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Updated: Jul 15, 2026

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Infant sleep position, head shape concerns, and sleep positioning devices
Lynne Hutchison1, Alistair Stewart, Edwin Mitchell
1Department of Paediatrics, School of Population Health, University of Aukland, Aukland, New Zealand. bl.hutchison@auckland.ac.nz
Aim:
The Back To Sleep campaign has successfully promoted the use of the supine sleep position for infants, with a corresponding decrease in sudden infant death syndrome death rates around the world. The aim of this study was to survey current infant sleep position practices, concerns about plagiocephaly, and the use of sleep positioning devices.
Methods:
A postal survey of 400 mothers of infants aged 6 weeks to 4 months was carried out in Auckland, New Zealand.
Results:
Of the 278 (69.5%) respondents, the supine position was usually used in 64.8%, the prone position in 2.9%, with 32.3% using the side position or a combination of side and back positions. Approximately one-third had a concern about their infant's head shape, and 80% described practices to help prevent head deformation. Thirty per cent reported they had changed their infant's sleep position because of head shape concerns. A third of the mothers used some sort of positioning system to maintain the infant's sleep position.
Conclusions:
Anxieties about plagiocephaly, aspiration of vomit, and poor quality sleep are the main concerns that parents have about sleeping their infants on their backs. Further education is needed to inform mothers about these issues and to alleviate their fears.
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