Survey of sleeping position recommendations for prematurely born infants on neonatal intensive care unit discharge
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Published on: August 25, 2014
Harish Rao1, Caroline May, Simon Hannam
1Division of Asthma, Allergy and Lung Biology, King's College London, MRC-Asthma Centre, Denmark Hill, UK.
Insights
Neonatal units increasingly recommend supine infant sleep before discharge. However, post-discharge recommendations for premature infants
Area of Science:
- Neonatal care
- Pediatric sleep safety
- Public health
Background:
- Premature infants face elevated risks of sudden infant death syndrome (SIDS), especially when placed in the prone sleeping position.
- Practitioner recommendations significantly influence parental infant sleep position choices.
- Previous surveys in 2001-2002 established baseline recommendations for infant sleep positions.
Purpose of the Study:
- To assess current neonatal unit recommendations for premature infant sleep positions before and after hospital discharge.
- To identify any shifts in these recommendations compared to a 2001-2002 survey.
Main Methods:
- A questionnaire survey was distributed to all 229 neonatal units across the United Kingdom.
- A response rate of 80% was achieved, providing data from 183 units.
Main Results:
- A significant increase was observed in units recommending supine sleeping 1-2 weeks prior to discharge (83%) compared to the previous survey (p < 0.0001).
- Post-discharge, only 38% of units actively discouraged prone sleeping, with 17% recommending side sleeping.
- Fewer units recommended side sleeping post-discharge (p = 0.0015), and disappointingly, fewer actively discouraged prone sleeping (p = 0.0001).
Conclusions:
- Current post-discharge sleep position recommendations for premature infants by some practitioners remain suboptimal.
- There is a critical need for evidence-based guidelines to standardize and improve neonatal unit recommendations.
- Implementing consistent, evidence-based guidelines could enhance sleep safety for premature infants after discharge.
Introduction:
Prematurely born infants are at an increased risk of sudden infant death syndrome (SIDS), particularly when sleeping prone. Parents are strongly influenced in their choice of sleeping position for their infant by practitioners. The aim of this study was to determine the neonatal units' recommendations regarding the sleeping position for premature infants prior to and after discharge and ascertain whether there had been changes from those recorded in a survey performed in 2001-2002.
Materials And Methods:
A questionnaire survey was sent to all 229 neonatal units in the United Kingdom; 80% responded.
Results And Discussion:
The majority (83%) of units utilized the supine sleep position for infants at least 1-2 weeks prior to discharge, but after discharge, only 38% of the units actively discouraged prone sleeping and 17% additionally recommended side sleeping. Compared to the previous survey, significantly more units started infants with supine sleeping 1-2 weeks prior to discharge (p < 0.0001) and fewer recommended side sleeping after discharge (p = 0.0015). However, disappointingly, less actively discouraged prone sleeping after discharge (p = 0.0001).
Conclusion:
Recommendations regarding sleeping position for prematurely born infants after neonatal discharge by some practitioners remain inappropriate. Evidence-based guidelines are required as these would hopefully inform all neonatal units' recommendations.
