INFANT SLEEP POSITION FOLLOWING NEW AAP GUIDELINES

Objective. This report examines the response of families to the Americ an Academy of Pediatrics June 1992 recommendation that healthy term in fants be put to sleep on their back or side to decrease the risk of su dden infant death syndrome. Parents at two clinics and private practic es were interviewed to ascertain sleep position practices. Methods. Pa rents of infants from 1 to 6 months of age who were in the waiting roo m for a well-child visit were eligible for study. A total of 760 inter views were conducted using a closed-ended questionnaire. Parents were asked about sleep position, positional changes during sleep, and facto rs that influenced their decision to position their infant prone, side , or supine. Interviews were conducted from September 1993 through Apr il 1994. This interval was divided into two equal, 4-month time interv al. Sleep practices were compared during the first and second time per iods. Differences between practice and clinic groups were measured. Gr oups were compared using the chi-square test, with results considered significant at P <.05. Results. The number of infants placed side or s upine for sleep increased significantly since the inception of the stu dy, from 38.1% to 59.1%. Despite this increase, parents reported that the impetus for changing position came from family or the media, rathe r than from health professionals. Initially, the proportion of infants in private practices placed side or supine was greater than that of c linic patients. That difference disappeared by the end of the study. P rone positioning continued to be more prevalent in the 3- to 6-month-o ld infants than in the 1- to 8-month-old group. The majority of infant s at all ages awoke in the same position that they were put to sleep. Conclusions. Side and supine positioning for sleep increased in all so cioeconomic groups. A small number of infants placed side or supine fo r sleep are found prone on awakening. Health professionals need to inc rease their role in providing sleep position guidance. As the proporti on of the population positioning their infants side or supine for slee p increases, it should be possible to examine the effect on the sudden infant death syndrome rate.