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Patterns of Infant Sleep and Care Practices: 2016-2020

Abigail Holicky1,2, Kristin Rankin2, Rebecca K Campbell2

  • 1Division of Academic Internal Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois.

Pediatrics
|September 21, 2025
PubMed

Insights

Few mothers follow all infant sleep recommendations. Understanding common sleep patterns and their variation by demographics can help improve infant safety and reduce sudden unexpected infant death (SUID).

Area of Science:

  • Public Health
  • Pediatrics
  • Sleep Medicine

Background:

  • The American Academy of Pediatrics (AAP) provides evidence-based guidelines for infant sleep to prevent sudden unexpected infant death (SUID).
  • Understanding how these recommendations are implemented in real-world settings is crucial for effective public health strategies.
  • Common infant sleep and care practices can vary significantly based on demographic factors.

Purpose of the Study:

  • To identify and define common patterns of infant sleep and care practices in Illinois.
  • To assess the prevalence of these patterns across various maternal demographic characteristics.
  • To inform targeted interventions for improving infant sleep safety.

Main Methods:

  • Maternal self-reported data on AAP-recommended practices were collected from the 2016-2020 Illinois Pregnancy Risk Assessment Monitoring System.
  • Practices included breastfeeding duration, maternal smoking status, and four key sleep environment factors (back sleeping, safe surface, clear sleep area, no bed-sharing).
  • Nonhierarchical cluster analysis identified six distinct patterns of infant sleep and care practices, with prevalence analyzed across demographic variables using chi-squared tests.

Main Results:

  • Only 19.3% of mothers reported adherence to all six recommended practices; this varied significantly by demographics.
  • Identified patterns included: 8.1% adhering to all four sleep environment recommendations, 28.1% bed-sharing with breastfeeding, 11.7% bed-sharing without breastfeeding, 25.1% no bed-sharing with back sleeping, and 7.8% no bed-sharing with non-back sleeping.
  • Individual practice prevalence ranged from 49.6% (no items in sleep area) to 90.8% (no maternal smoking).

Conclusions:

  • Common patterns of infant sleep and care practices are diverse and do not consistently align with all AAP recommendations.
  • Significant demographic variations in these patterns highlight the need for tailored approaches to promote safe infant sleep.
  • Analyzing these patterns offers valuable insights for developing and refining interventions to reduce SUID.
Abstract

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