Who Is Supplied With In-Bed Sleepers (Pēpi-Pod and Wahakura) for Reducing SUDI in New Zealand?

Smoking during pregnancy when combined with bedsharing is a major risk factor for Sudden Unexpected Death in Infancy (SUDI). In-bed sleepers like Pēpi-Pod and wahakura provide a safe space for infants within adult beds. But the distribution and reach of these devices to high-risk infants remain unclear. Therefore, this study aimed to assess who receives in-bed sleepers and determine if they are reaching infants at the highest risk of SUDI.

We conducted a retrospective cross-sectional study combining sales data analysis of Pēpi-Pod in-bed sleepers with data from the National Maternity Collection, Ministry of Health and Change for our Children from 2019 to 2021. We compared characteristics of infants receiving in-bed sleepers with all New Zealand births.

An estimated 15.9% of all infants born in New Zealand during 2019-2021 received in-bed sleepers, with significant regional variations. Only 37.5% of infants that were exposed to smoking during pregnancy received an in-bed sleeper. Of in-bed sleepers supplied, 72.9% were supplied to infants not exposed to smoking in pregnancy. In-bed sleeper reporting was poor, with only 36.4% of those supplied being reported.

The distribution of in-bed sleepers is not optimally targeted, consistently failing to reach high-risk infants, particularly those exposed to smoking in pregnancy. Therefore, improved strategies for distribution and reporting are necessary to enhance the effectiveness of this SUDI prevention measure.