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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
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Prone infant sleeping despite the "Back to Sleep" campaign

M C Ottolini1, B E Davis, K Patel

  • 1Department of General Pediatrics and Adolescent Medicine, Center for Health Services and Clinical Research, Children's Research Institute, Children's National Medical Center, George Washington University School of Medicine and Hea.

Archives of Pediatrics & Adolescent Medicine
|May 14, 1999
PubMed

Insights

Prone sleeping increased significantly in infants up to 6 months, with male sex and lower maternal education as risk factors. Consistent "Back to Sleep" messaging is crucial to reduce sudden infant death syndrome risks.

Area of Science:

  • Pediatric Sleep Medicine
  • Infant Health and Safety

Background:

  • Safe infant sleep practices, including avoiding prone sleeping, are critical for reducing sudden infant death syndrome (SIDS) risk.
  • Understanding sleep position trends and associated risk factors during early infancy is essential for targeted prevention strategies.

Purpose of the Study:

  • To investigate changes in infant sleep position during the first six months of life.
  • To identify demographic and social factors associated with prone sleeping in infants.

Main Methods:

  • A prospective cohort study followed 348 healthy term newborns for six months.
  • Parents received instructions to avoid prone sleeping and recorded sleep positions monthly.
  • Pediatricians were surveyed regarding their sleep position advice.

Main Results:

  • Only 34% of infants maintained a consistent sleep position throughout the study.
  • Prone sleeping increased from 12.2% at birth to 32.0% at six months.
  • Risk factors for prone sleeping included male sex, lower maternal education, single marital status, siblings, and Black race; perceived infant comfort was a primary reason.

Conclusions:

  • Most infants start in non-prone positions, but prone sleeping increases significantly by six months.
  • Pediatricians should reinforce "Back to Sleep" messaging, particularly between 2-4 months, a critical period for prone sleeping and SIDS risk.
  • Parents should be advised against using prone sleeping for infant comfort.
Abstract

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