Not All Parents Put Babies to Sleep on Back
Study Shows Advice on SIDS Prevention Isn't Being Heeded
Dec. 7, 2009 -- Despite warnings that it is safest to place a baby to sleep
on his or her back, the number of caregivers doing so has not increased in
recent years, according to a new report.
The National Institute of Child Health and Human Development's "Back to
Sleep" campaign began in 1994 after compelling evidence showed that babies who
slept on their backs had a much lower risk for sudden infant death syndrome
(SIDS). In the U.S., SIDS is the No. 1 cause of death in children under age
Since the campaign began, the number of babies being put to sleep on their
backs jumped from 25% to 70%. But the number of caregivers heeding the advice
has not changed since 2001, say Yale School of Medicine researchers.
The researchers looked at how 15,000 caregivers positioned their babies to
sleep since the campaign launch, using information from the National Infant
Sleep Position Study, an annual telephone survey of about 1,000 households with
infants. The survey asks nighttime caregivers of babies 7 months old and
younger: "Do you have a position you usually place your baby in?"
The study also revealed a racial disparity in sleeping positions. "We ...
found that African Americans still lag behind caregivers of other races by
about 20 percent in following this practice," Eve Colson, MD, associate
professor of pediatrics at Yale School of Medicine, says in a news release.
Choosing Sleep Positions
Colson and her team recently identified three key factors associated with a
caregiver's choice of an infant's sleeping position:
- Whether the caregiver was told by a doctor to place the baby to sleep on
- Concerns for the baby's comfort
- Fear of the infant choking while sleeping
While a third of the caregivers surveyed said their doctor did recommend
putting their babies to sleep on the back, others said they either were given
other advice or did not receive a recommendation at all.
More than a third of those surveyed said they didn't think the baby would be
comfortable sleeping on his or her back. Those who did not bring up this
concern were four times more likely to follow the Back to Sleep guidelines.
Ten percent of caregivers said they thought their infant might choke while
sleeping on his or her back. However, those who did not report this concern
were much more likely to put their babies in the back position.
"For the vast majority of infants, concerns about choking while back
sleeping are unfounded," Marian Willinger, PhD, special assistant for SIDS
research at the Eunice Kennedy Shriver National Institute of Child Health and
Human Development (NICHD), emphasizes in a news release. "Placing infants on
their backs for sleep remains the single most effective means we know to reduce
the risk of sudden infant death syndrome."
Willinger notes that in certain health conditions, a doctor may recommended
against back sleeping, but only after carefully weighing the risks and benefits
to the infant.