grand Forks, ND
| | - Brad B Randall
- Department of Pathology, Sanford University of South Dakota School of Medicine, Sioux Falls, SD
| | - Rebecca D Folkerth
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Department of Pathology, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Hannah C Kinney
- Department of Pathology, Boston Children's Hospital and Harvard Medical School, Boston, MA
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Cullen D, Vodde CR, Williams KJ, Stiffler D, Luna G. Infant Co-Bedding: Practices and Teaching Strategies. J SPEC PEDIATR NURS 2016; 21:54-63. [PMID: 27058962 DOI: 10.1111/jspn.12140] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 01/24/2016] [Accepted: 01/28/2016] [Indexed: 11/30/2022]
Abstract
PURPOSE Studies show that co-bedding is a common cause of death in babies. The purpose of this study is to identify teaching strategies that can be used to increase safe sleep practices. DESIGN AND METHODS A rigorous systematic literature search identified articles that expressed ways in which to provide co-bedding teaching or provided recommended approaches to educating mothers and families about co-bedding risks. NOTARI software, from OVID Tools, was used to appraise articles, extract data, and thematically organize the findings, resulting in meta-aggregation. RESULTS Two major findings were synthesized from four categories. First, co-bedding occurred despite knowing risks and having received teaching. Second, families should receive co-bedding messages tailored to their specific circumstances and risks. PRACTICE IMPLICATIONS Findings showed that the lack of dialogue in co-bedding teaching often deters caregivers and families from seeking further education or consultation. Nurses need to ensure that safe sleep practices are taught and that the material provided pertains to the caregiver's specific cultural and familial situation.
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Affiliation(s)
- Deborah Cullen
- Professor, Science of Nursing Care Department, Indiana University School of Nursing
| | - Cassandra R Vodde
- Honors Student, Science of Nursing Care Department, Indiana University School of Nursing
| | - Katherine J Williams
- Honors Student, Science of Nursing Care Department, Indiana University School of Nursing
| | - Deborah Stiffler
- Associate Professor, Science of Nursing Care Department, Indiana University School of Nursing, Indianapolis, Indiana, USA
| | - Gaye Luna
- Professor, Higher Education, Northern Arizona University, Phoenix, Arizona, USA
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Keys EM, Rankin JA. Bed Sharing, SIDS Research, and the Concept of Confounding: A Review for Public Health Nurses. Public Health Nurs 2015; 32:731-7. [PMID: 25941007 DOI: 10.1111/phn.12200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Confounding is an important concept for public health nurses (PHNs) to understand when considering the results of epidemiological research. The term confounding is derived from Latin, confundere, which means to "mix-up" or "mix together". Epidemiologists attempt to derive a cause and effect relationship between two variables traditionally known as the exposure and disease (e.g., smoking and lung cancer). Confounding occurs when a third factor, known as a confounder, leads to an over- or underestimate of the magnitude of the association between the exposure and disease. An understanding of confounding will facilitate critical appraisal of epidemiological research findings. This knowledge will enable PHNs to strengthen their evidence-based practice and better prepare them for policy development and implementation. In recent years, researchers and clinicians have examined the relationship between bed sharing and sudden infant death syndrome (SIDS). The discussion regarding the risk of bed sharing and SIDS provides ample opportunity to discuss the various aspects of confounding. The purpose of this article is to use the bed sharing and SIDS literature to assist PHNs to understand confounding and to apply this knowledge when appraising epidemiological research. In addition, strategies that are used to control confounding are discussed.
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Affiliation(s)
- Elizabeth M Keys
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
| | - James A Rankin
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
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Wennergren G, Nordstrand K, Alm B, Möllborg P, Öhman A, Berlin A, Katz‐Salamon M, Lagercrantz H. Updated Swedish advice on reducing the risk of sudden infant death syndrome. Acta Paediatr 2015; 104:444-8. [PMID: 25656219 PMCID: PMC6680202 DOI: 10.1111/apa.12966] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 01/25/2015] [Accepted: 02/02/2015] [Indexed: 12/27/2022]
Abstract
This article reviews updated advice and factual material from the Swedish National Board of Health and Welfare on reducing the risk of sudden infant death syndrome. Issues covered by the guidance for parents and healthcare professionals include sleeping positions, smoking, breastfeeding, bed sharing and using pacifiers. Conclusion The guidelines conclude that infants under three months of age are safest sleeping in their own cot and that a pacifier can be used when they are going to sleep.
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Affiliation(s)
- Göran Wennergren
- Department of Paediatrics University of Gothenburg Queen Silvia Children's Hospital Gothenburg Sweden
| | | | - Bernt Alm
- Department of Paediatrics University of Gothenburg Queen Silvia Children's Hospital Gothenburg Sweden
| | - Per Möllborg
- Department of Paediatrics University of Gothenburg Queen Silvia Children's Hospital Gothenburg Sweden
| | - Anna Öhman
- Department of Paediatrics University of Gothenburg Queen Silvia Children's Hospital Gothenburg Sweden
| | - Anita Berlin
- Centre for Family and Community Medicine Department of Neurobiology, Care Sciences and Society Karolinska Institute Stockholm Sweden
| | - Miriam Katz‐Salamon
- Department of Women's and Children's Health Karolinska Institute Stockholm Sweden
| | - Hugo Lagercrantz
- Department of Women's and Children's Health Karolinska Institute Stockholm Sweden
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Davanzo R, De Cunto A, Paviotti G, Travan L, Inglese S, Brovedani P, Crocetta A, Calligaris C, Corubolo E, Dussich V, Verardi G, Causin E, Kennedy J, Marrazzo F, Strajn T, Sanesi C, Demarini S. Making the first days of life safer: preventing sudden unexpected postnatal collapse while promoting breastfeeding. J Hum Lact 2015; 31:47-52. [PMID: 25339551 DOI: 10.1177/0890334414554927] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Early and prolonged skin-to-skin contact (SSC) after birth between a mother and her newborn has been shown to generate beneficial effects on the mother-infant relationship and breastfeeding. Close mother-infant body contact immediately after birth positively enhances exclusive breastfeeding during the hospital stay, with a dose-response relationship. Skin-to-skin contact may ease the infant's transition to extra-uterine life and helps regulate the infant's body temperature and nursing behavior. However, reports of sudden unexpected postnatal collapse (SUPC) soon after birth, in healthy term neonates, in association with SSC, have raised concerns about the safety of this practice. Based on available evidence, we developed a surveillance protocol in the delivery room and postnatal ward of the Institute for Maternal and Child Health of Trieste (Italy). The aim of our protocol is (a) to promote safe mother and infant bonding and (b) to establish successful breastfeeding, without increasing the risk of SUPC. As there is no known effective intervention to prevent SUPC, our protocol has been conceived as a potential best practice.
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Affiliation(s)
- Riccardo Davanzo
- Department of Perinatal Medicine, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Angela De Cunto
- Department of Perinatal Medicine, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Giulia Paviotti
- Department of Perinatal Medicine, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Laura Travan
- Department of Perinatal Medicine, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Stefania Inglese
- Division of Obstetrics & Gynecology, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Pierpaolo Brovedani
- Department of Perinatal Medicine, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Anna Crocetta
- Division of Pediatrics, San Polo Hospital, Monfalcone, Italy
| | | | - Elisa Corubolo
- Division of Obstetrics & Gynecology, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Valentina Dussich
- Division of Obstetrics & Gynecology, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Giuseppa Verardi
- Division of Obstetrics & Gynecology, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Enrica Causin
- Department of Perinatal Medicine, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Jaquelyn Kennedy
- Department of Perinatal Medicine, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Francesca Marrazzo
- Department of Perinatal Medicine, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Tamara Strajn
- Department of Perinatal Medicine, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Cecilia Sanesi
- Department of Perinatal Medicine, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Sergio Demarini
- Department of Perinatal Medicine, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
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Fu LY, Colson ER, Corwin MJ, Moon RY. Infant sleep location: associated maternal and infant characteristics with sudden infant death syndrome prevention recommendations. J Pediatr 2008; 153:503-8. [PMID: 18582898 DOI: 10.1016/j.jpeds.2008.05.004] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2008] [Revised: 04/09/2008] [Accepted: 05/01/2008] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To identify factors associated with infant sleep location. STUDY DESIGN Demographic information and infant care practices were assessed for 708 mothers of infants ages 0 to 8 months at Women, Infants and Children centers. Generalized linear latent mixed models were constructed for the outcome, sleeping arrangement last night (room-sharing without bed-sharing versus bed-sharing, and room-sharing without bed-sharing versus sleeping in separate rooms). RESULTS Two-thirds of the mothers were African-American. A total of 48.6% mothers room-shared without bed-sharing, 32.5% bed-shared, and 18.9% slept in separate rooms. Compared with infants who slept in separate rooms, infants who room-shared without bed-sharing were more likely to be Hispanic (odds ratio [OR], 2.58, 95% CI 1.11-5.98) and younger (3.66- and 1.74-times more likely for infants 0-1 month old and 2-3 months old, respectively, as compared with older infants). Compared with infants who bed-shared, infants who room-shared without bed-sharing were more likely to be 0 to 1 month old (OR, 1.57; 95% CI, 1.05-2.35) and less likely to be African-American (OR, 0.43; 95% CI, 0.26-0.70) or have a teenage mother (OR, 0.37; 95% CI, 0.23-0.58). CONCLUSIONS Approximately one-third of mothers and infants bed-share, despite increased risk of sudden infant death syndrome (SIDS). The factors associated with bed-sharing are also associated with SIDS, likely rendering infants with these characteristics at high risk for SIDS.
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Abstract
This exploratory study examined family sleep patterns and quality in a setting of normative napping and cosleeping. Participants were 78 members of 16 families from 2 locales in Egypt (Cairo and a village). Each family member provided a history of sleeping arrangements, 1 week of continuous activity records, and details of each sleep event. Sleep records documented late-onset and dispersed sleep patterns with extensive cosleeping. Of recorded sleep events, 69% involved cosleeping, 24% included more than 1 cosleeper, and only 21% were solitary. Mid-late afternoon napping occurred on 31% of days, and night sleep onsets averaged after midnight. Age and gender structured sleep arrangements and, together with locale, extensively explained sleep behavior (onset, duration, total) and quality. Cosleepers had fewer night arousals, shorter and less variable night sleep duration, and less total sleep. Increased solitary sleep in adolescents and young adults was associated with increased sleep dysregulation, including exaggerated phase shifts in males and more nighttime arousals in females. Where normative, cosleeping may provide psychosensory stimuli that moderate arousal and stabilize sleep. Such moderating features may address important self-regulatory developmental needs during adolescence.
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Affiliation(s)
- Carol M Worthman
- Department of Anthropology, Emory University, Atlanta, GA 30322, USA.
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