Abstract
Objective to evaluate women’s knowledge about the best baby sleeping position and to identify factors associated with a greater probability of putting infants to sleep in an unsafe position, in Rio Grande, Southern Brazil. Method This is a cross-sectional population-based study that included all women who bore children in 2013 in this municipality. A single, standardized questionnaire was given within 48 h after delivery in the only two local maternity hospitals. The outcome was that women reported the lateral and the ventral decubitus as the best sleeping positions for babies. A Chi square test was used for proportions and Poisson regression was used with robust variance adjustment in the multivariate analysis. The prevalence ratio was the measure of effect used. Results We included 2624 women in this study. Of these, 82.1% (95% CI 80.6–83.6) stated that the baby should sleep in the lateral or ventral decubitus positions. 76.4% reported having acquired this knowledge from their mothers and 34.7% were willing to adopt the correct (supine) sleeping position for their child if recommended by doctors. The adjusted analysis showed that the lower the schooling of the mothers and the greater the number of people per bedroom and number of children, the greater the probability of women choosing an unsafe baby sleeping position. Conclusions for Practice This study showed that the percentage of women who are unaware of the correct baby sleeping position is very high, that doctors should be convinced to recommend the supine baby sleeping position, and that campaigns on this subject should also include grandparents as a priority intervention group.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
AAP. (2016) Task force on sudden death infant death syndrome SIDS and other sleep-related infant deaths: Update 2016. Recommendations for a safe infant sleeping environment. Pediatrics, 138(5), e20162938.
Aitken, M. E., Rose, A., Mullins, S. H., Miller, B. K., Nick, T., Rettiganti, M., et al. (2016). Grandmothers’ beliefs and practices in infant safe sleep. Maternal and Child Health Journal. https://doi.org/10.1007/s10995-016-1945-9.
Barros, A. J., & Hirakata, V. N. (2003). Alternatives for logistic regression in cross-sectional studies: An empirical comparison of models that directly estimate the prevalence ratio. BMC Medical Research Methodology 3, 21.
Bezerra, M. A. D. L., Carvalho, K. M., Bezerra, J. L. D. O., Novaes, L. F. G., Moura, T. H. M. D., & Leal, L. P. (2015). Factors associated with knowledge of mothers on Sudden Infant Death Syndrome. Escola Anna Nery - Revista de Enfermagem, 19(2), 303–309. https://doi.org/10.5935/1414-8145.20150041.
Brasil, Ministério da Saúde. (2013). DATASUS. Retrieved June 15, 2016, from http://tabnet.datasus.gov.br/cgi/deftohtm.exe?sim/cnv/inf10uf.def.
Brasil, Ministério da Saúde. (2016). Indicadores do rol de Diretrizes, Objetivos, Metas e Indicadores 2015. Retrieved June 15, 2016, from http://tabnet.datasus.gov.br/cgi/pacto/2015/coapcirmap.htm.
Cesar, J. A., Cunha, C. F., Sutil, A. T., & Santos, G. B. D. (2013). The opinion of mothers regarding babies’ sleeping position after a national campaign: A population-based study in the far south of Brazil. Revista Brasileira de Saúde Materno Infantil, 13(4), 329–333.
Colson, E. R., Rybin, D., Smith, L. A., Colton, T., Lister, G., & Corwin, M. J. (2009). Trends and factors associated with infant sleeping position: The national infant sleep position study, 1993–2007. Archives of Pediatrics & Adolescent Medicine, 163(12), 1122–1128. https://doi.org/10.1001/archpediatrics.2009.234.
Gaydos, L. M., Blake, S. C., Gazmararian, J. A., Woodruff, W., Thompson, W. W., & Dalmida, S. G. (2015). Revisiting safe sleep recommendations for African-American infants: Why current counseling is insufficient. Maternal and Child Health Journal, 19(3), 496–503. https://doi.org/10.1007/s10995-014-1530-z.
Geib, L. T. C., & Nunes, M. L. (2006). Hábitos de sono relacionados à síndrome da morte súbita do lactente: Estudo populacional. [Sleeping habits related to sudden infant death syndrome: A population-based study]. Cad Saúde Pública = Public Health Reports, 22(2), 415–423.
Hwang, S. S., Rybin, D. V., Heeren, T. C., Colson, E. R., & Corwin, M. J. (2016). Trust in sources of advice about infant care practices: The SAFE study. Maternal and Child Health Journal. https://doi.org/10.1007/s10995-016-2011-3.
Issler, R. M. S., Marostica, P. J. C., & Giugliani, E. R. J. (2009). Infant sleep position: A randomized clinical trial of an educational intervention in the maternity ward in Porto Alegre, Brazil. Birth, 36(2), 115–121.
Kirkwood, B. R., & Sterne, J. A. C. (2003). Essential medical statistics. Oxford: Blackwell.
Krous, H. F., Beckwith, J. B., Byard, R. W., Rognum, T. O., Bajanowski, T., Corey, T., et al. (2004). Sudden infant death syndrome and unclassified sudden infant deaths: A definitional and diagnostic approach. Pediatrics, 114(1), 234–238.
Lauritsen, J. (2008). Ed. EpiData data entry, data management and basic statistical analysis system [Internet]. Odense: EpiData Association.
Macinko, J., & Harris, M. J. (2015). Brazil’s Family Health Strategy: Delivering community-based Primary care in a universal health system. New England Journal of Medicine, 372, 2177–2181. https://doi.org/10.1056/NEJMp1501140.
McKinney, C. M., Holt, V. L., Cunningham, M. L., Leroux, B. G., & Starr, J. R. (2008). Maternal and Infant Characteristics Associated with Prone and Lateral Infant Sleep Positioning in Washington State, 1996–2002. The Journal of Pediatrics, 153(2), 194–198.e3. https://doi.org/10.1016/j.jpeds.2008.02.005.
Pollack, H. A., & Frohna, J. G. (2002). Infant sleep placement after the back to sleep campaign. Pediatrics, 109(4), 608–614.
Salm Ward, T. C., & Balfour, G. M. (2016). Infant safe sleep interventions, 1990–2015: A review. Journal of Community Health, 41(1), 180–196. https://doi.org/10.1007/s10900-015-0060-y.
StataCorp. (2011). Stata statistical software: Release 11.2. College Station: Stata Corporation.
Takatsu, A., Shigeta, A., Sakai, K., & Abe, S. (2007). Risk factors, diagnosis and prevention of sudden unexpected infant death. Legal Medicine, 9(2), 76–82. https://doi.org/10.1016/j.legalmed.2006.11.015.
Thach, B. T. (2014). Deaths and near deaths of healthy newborn infants while bed sharing on maternity wards. Journal of Perinatology, 34(4), 275–279. https://doi.org/10.1038/jp.2013.184.
United Nations Children’s Fund, UNICEF (Ed.). (2014). Every child counts: Revealing disparities, advancing children’s rights. New York: UNICEF.
Victora, C. G., Aquino, E. M., do Carmo Leal, M., Monteiro, C. A., Barros, F. C., & Szwarcwald, C. L. (2011). Maternal and child health in Brazil: Progress and challenges. The Lancet, 377(9780), 1863–1876.
Victora, C. G., Huttly, S. R., Fuchs, S. C., & Olinto, M. T. A. (1997). The role of conceptual frameworks in epidemiological analysis: A hierarchical approach. International Journal of Epidemiology, 26(1), 224–227. https://doi.org/10.1093/ije/26.1.224.
Funding
Funding was provided by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior and Pastoral da Criança.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Cesar, J.A., Marmitt, L.P., Carpena, M.X. et al. Maternal Knowledge and Unsafe Baby Sleep Position: A Cross-Sectional Survey in Southern Brazil. Matern Child Health J 23, 183–190 (2019). https://doi.org/10.1007/s10995-018-2613-z
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10995-018-2613-z