INFANT SLEEP POSITION INSTRUCTION AND PARENTAL PRACTICE - COMPARISON OF A PRIVATE PEDIATRIC OFFICE AND AN INNER-CITY CLINIC

Objective. To determine infant sleep instructions that hospital person nel in our community were giving to parents and actual positions pract iced after the April 15, 1992 American Academy of Pediatrics recommend ation for nonprone positioning. Design. Survey of mothers of infants 4 months of age from November 1993 to March 1994 with follow-up survey of selected birth hospitals. Setting. A private practice (PP) serving predominantly white middle- and upper-income children and a pediatric clinic (CY) serving inner-city predominantly African-American low-inco me children in Louisville, Kentucky. Patients. Fifty infants from each practice site. Outcome Measure. The sleep instructions given and prac ticed, and other risk factors for sudden infant death syndrome (SIDS). Results. Nonprone sleeping instructions were received by 72% of the P P and only 48% of the CY parents, with 72% of the PP and 54% of the CY following the nonprone recommendations, Infants were more likely to b e in smoking households (60% vs 12%) from the CY practice than the PP practice. Conclusions. Our study showed that, despite having a higher prevalence of SIDS risk factors, there was a greater delay in disconti nuing prone positioning instructions in the hospital serving the CY in fants. The evidence suggests that this population is as likely as the PP group to follow medical advice given.