Wahakura Versus Bassinet for Safe Infant Sleep: A Randomized Trial

Area of Science:

• Public Health
• Pediatrics
• Sleep Medicine

Background:

• Sudden unexpected infant death (SUID) remains a concern, particularly in high-risk populations.
• Traditional indigenous sleep devices, like the wahakura, are being considered as alternatives to standard bassinets.
• Assessing the safety and impact of wahakura on infant sleep behaviors and breastfeeding is crucial.

Purpose of the Study:

• To compare the safety and infant sleep behaviors associated with wahakura versus bassinets.
• To evaluate the effect of wahakura on breastfeeding rates, maternal sleep, and fatigue.
• To inform public health policies regarding infant sleep devices in at-risk communities.

Main Methods:

• A randomized controlled trial involving 200 pregnant women from deprived areas in New Zealand.
• Infants were randomized to sleep in either a bassinet or a wahakura from birth.
• Data collected via questionnaires at 1, 3, and 6 months, and overnight infrared video at 1 month.

Main Results:

• No significant differences were found in infant-adult bed-sharing, head covering, or sleep position between wahakura and bassinet groups.
• The wahakura group reported a significantly higher rate of full breastfeeding at 6 months (22.5% vs 10.7%, P = .04).
• Maternal sleep and fatigue levels did not differ significantly between the two groups.

Conclusions:

• Wahakura are a relatively safe alternative to bassinets, with no increase in infant risk behaviors.
• Wahakura use is associated with improved and sustained breastfeeding rates.
• Promoting wahakura in high-risk populations may be beneficial and warrants supportive policies.