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Trends in infant bedding use: National Infant Sleep Position study, 1993-2010
Carrie K Shapiro-Mendoza1, Eve R Colson2, Marian Willinger3
1Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia; ayn9@cdc.gov.
Insights
Infant bedding use, a risk for suffocation, declined but remains common. Key predictors include young maternal age and non-white race, highlighting the need for targeted safe sleep interventions.
Area of Science:
- Pediatric Sleep Safety
- Public Health Surveillance
Background:
- Hazardous infant bedding (pillows, quilts, loose materials) is a risk factor for sudden infant death syndrome and suffocation.
- The prevalence of hazardous infant bedding use in the US was previously unknown.
Purpose of the Study:
- To determine the prevalence and trends of hazardous infant bedding use in the United States.
- To identify characteristics associated with infant bedding use.
Main Methods:
- Analysis of 1993-2010 data from the National Infant Sleep Position study.
- Classification of infants as bedding users if placed with blankets, quilts, or pillows for sleep.
- Logistic regression to identify predictors of bedding use.
Main Results:
- Bedding use decreased from 85.9% (1993-1995) to 54.7% (2008-2010) but remained prevalent.
- Highest prevalence was observed in infants of teen mothers (83.5%); lowest in term-born infants (55.6%).
- Young maternal age, non-white race/ethnicity, and lower education levels were significant predictors (2007-2010).
Conclusions:
- Infant sleep-related bedding use persists despite safety recommendations.
- Understanding trends is crucial for developing effective safe sleep interventions.
Background:
Use of potentially hazardous bedding, as defined by the American Academy of Pediatrics (eg, pillows, quilts, comforters, loose bedding), is a modifiable risk factor for sudden infant death syndrome and unintentional sleep-related suffocation. The proportion of US infants sleeping with these types of bedding is unknown.
Methods:
To investigate the US prevalence of and trends in bedding use, we analyzed 1993-2010 data from the National Infant Sleep Position study. Infants reported as being usually placed to sleep with blankets, quilts, pillows, and other similar materials under or covering them in the last 2 weeks were classified as bedding users. Logistic regression was used to describe characteristics associated with bedding use.
Results:
From 1993 to 2010, bedding use declined but remained a widespread practice (moving average of 85.9% in 1993-1995 to 54.7% in 2008-2010). Prevalence was highest for infants of teen-aged mothers (83.5%) and lowest for infants born at term (55.6%). Bedding use was also frequently reported among infants sleeping in adult beds, on their sides, and on a shared surface. The rate of decline in bedding use was markedly less from 2001-2010 compared with 1993-2000. For 2007 to 2010, the strongest predictors (adjusted odds ratio: ≥1.5) of bedding use were young maternal age, non-white race and ethnicity, and not being college educated.
Conclusions:
Bedding use for infant sleep remains common despite recommendations against this practice. Understanding trends in bedding use is important for tailoring safe sleep interventions.
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