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What Do Pediatricians Tell Parents About Bed-Sharing?
Paula Schaeffer1, Andrea G Asnes2
1Department of Pediatrics, Yale School of Medicine, 1 Long Wharf Dr. Suite 130, New Haven, CT, 06511, USA. Paula.Schaeffer@yale.edu.
Insights
Pediatricians vary widely in their advice on infant bed-sharing, with most guidance not aligning with American Academy of Pediatrics (AAP) recommendations for safe sleep. Education is needed to improve consistency in safe sleep guidance.
Area of Science:
- Pediatrics
- Public Health
- Child Safety
Background:
- Bed-sharing with infants poses risks, yet pediatrician guidance on this practice is not well understood.
- The American Academy of Pediatrics (AAP) provides specific safe sleep recommendations, including guidelines on bed-sharing.
Purpose of the Study:
- To investigate pediatricians' views on infant bed-sharing.
- To determine the nature of advice pediatricians give parents regarding bed-sharing.
- To assess the alignment of pediatrician advice with AAP safe sleep guidelines.
Main Methods:
- Qualitative study design utilizing the Theory of Planned Behavior framework.
- Interviews conducted with 24 primary care pediatricians from diverse practice settings.
- Focus on anticipatory guidance provided to parents of infants at risk for Sudden Infant Death Syndrome (SIDS).
Main Results:
- Significant variation exists among pediatricians regarding bed-sharing advice.
- Some pediatricians strongly advise against bed-sharing, citing infant risks, while others perceive it as safe.
- Guidance on supine infant sleep is clearer than advice on avoiding bed-sharing.
Conclusions:
- Pediatrician advice on infant bed-sharing is inconsistent and often deviates from AAP recommendations.
- There is a need for enhanced pediatrician education to standardize safe sleep anticipatory guidance.
- Addressing pediatrician attitudes and behaviors is crucial for improving infant safe sleep practices.
Abstract:
Background and objectives Despite the risks of bed-sharing, little is known about what pediatricians tell parents about bed-sharing with infants and whether pediatricians provide specific recommendations outlined by the American Academy of Pediatrics (AAP). This study aimed to understand pediatricians' opinions about bed-sharing and the advice pediatricians provide to parents about bed sharing. Methods The study employed a qualitative study design and the conceptual framework of the Theory of Planned Behavior. 24 primary care pediatricians from a variety of practice settings were interviewed about the anticipatory guidance they provide to families whose infants are in the at-risk age group for SIDS. Results Pediatricians' opinions about bed-sharing differed widely both with respect to identifying bed-sharing as a topic they routinely address in anticipatory guidance as well as in what they tell parents about bed sharing. Some strongly and routinely advise against bed-sharing and identify bed-sharing as a clear risk to infants. Others believe bed-sharing to be both safe and useful. A third group allow the content of anticipatory guidance to be driven by parental concerns. Most pediatricians are clearer in their recommendation to place infants supine to sleep than in their recommendation to avoid bed-sharing. Conclusions Overall, there is considerable variation among pediatricians in the advice they provide about bed-sharing, and most advice is not congruent with the AAP recommendations. Additional efforts to educate pediatricians may be necessary to change attitudes and behaviors with respect to anticipatory guidance about safe sleep.
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