Paediatric study shows safe sleep position for babies is not happening in practice

The American Academy of Pediatrics has released a report featured on USA Today with the alarming news that most parents were putting babies in unsafe sleep environments associated with an increased risk of death. 

This is despite the myriad warnings from health care providers and public education campaigns - such as that in Australia presented by Sids and Kids.

The study reported that researchers videoed infants for one night at ages 1, 3 and 6 months in family homes. Most parents were seen placing babies at risk "by positioning them on their sides or stomachs, using soft sleep surfaces or loose bedding or sharing a bed with a parent".

Similar to Australian rates, U.S. statistics show sleep-related infant deaths are the most common cause of death for babies between one month and one year of age.This could include sudden infant death syndrome (SIDS) and accidental suffocation and strangulation in bed.

The study involved more than 160 infants with some dropping out. Videos show that duing the three nights of sleep that were videoed, 10-21% of babies were placed on a non-recommended sleep surface, 14-33% were placed in non-recommended positions and 87-93% had potentially hazardous items on their sleep surface.

L'il Fraser recommends that all items be taken out of cots or bassinets before placing baby inside.

The study backs this up with risky items named as loose blankets, stuffed animals, pillows, bumper pads and sleep positioners.

About 12-28% of the infants were moved in the middle of the night, mostly it was the younger babies, and these were were often placed "in an even riskier environment", according to the study, "such as sharing a bed with an adult."

The study was of a group of predominantly white and highly educated parents, a group pediatricians often think of as being at lower risk.

“It reminds us that this is something for all people to be aware of regardless of socioeconomic background or education levels,” an American Academy of Pediatrics fellow is quoted as saying. “This is a group of people you’d assume have access to resources and knowledge and are still not following the advice.”

The U.S. has been asking parents since the early nineties to place babies on their backs for sleep. As well, authorities warn of the dangers of loose items on the sleep surface.

“We are getting the word out but people aren’t acting on that,” said Catherine Spong, acting director of the National Institute of Child Health and Human Development. 

Perhaps it's information overload.

"Families with infants are often inundated with recommendations while leaving the hospital or at a check-up" says Ian Paul, author of the report and Professor of Pediatrics and Public Health Sciences at Penn State College of Medicine.

“Perhaps we have to make it even simpler,” he said. “We need to be extremely clear and unambiguous in our advice and we need to make sure we model safe sleep environment when babies are in the hospital.”

L'il Fraser swaddles are recommended for safe sleep positioning by Karitane parenting advice support network, with the proviso that parents cease swaddling after baby can roll over (around 4-5 months). This advice is in line with that offered by SIDS and Kids.